Personal experience. Botox fillers for neck area correction

Botox injections into the neck are a rejuvenating cosmetic technique that successfully fights age-related skin changes and prevents the appearance of new ones. The skin on the neck and décolleté is much thinner than on other parts of the body, so it begins to age earlier, revealing a person’s true age. The Botox procedure in the neck is safe, painless and effective. The first results can be assessed within 3–4 days, and the maximum effect develops within 15–20 days. The skin at the injection sites is noticeably smoothed, rejuvenated, fresher and more attractive. Cosmetologists of the International Clinic of Hemostasis use only certified drugs, selecting the dosage and administration regimen taking into account the individual characteristics of the patient’s body. Such a responsible approach eliminates the risk of developing negative consequences and guarantees maximum effect.

Operating principle

The skin at the injection sites is smoothed, rejuvenated, and appears healthy and attractive. Cosmetologists use certified drugs and select dosages taking into account the body of each patient. The approach avoids side effects.

Botox is a drug made from botulinum toxin type A. The injection blocks existing neuromuscular impulses and immobilizes muscles. The main goal is the rapid smoothing out of wrinkles formed as a result of increased activity. In case of prolonged paralysis, the creases disappear. By the time the effect of the drug ends, the active substances are eliminated naturally, the muscles are fixed in a static position, preventing the appearance of new defects.

Botox quickly removes unsightly bands on the neck

The photo below is a clear example of neck skin rejuvenation. You can see the difference within a week after the procedure!

Botox can really work a real miracle! Just one 10-minute procedure gives a truly magical result! True, it will be possible to see it only after 5-7 days, when the drug begins to act fully. By relaxing the subcutaneous platysma muscle, botulinum toxin removes cords on the neck.

“How fast and inexpensive! We can limit ourselves to this!” think many patients who have had a Botox injection. The effect is really very noticeable, but Botox alone is still not enough! Having removed the cords on the neck, you need to take care of restoring the elasticity and density of the skin and removing ptosis, unless, of course, characteristic “sagging” has already appeared on the neck.

Advantages and disadvantages

Advantages of a drug based on botulinum toxin type A:

• safety. The presence of a harmful toxin in minimal doses, the absence of negative effects on the patient’s body. Intoxication is excluded;
• quick effect. The first results are noticeable on the 3rd day after the injection. Effect within 10 months;
• botulinum toxin is eliminated from the body naturally. A second injection is needed 3-4 months after the initial procedure;
• no side effects. Injections are given by experienced cosmetologists with higher medical education and completion of specialized courses. The risks of applying herbs are minimal.

Negative sides:

• it is necessary to duplicate the procedure after some time. Goals: consolidation of results, support of rejuvenation;
• risks of developing pathologies with incorrectly chosen dosage.

The procedure is carried out by international specialists. Risks of contacting illiterate cosmetologists.

Botox in platysma

Advantages and disadvantages

The advantages of botulinum therapy compared to other anti-aging procedures are undeniable:

• Safety. Despite the fact that Botox is a powerful toxin, in microdoses it does not harm health in any way. To cause intoxication of the body, you will need to administer a dose that is many times higher than normal.
• High performance. The first results can be assessed immediately upon completion of the procedure. Within a week, the effect will strengthen and last for about 6 – 10 months.
• Natural removal of botulinum toxin from the body. After the expiration date, the drug leaves the body on its own, so it will need to be re-administered.
• Almost complete absence of side effects. The procedure performed by an experienced specialist reduces the risk of complications to zero. Negative consequences can develop if the rules of rehabilitation are violated, so the patient must be responsible for their compliance.

Botulinum therapy with Botox 1 unit. 300 rub. Consultation with a cosmetologist, subject to the provision of the service on the day of consultation 0 rub.

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The disadvantages include the following:

• To maintain the rejuvenating effect, regular repetition of the procedure is required.
• There is a risk of developing specific and nonspecific complications.
• The procedure must be carried out by a high-level specialist with the appropriate skills and work experience.
• The technique has a number of contraindications, ignoring which can lead to unpredictable consequences.

Indications and contraindications

The procedure is indicated for patients aged 30+. Reason: formation of primary signs of age-related changes. An injection using the active component of botulinum toxin is indicated for:

• pronounced flabbiness;
• rapid formation of looseness;
• partial or complete loss of elasticity;
• rapid decrease in tone;
• the formation of deep circular folds;
• vertical and horizontal wrinkles;
• formation of a double chin;
• rapid development of gravitational ptosis;
• blurry oval face.

Botulinum therapy has contraindications. The decision to administer an injection is accompanied by a consultation with a treating specialist and comprehensive laboratory tests. Goals: to eliminate side effects and negative effects on the patient’s body.

Contraindications:

• benign or malignant tumor, other oncological diseases;
• diseases of the circulatory system;
• pronounced inflammatory processes;
• damage to the injection sites of active substances;
• development of myasthenia gravis;
• inflammatory processes of chronic diseases;
• hormonal imbalances;
• problems with the endocrine system;
• mental disorder;
• problems with heart muscle contraction;
• acute liver and kidney failure – stage of the inflammatory process;
• intolerance of the body to individual components of the drug;
• increased tendency to form keloid scars.

Additionally: the use of local and general antibiotics, antispasmodics, steroid drugs.

How does skin age?

Rejuvenation of the neck area is an important part of maintaining the beauty of every woman.
We all want to look young, we all take care of the condition of our face. However, if we ignore the condition of the neck skin, we can end up with a strange, unnatural effect of a youthful face on a flabby, senile neck. Many women know that the skin on the neck ages much faster than on the face. The reason is a small number of sebaceous glands and too thin skin. Should we despair? Of course not! Modern cosmetology offers us real opportunities for skin restoration and it would be stupid not to take advantage of it!

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How is the procedure done?

Stages of implementation:

1. Initial removal of existing makeup.
2. Effective skin cleansing using special products.
3. Using anesthesia – relieves severe pain during the injection.
4. Marking sites for future injections. The distance between the inputs is no more than 2 centimeters.
5. Systematic introduction of the active component into the subcutaneous tissue.
6. Applying a cooling, soothing cosmetic product.

The duration of the procedure is 15 minutes. The anesthesia works instantly. There is no side effect. Minimum rehabilitation period.

ELOS – course restoration of skin structure

ELOS is a hardware procedure without damaging the epidermis. This is a synergy (combination) of two energies - light and RF energy, due to which collagen production is stimulated, the skin becomes smoother and more elastic. In addition to rejuvenation, ELOS therapy eliminates age spots and vascular spots and returns the skin to an even and healthy color. ELOS therapy does not require rehabilitation, does not exclude you from social life and does not depend on the season. However, to achieve results, it is necessary to undergo not just one, but a course of procedures (3-6 procedures once a month).

Rehabilitation period

Rehabilitation period after administration of the active substance botulinum toxin:

• prohibition for patients to take a horizontal position in the first 4 hours after administration of the drug - the injection site does not matter. Ensures uniform distribution of the product under the skin;
• more limited use of decorative cosmetics – 6 days;
• Limit intake of fatty, fried, salty, spicy foods for 14 days. Consolidation of the Botox effect;
• Consumption of strong alcoholic drinks, carbonated water (sweet, mineral) is prohibited – 14 days
• limited consumption of strong tea, coffee – 7 days;
• minimum physical activity – 14 days;
• ban on visiting gyms – 10-14 days;
• exclude visiting the bathhouse, solarium, sauna;
• minimum stay outdoors under direct sunlight – 3 days;
• exclude massage and peeling until toxins are completely removed from the patient’s body.

Exceptions: testimony of cosmetologists based on examination results.

Botox injections into the neck are a rejuvenation technique used by cosmetologists to eliminate age-related changes in the skin, remove wrinkles and folds. The skin in the décolleté area is thin compared to other areas of the body. Therefore, the previous age clearly indicates the real age of a person.

The correct choice of botulinum toxin drug for work in a specific area is a very important question. What does a doctor focus on when it comes to correcting aesthetic problems in the neck area?

The neck area is a very complex area of ​​the body in terms of cosmetics. Thin skin and a small subcutaneous fat layer all contribute to its rapid dehydration. A small network of small vessels and slow blood microcirculation, low activity of the muscles of the anterior surface of the neck, all this forms a decrease in muscle tone and tissue atrophy, early skin ptosis appears and longitudinal and transverse wrinkles, cords and ring-shaped folds along the neck are formed, all these visible problems over time are only increasing. To carry out therapy in the neck area, a step-by-step correction is necessary. These can be injection methods (biorevitalization, contour plastic surgery, etc.) or hardware ones. But it is important to remember that botulinum therapy is carried out, as a rule, at the first stage of correction, which will undoubtedly give a good result.

Pharmacological aspects

Botulinum toxin A belongs to the group of muscle relaxants. The active substance is Clostridium botulimim toxin type A, which blocks the release of acetylcholine at the neuromuscular junction, which leads to the relief of muscle spasm in the area of ​​its administration. In first-generation drugs, the botulinum toxin molecule consists of a neurotoxin (active substance) and a protein complex, including non-toxin, non-hemagglutinin proteins and hemagglutinins. Under physiological conditions, such a complex disintegrates to release pure neurotoxin.

When administered locally in therapeutic doses, the active substance does not penetrate the blood-brain barrier (BBB) ​​and does not cause significant systemic effects. Antibodies to botulinum toxin type A are formed in 1–5% of patients after repeated injections. This is facilitated by the administration of the drug in high doses (for example, more than 250 units of Botox) and injections in small doses at short intervals.

Purified botulinum toxin is of increased interest, since its use reduces the risk of the formation of neutralizing antibodies in tissues. The fact is that the indications for the use of BTA in cosmetology have long been not limited to wrinkles between the eyebrows and the upper third of the face, where relatively small dosages are used with an interval of 5–6 months (in these cases, the risk of resistance is minimal, since the introduction of complexing proteins is insignificant). Today, botulinum toxin preparations are used in the lower third, and in the periorbital region, and in the neck area, and for the treatment of rosacea, seborrhea, etc., which requires more frequent use of toxins (that is, booster injections), and in significant dosages. For this purpose, it is preferable to opt for purified preparations that do not contain complexing proteins.

Characteristics of botulinum toxin preparations

Diffusion of drugs

From a physical point of view, the distribution, or diffusion, of botulinum toxin depends on the drug itself and the state of the tissue into which it is injected. In the case of tissue sparseness, which occurs during involutional changes, diffusion increases, so in elderly patients there is a high risk of side effects in the form of unwanted entry of botulinum toxin into neighboring muscles.

As for the drug, two factors should be taken into account: its viscosity and the size of the molecule.

It makes sense to compare the size of molecules only for identical drugs, that is, those containing a neurotoxin and complexing proteins (for example, Botox and Dysport). “Xeomin” is completely purified and begins to work in tissues immediately, so its diffusion takes place differently. As for the viscosity of the drugs, according to the data presented, having the maximum amount of albumin in the form of an excipient (a component that performs a supporting function and regulates the process of penetration of active substances into the skin), Xeomin exhibits minimal diffusion.

Since all drugs are lyophilisates, to carry out the procedure it is necessary to restore botulinum toxin with 0.9% sodium chloride solution. The volume of sterile saline solution is added according to the manufacturer's instructions and depending on the indications. As a rule, studying experience, taking into account the instructions for the drugs, the recommendations of various consensuses (and they have not yet come to a common denominator), the following standard dilutions are used.

Dilution of drugs in standard regimens.

Features of neck area correction

The texture of the skin of the neck cannot be restored without botulinum therapy, since hypertonicity of the subcutaneous muscle of the neck (m. platisma) not only leads to the early manifestation of involutional changes, but also causes ptosis of the soft tissues of the lower third of the face and the formation of “jowls”.

M. platisma is a fairly thin muscular plate that is located under the skin of the neck, merging tightly with it. Its muscle bundles begin in the chest area at the level of the 2nd rib and are directed upward and medially. At the edge of the lower jaw, the medial bundles of one side of the muscle intertwine with the bundles of its opposite side and are attached to the edge of the lower jaw, and either their excessive intersection or its absence can be observed (Fig. 1). According to the literature, the usual variant, or type I, occurs in 75% of people, type II with excessive intersection - in 15%, and type III with no intersection - in 10% of the population. The best results of botulinum therapy are observed in patients with type I intersection. Laterally the bundles of m. platisma pass to the face, where they are woven into the fascia of the parotid gland, reaching the corner of the mouth.

Figure 1. Anatomical variants of the mandibular symphysis platysma.

The subcutaneous muscle of the neck protects the saphenous veins from compression. M. platisma works as a depressant and supports the soft tissues of the neck. Although strictly speaking it cannot be considered a muscle of the head, it plays an important role in the formation of facial expression. When contracted, it pulls the skin of the neck and lower jaw downward. Platysma also helps the movement of the upper lip. In addition, it forms a powerful symplast with DAO (m. depressor anguli oris - muscle that depresses the angle of the oris), enhancing the effect of this depressor.

When carrying out botulinum therapy in the neck area, due to the strong symplast of the platysma with nearby muscles, it is preferable to work with drugs with low diffusion. In addition, the choice of drug is determined by the presence of complexing proteins in it. Since the total dosage of botulinum toxin administered is relatively large (for example, Xeomina - 50-60 units), the load with foreign protein should be minimal. The instructions for use of the drug must indicate these indications.

Hypertonicity m. platisma is determined when pronouncing the sound “s”. Injections are carried out superficially subcutaneously, the distance between injections is 2–3 cm.

In addition, with pronounced hypertonicity of the muscles in the lower jaw area, so-called “jowls” are formed and the procedure is performed by placing two to four subcutaneous injections. It should be noted that, as a rule, not all strands of the subcutaneous muscle of the neck are in a state of hypertonicity, so only those for which this condition is determined should be corrected.

Botulinum toxin injections in the neck area are often performed as part of complex correction of facial contours. For example, for the “Oval of Nefertiti” procedure (photo 1), it is desirable to remove the hypertonicity of the DAO and mentalis muscle (m. mentalis), since their symplast in the lower jaw area is strongly pronounced and constitutes a whole complex of depressor muscles that are in hypertonicity: m. depressor anguli oris, m. mentalis and m. platisma.

Photo 1. Diagram of the location of injection points into the subcutaneous muscle of the neck when correcting the oval of the face (the “Nefertiti Oval” procedure).

Patient, 58 years old: a – before, b – after correction of the platysma bands of the BTA.

Patient, 44 years old: a – before, b – after correction of the platysma bands of the BTA.

Conclusion

It is necessary to understand that there are no bad or good drugs. There is a structure and physical and chemical components of the product that determine its priority use in various clinical cases. So, there are very important circumstances when correcting the neck with botulinum toxin, which the doctor should take into account:

1. Use of relatively large doses, which requires minimizing the load of foreign protein.

2. Repeat procedures at short intervals.

Boosting (small doses of botulinum toxin administered at short intervals) can lead to the development of insensitivity to botulinum toxin. If a doctor uses botulinum toxin in his work only to correct wrinkles between the eyebrows and the upper third of the face once every 5-6 months, then the issue of protein load is irrelevant, and the choice of drug is as wide as possible. But if this is correction of the lower third of the face and neck, then second generation botulinum toxin becomes the drug of choice.

3. Features of facial muscles. The facial muscles are very small in size and volume and often form a symplast with antagonist muscles, so the choice of the drug is based on the viscosity of the solution and the ease of working with it.

Zhanna Yusova, Ph.D., leading researcher of the NPO of physiotherapy, cosmetology and rehabilitation of the Federal State Budgetary Institution NKTsO FMBA of Russia, Associate Professor of the Department of Aesthetic Medicine of the Faculty of Pedagogical Training of the People's Friendship University of Russia, dermatovenerologist, cosmetologist, physiotherapist, member of the European Academy of Dermatovenereologists, Moscow

Platysmaplasty in Moscow: the effect of the procedure

At the BL clinic, injection techniques are used for neck and chin lifting:

• fillers based on hyaluronic acid, which restore lost volume and make the skin firmer and more elastic;
• botulinum therapy, which smooths out facial wrinkles;
• Belgian drug Profhilo, which has a complex lifting effect.

The latter contains high-molecular and low-molecular concentrated hyaluronic acid. A drug:

• has a pronounced lifting effect;
• improves local blood circulation;
• provides a reinforcement effect;
• moisturizes the skin, gives a natural glow;
• removes age spots;
• stimulates the production of its own hyaluronic acid, collagen and elastin.

After an injection neck lift, the contour of the chin becomes clear, folds and wrinkles are smoothed out. The skin is rejuvenated, jowls disappear. The effect lasts up to 8 months. The procedure is repeated as prescribed by the doctor.

How does mesobotox for the face work if it is injected into the skin?

Initially, botulinum toxin was developed to affect muscles - to smooth out wrinkles from excess emotions and stress. After administration of the drug, the muscles relax and stop gathering the skin into folds. Wrinkles on the forehead, nose, between the eyebrows and crow's feet around the eyes are smoothed out.

But everyone knows that there is no muscle layer in the dermis - why do you need to inject Botox there?

The dermis is the second layer of skin, which is located between the epidermis and subcutaneous fat.

Absolutely right, there is no skeletal muscle in the dermis. But it turns out that the dermis is also rich in muscles - the so-called skin muscles.

The muscle fibers in the dermis are very small. But they also contract and relax - they cause the effect of goose bumps in the cold, are responsible for the liveliness of facial expressions and, alas, for the formation of a fine network of wrinkles.

Due to their small size, these fibers respond well to injections of low doses of botulinum toxin - mesobotox.

Tatyana Tereshina gives Botox injections using a special micro-injection technique for Andrey Iskornev’s drug.

Platysma lift with Botox

Botox injections relax the platysma - the muscles of the neck. Injections are made directly into the platysma cords, which become less pronounced after the procedure. As a result, the skin tightens, the oval of the face improves, and wrinkles from the corners of the lips to the chin disappear. The effect usually lasts 4-6 months. The best results are obtained with Botox injections in combination with flexible fillers. Botulinum therapy for correction of the neck and chin area is recommended for patients 35-40 years old, in whom the platysma cords are very noticeable during a conversation.