Botox is the trade-name for onabotulinumtoxin A. It is one of the many brands of neurotoxins, all of which use purified protein from the bacterium Clostridium botulinum to cause muscle weakness or paralysis. The neurotoxins are injected into the desired muscle to cause either a weakening or a paralysis of the muscle activity. In the cosmetic industry, these products are used to reduce, soften or eliminate lines or wrinkles associated with muscle activity. Common areas injected include the forehead (horizontal lines), eyebrows (angry 11’s) and crow’s feet (radial wrinkles around the corner of the eyes). The effects of the neurotoxins are TEMPORARY and on average last approximately 3-4 months.
So what factors affect the longevity of the result?
1. Metabolism: clients with fast metabolism will process the toxin faster, potentially leading to shorter-lived effects.
2. Physical activity: clients who exercise regularly and are very expressive with their facial muscles/movements will process the toxin faster, reducing the treatment time.
3. Medical conditions: certain skeletal-muscular disorders may reduce the effectiveness and may even be a contraindication to receive treatment at all!
4. Age: more of an anecdotal observation, but younger clients may notice a longer-lasting effect due to healthier, thicker skin. Age shouldn’t impact your decision to proceed with treatment, as it is a safe treatment for clients 18 years of age and older.
5. Dosage: in general, the more product that is used, the longer the effects! However, with increased, often unnecessary dosage, risk of developing antibodies or migration of product into undesired muscles increases. Not to mention, the damage to your wallet! It is important to work with your provider to develop a unique treatment plan that is individualized so you receive exactly what you need! With increased doses, the product can actually migrate and affect nearby muscles causing UNDESIRED effects such as a lowering of the eyebrow, eyelid or asymmetric smile.
6. Injector: Yes! The actual injector’s technique matters! If the product is not delivered directly INTO the desired muscle, it will be less effective and you will notice activity of the muscle, and therefore associated wrinkles, faster!
7. Timing of injections: When clients come for their treatments on a regular basis, every 3-4 months, they notice the effects last longer! Eventually, through repeated, consistent treatments, the muscle gets the hint that you don’t want it to work as hard and it starts to atrophy or shrink. Clients will notice that the effects last longer and they are able to stretch out their treatment sessions to every 4-6 months, but this is only AFTER initial consistent treatment every 3-4 months.
8. Treatment area: Sometimes our goal is not to fully paralyze the muscle, but to WEAKEN it, such that it still functions but at a reduced capacity. If we were to inject these muscles at a full dose, it would cause a devastating functional impairment for the longevity of the treatment (3-4 months). For example, in a lip flip, neurotoxin is injected into the upper border of the lip, causing the lip to roll out leading to increased volume. If we were to place a full treatment dose in this area, it would significantly impact the function of the upper lip, reducing ability to seal lips around a glass (drooling), keep food in the mouth and purse lips – affecting ability to whistle, drink through a straw or kiss! Because a lower dose in these areas is required, the effects are not as long-lasting, so as to mitigate adverse functional impairments.
Is one brand better than the others? In all honesty, no. Each provider has their own preferred product based on the responses they have seen in their own clients, ease of obtaining the product and rewards packages offered by each company. Clients also may process each of the products differently, so they may come into the office specifically asking for a particular product based off of their own experiences. It is possible to develop antibodies, or a tolerance to a particular name-brand. This would result in ineffective or short-lasting treatments. The solution? Switch to a different brand!
So in short, the neurotoxins are a safe, effective treatment for cosmetic use. The duration of effect can be influenced by factors such as activity, metabolism, dose and injector. While one brand is not necessarily “better” than the other, it may be necessary to switch between brands if a tolerance or non-response develops against one particular brand.