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What you should know before procedure?

During consulting with a specialist, the anatomical area of the face is analyzed and the patient’s optimal correction plan and the expected effect are determined. Often, when planning correction of forehead and interbrowal wrinkles, preliminary upper blepharoplasty is possible. The clinical effect after the injection in the facial muscles begins to manifest within 48 hours, while the maximum effect occurs in the interval of 1-2 weeks, and the stable result persists for about 3 months. By the end of this period, in connection with the formation of new neuromuscular junctions and the weakening of the clinical effect, a second injection is recommended after 3-4 months.

Muscle activity usually recovers within 4-6 months. I must say that the duration of the effect also varies depending on the patient’s anatomical features, genetics, age, sex, and so on. It facilitates the injection of the use of ice and the application of anesthetics before correction, which provides the necessary degree of anesthesia. It should be borne in mind that the relatively strong facial muscles of the face, for example m.corrugator supercilii and m.procerus, may require more frequent injections compared to the weaker ones (for example, m.orbicularis oculi).

When examining a patient, it is important to distinguish between the static and dynamic components of a particular area of the face. For example, when forming a "fold of a puppet", a specialist should take into account that the change is due to the gravitational ptosis of the facial soft tissues, and not only to the function of the muscles. The dynamic component in the appearance of "marionette wrinkles" and the omission of the face oval is determined primarily by the activity of the muscles of the lower third of the face: triangular muscles (muscles - depressors), platisms (subcutaneous muscle of the neck) and the chin muscle, and tonus of antagonist muscles - levators of the middle third of the face.

The work of the muscles that affect the position of the contours of the mouth and lips should be evaluated with the patient’s active facial expressions, and face analysis in the full face and profile is necessary.

It is absolutely necessary to clarify the patient’s state of health at the moment, and also to agree on the intake of any medications. It is recommended to cancel the intake of vitamin E and anti-inflammatory drugs 2 weeks before the appointed day of correction.

Possible complications after botulinum therapy:
  • Moderate swelling, which usually appears after the procedure and lasts for several days.
  • Moderate soreness of short duration
  • Allergic reactions
  • Excessive correction (ptosis of eyebrows, upper eyelid, asymmetry of a smile), muscle weakness in the area of injections
  • Hematomas