Botox is a toxin produced by a gram-positive bacterium called Clostridium botulinum that paralyzes muscles by acting on the neuromuscular junction in the area where it is injected. Medically, it is used in some neurological disorders, as well as in underarm sweating that does not respond to topical treatments. Cosmetically, it is used to treat lines that have been exposed to the long-term effects of facial muscles and have lost some elasticity. It yields successful results, especially when used in the glabellar region (bridge of the nose-forehead junction), crow’s feet around the eyes, forehead lines, neck, chin, and around the mouth, when used with appropriate indications. In addition, it can be applied to the muscles that pull the eyebrow downwards to provide a slight eyebrow lift. Before Botox application, a detailed facial analysis is necessary to determine if you are a suitable candidate or if additional procedures are needed. In some patients, it may be necessary to apply fillers in addition to Botox to treat deep lines that are present even at rest without active facial movement. If a filler injection is necessary, it’s advisable to postpone it for a week after the Botox treatment. Contrary to popular belief, Botox is not a method to eliminate wrinkles that we would get rid of as we age. On the contrary, as skin elasticity decreases significantly after a certain age, the procedure loses its effectiveness. It is not recommended for those over 65. We observe that it is much more effective when applied to prevent wrinkles from forming, especially in young patients in their 30s with hyperactive facial expressions.

Botox is perceived as a simple procedure, and unfortunately, it is applied by many physicians and even non-physicians who do not have the necessary expertise. The results seen after inappropriate applications have changed many people’s approach to Botox. Contrary to popular belief, when Botox is applied in appropriate areas and in appropriate dosages after a good facial analysis, it does not create a mask face, expressionless face, unsmiling face, face without facial expressions, or a “Botoxed face.” An injection applied with the correct technique does not affect conscious facial movements; however, it should affect unconscious facial movements such as frowning.

Botox injections are a procedure performed in an outpatient setting and do not require any anesthesia. Applying local anesthetic creams and ice before the procedure reduces the burning sensation. The patient can resume daily activities after the procedure; however, minor redness, more pronounced in some sensitive skin types but lasting no more than a day, may occur. The effect begins within 24 hours and reaches its maximum in the first week. Its effectiveness is most noticeable for 3-4 months, and it completely loses its effectiveness after 6-7 months. Therefore, re-application after 6 months is recommended.

Another use of Botox in plastic surgery is for excessive underarm sweating. Based on the principle of preventing excessive sympathetic stimulation of sweat glands, this application provides effective dryness for 6 months and is also a preferred method compared to other invasive procedures, as it is simple, poses no major risks, is performed in an outpatient setting, and is inexpensive.