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Botox © is the best known, as it was the first to be used for aesthetic purposes, followed by other neuromodulating molecules such as Dysport or Nuceiva (manufactured in Canada).

Dr. Jean Caruthers
Canadian Dr. Jean Carruthers, the first to discover the aesthetic virtues of BOTOX

First used in the 70s in ophthalmology (treatment of diplopia), it was a Canadian doctor, Dr Jean Carruthers (ophthalmologist) and her husband Alaster Carruthers (dermatologist), based in Vancouver, who first described the aesthetic virtues of this protein. Together, they will democratize all the aesthetic indications we know so well today.

Since its approval in Canada in 2001, then in the United States in 2002, the popularity and development of aesthetic techniques have continued to grow. After 30 years of use and hindsight, Botox remains the benchmark product in the field, despite its age.

Molecules other than Botox(Dysport ©, Nuceiva ©, Xeomin©, etc.) have appeared on the market over the last 15 years. Each has its own advantages, but overall, their functioning, duration of action and safety remain the same.

Physiological aging of the muscle leads to atrophy and loss of elasticity. Until the age of 25 or 30, this phenomenon is invisible, then it progressively appears as micro fine lines, then wrinkles and folds, particularly in the upper part of the face: forehead, glabella (lion’s wrinkle) and crow’s feet.

The magic of neuromodulators lies in their ability to relax muscles over a prolonged period, resulting in theattenuation or even complete disappearance of undesirable wrinkles and folds.

Muscle loss
Muscles shorten with age
Synaptic action of BOTOX
Synaptic action of BOTOX

This effect is obtained by blocking the release of acetylcholine from the neuromuscular synapse. This can take between 5 and 10 days to appear. The effect will last from 4 to 8 months. The duration of action depends on the individual and the number of units injected. It should be noted that smoking shortens this duration of action.

Another virtue of neuromodulators is neuroexocrine blockade: they stop sweating when injected into a sweat gland. Its most classic application is the hyperhidrosis (axillary or palmo-plantar hypersudation).

The classic indications for neuromodulators are the treatment of forehead wrinkles, glabellar lines and crow’s feet.

Botox on forehead wrinkles
Forehead wrinkles

But many other indications have emerged in recent years:

  • Brow lift: the tail of the eyebrow can be lifted to open up the eyes.
  • Gummy smile: when the gums appear when you smile
  • Bunny lines: oblique wrinkles at the base of the nose
  • Raising the tip of the nose: by injecting the nose’s depressor muscle, the nose is raised by 5 to 10°.
  • Creating a resting smile: raising the corners of the mouth at rest
  • Orange peel appearance of the chin
  • Plastysmal cords: vertical cords on the neck due to hypercontraction of the platysma muscle
  • Fine perioral wrinkles: correction of hypercontraction of the oral orbicularis muscle
  • Bitterness fold: injection into the depressor muscle of the angle of the mouth and correction of its hypercontracted state
  • The V shape: Injection into the masseters. Some patients have a very visible, hypertrophic masseter muscle, which gives the jaw a square appearance. Injecting this muscle with 20 to 30 Units causes atrophy of the masseter muscle, giving the lower part of the face a slimmer, “V”-shaped appearance.
  • Nefertiti neck: micro-dosed injections in the neck or along the jawline to relax folds.
  • Hype rtranspiration (hyperhidrosis): by blocking the signal to the sweat glands under the arms (sweat glands), palms, feet or forehead, the problem of hypersweating can be treated.
  • Correction of bruxism and grinding By relaxing hypercontraction of the masticatory muscles.
  • Migraine Injecting the forehead, temples or cervical tension cords (trapezius muscle) will result in muscle relaxation, accompanied in 80% of cases by an astonishing improvement in the intensity and frequency of migraines and tension headaches.

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