Svetlana Rogal: “To stab or not to stab: top myths about injections into the forehead”

Almost every woman on our planet can boast of fine lines on her forehead and near her eyes. And, believe my experience, at least one in two of them is uncomfortable with them. We owe the appearance of these wrinkles to our active facial expressions. The way you are used to talking and showing your emotions determines the activity of the muscles on your face (and more often than not, it is hyperactivity), and this determines the appearance of wrinkles on the skin. To prevent the depth of the wrinkle from increasing, you need to relax the muscles (so to speak, fix the forehead). What can we do this with? This is our “formidable” (and my favorite) botulinum toxin, which is popularly nicknamed Botox. This drug has already been overgrown with myths, and now we’ll try to set the record straight.

MYTH № 1. All facial injections are Botox

This is the most common myth. So, let’s start with botulinum therapy. “Botox” is the first trade name of a drug based on botulinum toxin (botulinum toxin). But now there are many other botulinum toxin-based drugs with similar properties and effects. Botulinum therapy is used to restrain (reduce) muscle mobility and prevent the formation of wrinkles in these areas. Injections are made in the forehead, eyebrows, crow’s feet (near the corners of the eyes) and rabbit wrinkles (on the nose), and it is possible to inject into the neck — the platysma muscles and chin, but this depends on the patient’s need and the doctor’s skill.

Often, patients confuse this procedure with injections of fillers based on hyaluronic acid or calcium hydroxyapatite. These drugs are injectable implants — they replace the lack of missing tissue and fill it. Therefore, such injections are used to increase or reshape the lips, cheekbones, chin, or even the nose, as well as to fill the nasolacrimal groove.

MYTH № 2. Botulinum toxin is used by elderly people to restore youth

It is generally not advisable for people over 60 to start botulinum toxin therapy, because it will not give the desired result in its mono-variant form. In general, the whole world has long since switched to botulinum toxin as a prevention of the formation of deep wrinkles in old age. If your muscles are very mobile at a young age due to active facial expressions, this is a reason to visit a doctor. Because over the years, creases and deep intradermal wrinkles will form on the skin. It will be difficult to deal with this, and in this case, it will be necessary to use biorevitalization or even contouring. According to the law, a patient can make a decision from the age of 18. But in my practice, I have seen cases where girls as young as 20-25 years old had quite deep wrinkles that are comparable to those of 45-year-old women. So there is no “right” age — it’s up to the doctor and the patient to decide, based on the initial situation.

MYTH № 3. Botulinum toxin will turn my face into a plastic mask

This myth was true a decade ago, but much has changed since then. Now doctors work with modern injection techniques and minimal effective dosages of the drug — not to completely immobilize the muscles, but to relax them and achieve incomplete contraction. So no one will encroach on your facial expressions. In recent years, botulinum toxin therapy drugs have also improved.

MYTH № 4. Injections must be given frequently and the dose must be increased each time. After the injection, the forehead muscles atrophy, and injections will have to be done regularly

Nowadays, everyone has reached the minimum effective units of the drug, but the exact dose should still be calculated by a doctor depending on the mobility of the facial muscles. Protocols and recommended doses for different areas have been developed. In a standard situation, for the forehead and interbrow area, this is approximately 30 units in the case of Botox, Xeomin (50 to 100 units in one ampoule). For comparison, in neurology, twenty- or even fifty-fold higher dosages are used for people with cerebral palsy, torticollis, and myasthenia gravis. Another good news is that the dose is usually reduced over time. During the first procedure, a fairly large dose of botulinum toxin may be injected, but by the third or fourth procedure, it may decrease. Because during this time, the patient gets used to not contracting relaxed muscles.

The procedure itself lasts up to 15 minutes, the duration of the effect is individual. It depends on how quickly the body tissues regenerate, but in a standard situation, the effect of the drug lasts 4-6 months.

You will not get wrinkles without the constant injection of botulinum toxin — this is a fact. Without botulinum toxin therapy, the facial muscles will simply return to their normal rhythm of mobility. But the procedure has several unobvious but unambiguous bonuses. First, the forehead is a lifting zone. This means that after the injection, your forehead will tighten and your eyes will “open”. The drug also slightly blocks sebum production, and oily, porous skin begins to look much better. And due to the fact that the smooth surface of the forehead skin refracts the rays of light, a “glow” appears.

MYTH № 5. Botulinum toxin injections can be done by my beautician or even a friend

This is a categorical lie that can cost you a beautiful face. Remember: injections should only be done by a doctor (!), that is, a person with a medical degree. The doctor must have a perfect knowledge of anatomy and understand exactly what muscle he or she is injecting botulinum toxin into and what exactly he or she wants to block. If the doctor misses, punctures, or hits the wrong muscle, the eyebrows may fall over the eyes or, conversely, be too raised. And in the worst case, this can happen to only one eyebrow, and then you get a pronounced asymmetry. Of course, in a month, when the nerve endings begin to recover, everything will begin to return to its place, but during this time you will have to coexist with such a face. To protect yourself from this, ask if the doctor has a higher medical education and special training in injectable anatomy.

In conclusion, I would like to note that for all its advantages, botulinum toxin injections are not a panacea. In addition to hypermobility of muscles, it is necessary to work on the quality of the skin, to make it more elastic and moisturized. Procedures such as mesotherapy and biorevitalization help us with this — injections of the same hyaluronic acid that stimulates fibroblast cells, and they, in turn, produce their own hyaluronic acid and their own collagen.

In any case, you need to love your skin, take care of it, and protect it from stress. And then, after many, many years, it will thank you with a beautiful aesthetic appearance.