Almost everyone these days knows what Botox is — but far fewer people understand what it does. It’s a common misconception that Botox is a cosmetic filler that plumps up skin and smooths wrinkles. In truth, Botox reduces the appearance of facial lines by stopping specific muscles from contracting.
Botox is the brand name of botulinum neurotoxin, an injection used to treat various medical and cosmetic conditions around the face and body. It can treat excessive sweating, muscle spasms around the eyes, and in a small percentage of people, help their migraines. However, Botox is most commonly used to reduce crow’s feet, vertical lines between the eyebrows, and forehead lines by relaxing the muscles that cause the facial wrinkles.
In order to understand how Botox works, you must first understand how our muscles usually function. Your brain sends a signal down a motor nerve to tell a muscle to contract. At the end of the nerve there are nerve terminals that contain numerous synaptic vesicles, which store a neurotransmitter called acetylcholine. Neurotransmitters take a “message” from one cell in the body and delivers it to another. Normally, a SNARE protein, inside the nerve terminal “escorts” the synaptic vesicle to the outer membrane of the terminal and helps it to release the stored acetylcholine. Since the nerve terminal is positioned just above the muscle fibers, acetylcholine can easily crosses the space, called a synaptic cleft, and trigger the muscle to contract. The acetylcholine binds to a specialized acetylcholine receptor on the muscle’s outer membrane, and through a lock and key type interaction, the muscle contracts.
After a Botox injection, the SNARE proteins in the nerve terminal are denatured and the synaptic vesicles have no escort. As a result, the corresponding muscle does not get the signal to contract and the fold in the skin does not occur. The nerve terminal will naturally start making new SNARE proteins, to replace the dysfunctional proteins, so after about three to four months, the Botox “wears off”.
Botox administered in a professional setting is very safe. Some patients experience mild side effects like swelling or redness, and very rarely, people can experience allergic reactions. Unfortunately, as with many medical treatments, Botox can be dangerous in the wrong hands. Anyone interested in trying the product should seek an experienced professional rather than attending a “home Botox party.”
Using an experienced practitioner for Botox administration is not only a safety issue — it will likely help people see better results. Not all wrinkles are the same! Botox can be very effective on some lines and relatively useless on others. A practitioner can analyze the areas you want to improve and make appropriate recommendations. Sometimes, they might recommend a filler instead.
Dr. Scott, at Eye Plastic Associates, has years of experience administering Botox in a clinical setting and helping patients achieve their desired improvement. If you have questions about Botox or cosmetic fillers, please call our office to schedule a personalized consultation.