Botulinum toxin works by inhibiting signal transaction form nerves to muscles (or other end organs, like sweat glands). It has an ability to temporary paralyze these muscles, and this is used in cosmetic medicine, primarily to reduce wrinkling. It is commercially available as Botox or Dysport.

Wrinkles are part of the ageing process. They are caused by muscle contraction and are susceptible to the effects of gravity (sagging). Botox can paralyze the muscles causing wrinkles (such as frown lines, forehead lines and crows’ feet).


Botox is the commercial name for the Botulinum toxin, which is produced by Clostridium botulinum. Type A toxin is the most potent of the several toxins that this bacterium can produce. Botox acts by blocking acetylcholine, a chemical that is responsible for transmitting nerve signals. In the case of muscles, it results in paralysis. The paralysis caused by Botox is temporary, and full muscle function returns in 4 months.


Botox is injected directly into the muscles that cause the wrinkles, using a very small needle. You will have several injections depending on the area treated. Local anesthetic is not normally needed. You can return to your normal activities immediately.

F5: Areas - points of Botox injections for facial rejuvenation
Areas – points of Botox injections for facial rejuvenation

You will start seeing the result within 1-2 days from the injection, but the maximum effect can take up to 1 week to manifest. The effect will gradually fade within 3-4 months

Side effects

Botox injection is a relatively safe procedure. The most common reported side effects of Botox treatment are headaches, flu-like syndrome, pain and redness at the injection side, and nausea. Occasionally, there might be bruising on the injection side. Botox injection treatments should be avoided during pregnancy and lactation. It should not be given to people with neuromuscular disorders such as myasthenia gravis, those who are taking certain muscle relaxants and antibodies such as aminoglycosides.


Botox is effective in wrinkles caused by muscle contraction. It is not effective in wrinkles caused by gravity and sagging – you should consider surgical correction of those, via a facelift. Another limitation to Botox injections for TMJ treatments is that there is a possibility of developing antibodies that would render the TMJ treatments less and less effective over time.

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