Dr Lisa Chan on 5 Botulinum Toxin Uses You Might Not Know

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Dr Lisa Chan on 5 Botulinum Toxin Uses You Might Not Know


Dr Lisa Chan explains five uses of botulinum toxin you may not know, which can help in achieving that certain smile — and more.

Reality TV star Kim Kardashian swears by them and country and western legend Dolly Parton sings their praises, joking they’re the reason she always looks happy. But what are botulinum toxin injections, how do they work and how safe are they?

Botulinum toxin injection procedures first caught the public imagination nearly 20 years ago as an extravagant and slightly bizarre cosmetic indulgence for celebrities and the super-wealthy. Today, they’re booming in popularity worldwide.

More than 4.4 million botulinum toxin procedures were carried out in the US in 2020, according to the American Society of Plastic Surgeons.

Closer to home, the market for botulinum toxin in China is booming and nearly tripled in value from 1.75 billion yuan in 2015 to 4.86 billion yuan in 2019, according to data analyst Statistica.

The reasons for the phenomenon are plain to see. Injecting botulinum toxin makes the skin look smoother with fewer wrinkles, with effects lasting for three to six months. Nevertheless, it does involve injecting toxin into your body, so patients understandably ask, “Is it safe?”

I’d answer that question with the words of the Renaissance physician and philosopher Paracelsus, five centuries ago: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.”

Botulinum toxin injections have a generally safe record but, as with any medical procedure, there’s an element of risk. They can result in unintended paralysis of certain facial muscles, causing partial facial weakness or eyelid drooping – temporary symptoms that go away as the effects of botulinum toxin wear off.

They may also cause flu-like symptoms, such as headaches after the injections, and bruising or pain in the areas where the botulinum toxin is injected. The chances of botulism-like signs and symptoms that include breathing difficulties, trouble with swallowing and slurred speech due to systemic spreading of the toxin are extremely low in a careful setting where the correct dosage is applied to the right areas.

A recurring niggle is the somewhat frozen expression the injections sometimes produced by inhibiting facial muscles. Pretty Woman star Julia Roberts recalled how she tried botulinum toxin and ended up looking “permanently surprised for a couple of months”.

Anyone considering botulinum toxin injections should observe three carinal rules: Only ever go to a registered doctor; make sure the brand the clinic uses has been approved by medical authorities; and always share your medical history and details of any allergies with your doctor first.

The mention of botulinum toxin makes most people think of a procedure that smooths out wrinkles, makes crows’ feet around the eyes magically disappear, and creates the kind of age-defying looks.

What’s not so well known is that the injections have a surprisingly wide range of applications. Botulinum toxin injections are also used for treating:

  • Gummy smiles: Smiles that reveal too much gum are caused by overactive muscles retracting our upper lips. Botulinum toxin injections can reduce the movement of upper lip muscles, displaying less gum when we grin.
  • Heavy sweating: Botulinum toxin can treat sweaty palms and underarms by blocking the nerve impulses to sweat glands in our skin, greatly reducing the amount of perspiration we produce.
  • Shoulder lines: Poor posture leading to overdevelopment of the trapezius muscles and hence rounded shoulders is common in women executives who spend too long hunched over desks and using mobile phones. Botulinum toxin injections can restore a leaner and more elegant shoulder line, as well as easing pain from stiff, aching shoulders.
  • Skin-pore size: Multiple small injections of diluted botulinum toxin to the face block the nerve impulses to sweat glands on the skin, reducing oil production and facial sweat. This in turn reduces pore size, and brightens the skin, and is a particularly popular treatment in South Korea.
  • Chunky calves: If a woman’s calves are too muscular, botulinum toxin can be injected to reduce their size by restricting muscle activity, making legs appear slimmer and longer over a period of time.

NOTE: Some treatments mentioned above are off-label, meaning they’re not FDA approved but are neither illegal nor unethical. In all cases, doctors must make a judgement in the best interests of the patient, and have a responsibility to inform their patients fully about the product and counsel them about the benefits and risks of any treatment.





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