Treatment of blepharospasm with botulinum toxin: lift my eyelids

Age-related changes in facial skin

With age, facial skin begins to age and fade - it loses moisture, elasticity and turgor. The first changes can be observed as early as 25 years of age. First, dynamic wrinkles appear, which are also called facial wrinkles, because they form on facially active areas of the face (forehead, between the eyebrows, the area around the eyes). Over the years, they turn into deep, static creases and folds. In people with active facial expressions, the first wrinkles may appear even before the age of 25.

The mechanism of wrinkle formation lies in structural changes in the skin and muscular transformations. The skin loses strength and elasticity due to a reduction in the main components of youth: collagen, elastin, some fats, water. And the muscles spasm from overexertion, that is, they literally become shorter. And here is the result: the skin folded into an accordion.

Often, facial wrinkles appear earlier than others on the face near the outer corners of the eyes (“crow’s feet”) and on the lower eyelid. The skin in this area is delicate and quickly becomes covered with grooves and folds. To do this, simply smile and squint often.

It is believed that in 25% of cases the skin ages naturally, and in 75% the process is accelerated due to external factors: poor climate, poor diet, cosmetics, stress.

As a rule, by the age of 30, women are already looking for ways to get rid of wrinkles - the cult of youth, fashion and modern trends make us ashamed of our age and age-related changes. Because of this, in recent years even 20-year-old girls have been thinking about Botox. And this is just a disaster! And cosmetologists are unlikely to dissuade them and tell them the whole truth about this unnecessary and destructive procedure. And formally, contraindications to Botox injections exist only for persons under 18 years of age.

Why is Botox done under the eyes?

Almost every woman, regardless of age, wants to remain beautiful and well-groomed. When she sees the first wrinkles in the mirror, she begins to panic, goes through options for rejuvenation and, in general, is ready to give everything she can just to somehow reverse the aging process.

And then cosmetologists appear with their “magic” procedure for instantly smoothing out wrinkles using Botox injections.

What age-related changes in the area around the eyes are proposed to be solved with Botox:

• wrinkles near the outer corners of the eyes (“crow’s feet”) and in the lower eyelid area,
• swelling and bags under the eyes,
• drooping (ptosis, drooping) of the upper eyelids,
• low location of eyebrow arches.

But what does the client get as a result, and at what cost?

What is Botox

Botox is a drug based on botulinum toxin, a powerful poison of natural origin. It is a protein toxin produced by bacteria. Literally translated as "sausage poison", as it was discovered as a result of fatal food poisoning from spoiled sausage.

Man learned to produce botulinum poison artificially as a biological weapon, and then this development was put into use by doctors, followed by cosmetologists.

Botulinum toxin is a neurotoxin, that is, a poison that has a neuroparalytic effect. It blocks the production of acetylcholine, which ensures the transmission of nerve impulses to the muscles, causing them to be paralyzed. In medicine, this ability of botulinum toxin to affect muscles is used to correct various involuntary muscle spasms and movement disorders. Botox is especially common in ophthalmology and in the treatment of cerebral palsy.

What is important to know about the use of Botox in cosmetology? It does not eliminate the cause of aging, but only creates a temporary effect of smoothed and tightened skin for 2-5 months. This is not a means of rejuvenation! Botox deprives the muscle of its natural function of contracting, which is why the skin appears to smooth out. But the structure of the dermis does not change, the lost elasticity and strength do not return. The muscle is simply affected and then does not even fully recover.

Moreover, Botox accelerates the aging process of the skin. A paralyzed muscle will not completely return to its original state (although cosmetologists talk about its complete restoration). And, what’s even worse, when the muscle affected by botulinum poison stopped functioning, other neighboring muscles began to work for it. This led to their overstrain, loss of healthy tone and correct configuration of the muscular system. The result is new wrinkles on the face that were not there before the Botox injection.

Efficiency

The effect of Botox lasts, on average, 1-5 months. Then the result disappears. Manufacturers of some drugs containing botulinum toxin claim 9 months as the maximum duration of effect, but in practice this does not happen. In some cases, Botox does not produce any results.

Remember! Botox does not solve the problem of age-related changes in the eyelids, but only creates temporary appearance. You have to pay for a fleeting illusion with health and beauty. Botox disfigures the face, is toxic to the body and - attention! – accelerates the aging process. It is a poison that only causes harm.

We prove what cosmetologists are silent about or mention in passing as something incidental and insignificant.

Preparations containing botulinum toxin

Botox is commonly called any drug containing botulinum toxin. But in the strict sense of the word, Botox is the trade name of the first drug based on botulinum toxin. It was released by Allergan from the USA about 30 years ago. Having realized how profitable this business is, several more manufacturers from different countries began to produce analogues of Botox. All drugs contain the same active ingredient - botulinum toxin type A (BTA), produced at one time as a bacteriological weapon. The products differ in different concentrations of BTA, composition of excipients, particle size, duration of effect and a number of other parameters.

Botox

Botox is the first and most popular remedy among botulinum toxin-based drugs. This product from America was registered in Russia in 1994. In addition to BTA, Botox contains albumin and chloride, which should limit the diffusion of the poison, that is, its spread beyond the target. But this does not stop the toxin from spreading under the skin, which is why the face takes on an unhealthy shape. Botox is considered to contain a moderate dose of botulinum toxin and is of moderate potency. The initial effect appears on the 4-7th day and reaches its maximum after 2 weeks.

Dysport

Dysport is the main competitor of French-made Botox. Unlike Botox, Dysport has a 2.5-3 times lower dosage of BTA, but it is also about 2.5 times cheaper. Given the need to administer more units of Dysport, the cost of these drugs is comparable. If you need 10-20 units of Botox for crow's feet, 30-60 units for Dysport. Dysport acts stronger and longer than Botox, since its active particles are smaller and contain less albumin, which is designed to stabilize BTA molecules. All this indicates that Dysport has higher diffusion, that is, it spreads more actively beyond the target. The initial effect occurs faster than Botox: within 1-4 days from the date of the procedure.

Botulax

Botulax is a drug from South Korea, the country that produces the largest number of products competing with Botox. In terms of its composition, Botulax is almost a complete analogue of Botox, but cheaper. Accordingly, all their characteristics are almost identical, as are the consequences. It is noted that the duration of action of Botulax is somewhat shorter than Botox. There is also information that the use of the Korean drug is accompanied by more pronounced discomfort.

Relatox

Relatox is a Russian-made drug that entered the market in 2012. Cheaper than foreign drugs. It is positioned as an analogue of Botox, which begins to act faster and the effect of which lasts longer. But in many ways, this activity of Relatox is explained by the multiple smaller size of its particles: its molecular weight is 6 times lower than that of Botox. Therefore, it acts faster and seemingly more evenly on the target muscle, but at the same time it penetrates more actively into other muscles (strong diffusion), which is fraught with side effects. Also, unlike Botox, Dysport and Botulax, Relatox does not contain albumin, a stabilizing protein that inhibits the diffusion of poison and softens its effect. There are many reviews on the Internet about the poor quality of Relatox and the pain of its administration.

Xeomin

This is a German drug that contains botulinum toxin of the highest purity, therefore it is supposedly safer than its analogues, but also more expensive. The action comes a little faster than Botox and Dysport, but also ends earlier. Like the Russian Relatox, the molecular weight of Xeomin is very low, which indicates, on the one hand, a more uniform distribution of the drug, and on the other hand, a high ability to spread beyond the injection zone. But the diffusion of Xeomin is inhibited by the stabilizer albumin, which is even more abundant in the German drug than in Botox. It is believed that the effect of Xeomin is softer, without the “stony face” effect. It differs from its competitors in that it can also be stored at room temperature.

Lantox

A cheaper Chinese analogue of Botox, comparable in dosage and molecular weight, but does not contain albumin, which inhibits diffusion. Instead of albumin (human immunoglobulin), Lantox contains gelatin of animal origin, the task of which is the same: to impart stability to the botulinum toxin molecule and prevent excessive diffusion. The effect of Lantox is average in strength between Botox and Dysport.

Degrees of ptosis

Ptosis varies in the degree of impact on the patient’s life:

• First degree (partial ptosis) – the eyelid is drooping, but the volume of the palpebral fissure is reduced by no more than 1/3;
• Incomplete (2nd degree) – a drooping eyelid covers 2/3 of the iris, accompanied by significant visual impairment (double vision, lacrimation, narrowed vision);
• Complete (3rd degree) – the palpebral fissure is completely blocked, the drooping eyelid makes it impossible to see with the affected eye.

With Botox, partial ptosis most often develops, and incomplete ptosis is extremely rare. Complete ptosis develops in severe forms of allergy to the drug.

How does the Botox procedure work under the eyes?

Typically, the Botox injection procedure follows the same scenario, regardless of the area of ​​the face being treated. With injections into the area around the eyes, the sequence of actions is as follows:

• The cosmetologist asks the patient to smile, make a sad face and express other emotions to identify problem areas.
• Areas for injections are marked on the face. Four points are selected: two points near the outer corner of the eyes and one each near the tip of the eyebrow and in the area of ​​​​the bone border.
• A special anesthesia is applied to the face.
• The drug is administered using thin needles.
• After the injections, the patient lies down for 10 minutes.

Order of conduct

The active drug is administered by a doctor with a medical education. Additionally: certificate of completion of advanced training courses.

Injection field - treatment of the injection site with antiseptic drugs. No wet sterile dressing is required. Consulting recommendations for the duration of the rehabilitation period.

How long does it take for wrinkles to smooth out after Botox?

The visual effect of Botox injections appears 3-4 days after the procedure and reaches its maximum by the end of the second week. Some manufacturers promise visible results in just one day.

Waiting for change is accompanied by many troubles. As a rule, you have to put up with bruises and unevenness on your face for the first week. Your hands feel like the skin is falling inward. Often the face swells and additional folds appear that were not there before. You should not laugh or frown a lot, so as not to provoke wrinkles.

Often the effect after one procedure turns out to be such that it needs to be corrected. And this is a new trip to the cosmetologist and new portions of poison.

Advantages

Positive sides:

absence of severe pain. Use of local and general anesthesia;

• minimal impact on the patient’s internal organs;
• price;
• use of technology;
• minimal risk of injury;
• fast rehabilitation period;
• first results 48 hours after injection;
• duration six months;
• no repeated correction procedure is required;
• no surgical intervention;
• time – 15 minutes;
• uniform distribution of botulinum toxin on the damaged area of ​​the skin;
• work of a professional cosmetologist;
• minimum dose of harmful toxin.

Additionally: accessibility, minimum prohibitions. Regular visual examination by a professional cosmetologist.

Botulinum toxin type A preparations, for medical reasons. It will eliminate pronounced spastic contractions of muscle tissue, regardless of the nature of their origin.

Pros and cons of Botox under the eyes

If your goal is to get rid of wrinkles, then Botox is definitely not your option. Botulinum poison does not remove wrinkles. It gives a temporary effect due to muscle paralysis and does not in any way solve the problem of skin losing elasticity and strength. Botulinum toxin only works on facial wrinkles and does not affect deep ones.

And we haven’t yet talked in detail about the dangers of botulinum toxin and the mass of ugly side effects! The disadvantages of Botox injections under the eyes, like any other botulinum therapy procedure, can be listed endlessly. Judge for yourself. Botox under the eyes is:

• A blow to facial expressions and beauty.
  The face loses facial expressions and becomes stony. At best, you won't be able to express your emotions. At worst, a paralyzed person will replace some emotions with others. It will seem to others that you are wincing in disgust, although you are smiling at that moment. Or you will seem angry when you are surprised by something. In addition, various side effects may occur on the face - a very common occurrence. This could be ptosis (drooping) of the upper eyelid, swelling, bruising, facial distortion, new wrinkles, and the like (read details in the next chapter).
• Bad feeling.
  After Botox, the injection areas often cause headaches. Fever, vomiting, dizziness and other health problems also occur.
• Danger.
  Since botulinum venom has diffusion, that is, it spreads beyond the injection zone, it can cause various complications in the eyes and not only.
• Acceleration of aging.
  Botox accelerates age-related changes. Paralyzed muscles do not fully recover, and the neighboring muscles that worked for them wear out faster. As a result, not only the wrinkles exposed to the poison return, but also new ones appear.
• Botox addiction.
  When, several months after Botox injections, the effect of the drug stops, the patient goes for a new portion of the poison. This happens over and over again. An addiction to botulinum toxin develops. The frequency of visits and dosages are increasing. Appearance is disfigured, health is undermined.

Are there any benefits to Botox under the eyes? In cosmetology - no. Only an illusion that turns into terrifying consequences. Even in medicine, where the use of Botox is justified for therapeutic purposes, this drug is feared. According to neurologists, the consequences that botulinum toxin can lead to have not yet been sufficiently studied.

Patient reviews

Those who have had Botox done to the eye area write that:

• no effect
• a frozen surprised look appears,
• injection sites become numb,
• eyelids become very swollen for several months,
• the eyes stop opening completely or partially,
• the face swells, the skin collapses when touched,
• the upper eyelid droops,
• new wrinkles appear.

Quote from a patient who had Botox done in the eye area:

“I can’t open my eyes and I have no idea when this horror will return to normal.”

The review was updated 7 months after the procedure:
“The drooping eye remained unchanged. After consultation with a neurologist, neuropathologist, after a total examination by an ophthalmologist, an MRI of the brain and facial nerve, and an appointment with a leading neurosurgeon, the unequivocal verdict is Botox’s FAULT!”

Consequences and side effects of Botox under the eyes

But there are many known consequences of Botox that botulinum toxin treatment victims experience everywhere. We are especially interested in the side effects that occur after injections of botulinum venom into the area around the eyes. Let's name the main ones:

• Dry eyes and skin tightness.
  Lasts several days in most patients.
• Bruises, hematomas.
  Capillaries are injured during injections in everyone, which is why bluish dots appear on the face, and often even ugly hematomas. The story may drag on for several weeks.
• Pain when touching the eyes.
• Ptosis (drooping) of the upper eyelid.
  Happens frequently. Occurs due to uneven distribution of botulinum toxin. The extreme form is the inability to open the eye. For the problem to disappear, it will take more than two months to completely remove the poison from the body.
• Headache.
  They may bother you for up to two weeks or more.
• New wrinkles.
  They arise due to the fact that neighboring muscles, trying to replace atrophied ones, worked in an increased mode and spasmed.
• Severe swelling.
  Due to unhealthy muscle tone, lymph flow is disrupted, resulting in swelling. It can be pronounced and not go away for a long time.
• Facial asymmetry.
  In the case of Botox in the area around the eyes, it usually appears in the form of asymmetrical eyebrows: one raised, the other lowered, and so on.
• Eye pathologies.
  Due to damage to non-target areas by the drug, eye complications may occur: paralysis of the eye muscles, anisocoria of the pupils (different sizes), mydriasis (pupil dilation), strabismus, blindness.
• Allergy.
  It occurs due to both botulinum toxin and auxiliary components. Possible anaphylactic shock.

Reasons for the development of ptosis

Ptosis can develop not only due to incorrect actions of the doctor or patient, but also for physiological reasons. Anyone who does Botox around the eyes for the first time is exposed to these risks:

1. Low muscle tone of the eyelid - in this case, Botox reduces it even more, and the result is obvious in the most literal sense of the word;
2. An allergic reaction with severe swelling - not a single person is immune from it either. Edema severely deforms facial tissues, leading to its asymmetry, causing pain and severe discomfort;
3. Disorders of microcirculation of blood and lymph in the tissues of the eye - Botox aggravates them, which also causes swelling.

Not a single patient is immune from such situations, especially if she decided to undergo Botox for the first time. If such complications arise, you need to contact a cosmetologist.

Experts' opinion

There are many forums on the Internet where cosmetologists can communicate with each other. Go to them and read what experts really think about Botox. Here are just a few statements:

Botulinum toxin is poison. A person is already exposed to the influence of harmful substances, and during the procedure he voluntarily agrees to the introduction of a toxin

(Alexey, cosmetologist with 15 years of experience, Voronezh)

The drug is addictive – physical and psychological. Under the influence of botulinum toxin, the muscles relax. After the drug wears off, the situation gets worse. From a psychological point of view, a person gets used to a smooth face, so even small wrinkles make him want to urgently inject botulinum toxin

(Nikita Yashin, young specialist in the field of cosmetology, Moscow).

There is a high risk of medical errors. There are very few experienced cosmetologists whose hands do not tremble. If the doctor injects into a point that is only a couple of millimeters away from the desired point, the result may be hopelessly spoiled

(Anton Laptev, cosmetologist in a private clinic, Samara).

Application in ophthalmology

Ophthalmologists use Botox in their practice for:

• Muscular-tonic syndromes;
• Blepharospasm, when the patient cannot open his eyelids;
• Hemifacial spasm;
• Myofacial pain syndrome, accompanied by facial pain.

In addition, the toxin helps eliminate tics, nystagmus, pain, strabismus and migraines.

It is contraindicated to prescribe the drug in case of hypersensitivity to it, with myasthenia gravis, while taking antibacterial agents (aminoglycosides, tetracycline), during pregnancy and hemophilia.