Botox in Tunisia

Botulinum toxin or Botox is a substance that reduces muscle contraction acting at the neuromuscular junction (muscle relaxant action).

Since 1975, doctors use Botox to correct strabismus in children, facial tics and uncontrollable blinking of the eye.

In practice, the most classic indications of botulinum toxin in the field of aesthetic concerns inter-brow wrinkles, forehead wrinkles and wrinkles of the crow's feet.

Botulinum toxin - Botox

Forehead wrinkles

Botox for forehead wrinkles

Frown Lines

Botox for frown wrinkles

Crow's feet wrinkles

Botox for crow's feet wrinkles

The principle of botulinum toxin is the use of muscle relaxing properties of the product.

The most common purpose is to reduce the action of muscles located in the forehead and eyebrows, to mitigate both the horizontal wrinkles that vertical wrinkles caused by the contraction of these muscles.

Such use can smooth skin reliefs and thus obtain a rejuvenating effect by releasing muscle’s tension.

From a more global point of view, be aware that the position of the eyebrows is ensured by a balance between two opposing forces, consisting of step-down muscles (located near the eyebrows),

and levator (the frontal muscle).

The horizontal lines are due to the contraction of the muscle that is front reliever. Inter-brow vertical wrinkles are caused by contraction of the depressor muscles.

The areas suitable for this treatment are:

• Forehead: forehead lines are ideal for this treatment.
• Frown lines between the eyebrows.
• Crow’s feet around the eyes that are caused by the action of underlying facial muscles.

After treatment the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract normally.

What are the goals of treatment with Botox Injection?

Like dermal fillers, the main goal of this treatment is to reduce fine lines and wrinkles to rest and not to prevent muscle contraction: we therefore deem the result primarily on the appearance of wrinkles at rest.

As for the balance between the depressor muscles and elevators, by reducing the action of a muscle group, botulinum toxin reduces wrinkles due to these muscles but frees the action of antagonistic muscles: the goal is to treat muscular balance and thus achieve a harmonized face.

Treatment with botulinum toxin must be designed and managed in time: so it should be treated gradually and avoid the risk of "doing too much" during the first injections.

It is better to do a first moderately effective session then to do a very effective one: it is therefore not desirable to want the best results with the first dose.

In some cases it may be necessary to perform several injection sessions before adapting all of the possibilities of the product to each patient (e).

Preparation for the Botox Injection procedure

No special preparation is required.

The day of injection, you do not need to be fasting. For women, they should come without makeup or to remove it before the injections.

It is very important to minimize the risk of bleeding in treated areas and avoid taking aspirin for 15 days before injection and 15 days after.

What are the cons-indications of botox?

Please observe the following cons-indications:

• Some neuromuscular diseases such as myasthenia gravis.
• Pregnancy and lactation: being pregnant, even a few days, are imperative to postpone the date of the injections after pregnancy and stopping the possible feeding. It is therefore necessary in case of doubt to perform the necessary tests and report the results to your doctor.

Botulinum toxin is ill-indicated in patients with known hypersensitivity to botulinum neurotoxin A or to serum albumin and treatment with aminoglycosides (including family of antibiotics are among the Amiklin and Gentalline).

It should also meet a number of precautions:

• If you are treated otherwise by injections of botulinum toxin for pathological spasms, if you have had an episode of paralysis of the muscles of the face, if you have a neuromuscular disease or clotting disorders You need to share the practitioner who supports you for these injections of Botulinum Toxin. Your doctor then will judge the advisability of injections on your person and how to proceed if necessary.
• If by injections, you take anticoagulants like drugs or aspirin or antibiotics or if you have any health problem (including infection, flu, abscessed tooth ...) you must report this to your doctor before injection.
• In general, you should not hesitate to tell your doctor, any health problem encountered. In the same order of idea, you must tell him all your questions and tell them about any treatments you could be or still doing.

Is anesthesia required for botox injection?

No, no anesthesia is needed.

Botox injection procedure

The treatment will be made to the practitioner's office or cosmetic surgery clinic in Tunisia, at the choice of your doctor's practices.

This treatment consists in a series of injections on the face. The needle is fine, and injections are usually very painful.

The treatment duration is of the order of a few minutes.

After the Botox Injection procedure

During the two hours after the injections, it is recommended that you do not make intensive sport and to not lie down.

You should also avoid handling your face or massaging it using pressure for 24 hours after the session.

It is very important to minimize the risk of bruising or bleeding of the treated areas during the fifteen days prior and following the injections (to limit the risk of product leakage to peripheral muscles which could leads to unwanted effects).

Furthermore, during the three days of injections, it is desirable to strongly contract the injected muscles three times daily for about 5 seconds per muscle.

Usually, the consequences of these injections are simple. Some brands remain somewhat inflated 20 to 30 minutes then disappear.

The patient(s) can resume their normal activities after the injections.

Some rare side effects may occur. They are transient. It may be:

• Redness: localized redness at injection sites has sometimes been reported and rarely persists beyond 3 to 6 days.
• Ecchymoses ("blue"): blue are in fact rarely observed in the areas of injection and can last several days.
• Edema: swelling, most commonly around the eyes, can be installed gradually in 4-5 days, then decrease within days to weeks.
• Disturbed sensation: a feeling of tension or fixity of the forehead, mouth or neck, according to the injected areas, and a change in sensitivity often linked to a cardboard sensation may persist for several days.
• Fleeting Eye or facial pain: such pain has been described in the injected areas are quite exceptional.

Nevertheless, in the aftermath of these injections, do not hesitate to contact your physician if you have any concerns.

Botox Injection risks and possible complications

Complications are rare. Possible complications known to date are:

Locoregional complications:

• Headaches: they can be present at the waning of first injections and disappear after a few hours to days.
• Eyebrow ptosis: the injection of the front may cause a slight lowering of the eyebrows. This descent is generally due to the fact that the eyebrows were already in the lowered position prior to injection. This slight lowering of the eyebrows usually regresses within weeks.
• Eyelid ptosis: the injection of frown lines can cause a partial collapse of the upper eyelid which may last 4-8 weeks. Which is rare (less than 1% of cases), and always disappears after a few weeks.
• Discomfort or smile and swallowing: injection into the lips can cause discomfort to smile or small abnormal movements. The injection in the neck can cause difficulty in swallowing.
• Dry eye: by decreasing lacrimal secretion may cause keratitis, especially in carriers of contact lens patients (it is appropriate in this case to ensure moisturize the cornea).

Paradoxical contraction of a muscle disorder and mimicry: in the days following the injection, the treated muscles may present some paradoxical movements (spontaneous contractions) without gravity.

General complications:

They are quite exceptional:

• Allergic reaction: rash, hives, general allergic reaction.
• Nausea, dizziness
• Fatigue, fever, flu syndrome
• Dry mouth or skin.

To these are added the known risks unpredictability of life and aspects and finally, the exceptional risks, or even unknown risks inherent in any medical procedure.

In all, one should not overstate the risks, but just be aware that any injection on the face still has a small share of hazards.

How long does the effect of Botox last?

The result is a reduction of wrinkles with a conservation of small movements is obtained between three and fifteen days after the injections.

• Effects: the results are visible after a few days but for about 15 days, the effects on the face can be variable (see asymmetric at times) before eventually stabilize.
• The result after the first session lasts about 3-6 months beyond which, the injection can be renewed.
• The purpose of these injections is to make an improvement and not to achieve perfection. If your wishes are realistic, the result should give you great satisfaction.
• Frequency of injections: injections should be practiced several times with intervals of 3 to 6 months to obtain a certain stability of the result. From the second injection, the results may last longer (6-8 months). It is then necessary to repeat the injections every 3 to 6 months.

However, it is recommended never do more than three months apart between the injections’ sessions to avoid creating such resistance produced by a "vaccine effect". The appearance of the result can be stabilized beyond 3 injections but in some cases, it is appropriate to use at least 8 to 10 injections to get some stabilization in the result.

Conversely, it should be noted that if we stop the injections, the treated muscle regains its function prior to injections.

What are the imperfections? Localized imperfections:

In some cases, localized imperfections (persistence of fine lines) can be observed without that they are real complications. They depend on the surface appearance of the skin that can present even before the injections, a indelible "break" due to the age of the wrinkle.

There may also be insufficient and even asymmetrical results: they are due to the fact that we have more or less powerful muscles especially often asymmetrical.

These imperfections are usually treated by an additional injection of Botulinum Toxin, month after injection.

It should be noted that if a localized additional injection to make the result better may sometimes be desirable after an injection, it will need to be conducted before the 15th day since the muscle balance (balance between muscle groups) take about 15 days to settle.

Residual asymmetry:

Asymmetry of the two sides of the face, as well as more pronounced wrinkles on one side than the other, usually exists prior to injection.

Finally the muscle responsible for the wrinkle can be stronger on one side than the other. This is usually scanned before the injection. In such a case, the injections will be used in the appropriate technique, slightly different from one side then to the other. Despite this precaution, a residual asymmetry may persist and is likely to eventually benefit from additional injection.

The acts referred to aesthetic aim, to make you happy and satisfy you in realistic proportions. Sometimes, however, the desired effect will not be met and that these acts are increasing in contrast to pre-existing psychological disorders. The post-injection you experience, can be extremely different from one patient to the other, even with a similar aesthetic result.

In the case of Toxin Botulique, rejuvenation is obtained in exchange for a reduction or disappearance of certain facial expressions. This aspect will be evaluated with you to avoid the risk of disappointment especially if you are an actor, presenter, etc...

Treatment with Botox can visibly smooth and soften moderate to severe frown lines between your brows. A few tiny injections and within days there's a noticeable improvement in your expression wrinkles. Botox can help you turn back time, and give you a more youthful appearance.

The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.

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