Hi everyone!!

Hi everyone!! This is a video explaining botulinum toxin! It’s number 1 because, depending on your questions, number 2 may come up 😁😁
I made it with lots of love for you, I hope you like it!!
Tag the friends who will enjoy it 🥰
#toxinabotulinica #dysport #botox #injetaveis #cosmiatria

Video transcript

Hi everyone, my name is Carolini, I’m a plastic surgeon here in São Paulo, and I’ve come to bring up a topic that, despite being extremely widespread on social media, still leaves many people with doubts and questions: botulinum toxin, popularly known as Botox. Botulinum toxin is a medication; it comes in a vial, we dilute it and inject it into certain areas. It can be applied to the face and to some areas of the body as well. What is the main function of this medication? When we inject it into the muscles, it softens the contraction of those muscles for a period of time. And when we inject it into other sites, such as the sweat glands, it reduces sweat production for a certain period of time as well. And how does it work? Well, this toxin comes from a bacterium. Does that bacterium cause a disease? Yes, and it can be scary to hear that it’s botulism. So what did they do? Since this toxin has the power to paralyze muscles, they purified it and created a formulation that we can use at a safe dose to achieve the effects we want. So, before talking about the effects and how botulinum toxin works, let’s talk a little about how our muscles work, how we produce muscle movement. This applies, in general, to most of the voluntary muscles in our body. Starting with the brain, I’ll try to put this in easy-to-understand language, without overly technical terms. Our brain holds all of our thoughts, all of our intentions, and it sends messages to our muscles. So when I want to run, the brain sends a message and contracts a certain number of muscles in my face. When I’m angry, the brain sends that message and contracts certain muscles that create that angry expression. People will look at me and know: look, she’s angry. But all of this happens automatically. I feel my emotions, and my brain already knows which muscles to contract. But over time, just as a muscle we train at the gym gets stronger, these muscles get trained too, and when we use them a lot, they stay contracted even when I’m not feeling that emotion. So sometimes my muscle is contracted, but my brain isn’t telling me I’m angry, yet I have an angry look on my face. People will look at me and say: wow, you look angry, you look tired, you look worried. And actually, I’m not. It’s just that my muscle, from contracting so many times for so long, has developed what we call hypertonia. So even without my expressing that emotion, my muscle is contracting. And when a muscle contracts, in the face that shows up as expression lines. Everyone has heard that term: expression lines. Lines that appear on our face when we make an expression, okay? So, to illustrate with a photo here: in this region we have the glabellar lines, which give an angry expression, for example. We have these lines here, the orbital ones, in the orbicularis muscle, known as crow’s feet. And we have the frontal lines, the transverse lines we have here on the forehead. These are the best known. There are others. But, to keep it simple: we use botulinum toxin for aesthetic purposes on the face mainly to soften this region we know as the glabella, this region we know as the orbital area, which is our orbicularis muscle, and this region we know as the forehead. Because here on our face we have several muscles at different depths. So, depending on where we inject the toxin, we get certain effects. Okay? Now, botulinum toxin injections are a very straightforward procedure. It’s done with injections. So that powder we diluted, we draw up and inject with a very fine needle. Sometimes we apply a topical anesthetic, a little ointment, on the face, and we examine the patient. Then, with a thorough knowledge of anatomy, we know where the muscles are, where the other important structures we need to watch out for on the face are, and how deep those muscles are. Because we have muscles in more superficial layers and other muscles in deeper layers. For example, this muscle here, the orbicularis, lies very close to this other muscle here, the zygomatic, which we must not block, otherwise it will alter our smile in a strange way. That’s why knowledge of anatomy is so important. So we do an assessment, we ask the patient to make faces, we take photos, we ask what bothers them most, and from there we determine the points where we’ll inject. The effect starts at around 48 hours. Many people are under the impression that the effect on the face is immediate, but that’s an incorrect idea. Botulinum toxin works by paralyzing the muscles, so the effect is not immediate. You wake up the next day as if you hadn’t had anything done. Of course, if a small vessel is touched, you may get a little bruise, something like that. So it’s important to know when to start expecting the Botox effect, which is from 48 hours on. At some point, you start to notice that a muscle that used to contract with a certain ease is no longer contracting. That effect keeps building for up to two weeks, and then it lasts for about three, four, up to five months, depending on the person and how it works for them. So, as I said, our brain sends a message to our muscles and they contract. How does it do that? It’s like an electrical connection: for it to work, the contact has to be made. And what makes the contact? When the message reaches the very end, right next to the muscle, there are little vesicles there, vesicles that release a neurotransmitter called acetylcholine. So the nerve arrives, releases acetylcholine, and the muscle contracts. So what does our beloved, dear toxin do? When I inject it here, it blocks that release. It’s as if it said: no, no contact will be made here. My brain says: wow, she’s very angry, and the message reaches our muscle here, the corrugator muscle that sits here. Because the great trick of botulinum toxin in treatment planning is not necessarily to leave the face completely paralyzed, but to reduce the strength of those muscles that are too strong. That’s how we usually work to achieve the results. So the botulinum toxin binds to some of those vesicles and keeps them from releasing the neurotransmitter, so the circuit isn’t closed and the muscle doesn’t contract. That’s really cool. And then, how does the effect wear off? Is it permanent? No, because at a certain point new nerve endings start to appear that allow that connection to happen again. Over time, the botulinum toxin is no longer there, and new branches appear as well. So our body is very intelligent: it says, if this pathway is blocked, I’ll look for another one. So it finds other routes to send that message and make it effective. I mentioned it lasts about three to five months, depending on the person. The recommendation is that you have this procedure about two to three times a year. Is there a problem if you don’t want to? No, you’ll simply be without the effect of the toxin. But it’s very important to maintain it long term for the preventive effect, because what starts as an expression line, if you let that muscle keep contracting for a very, very long time, will turn into a static wrinkle. If you can’t see it in this photo: it’s when the wrinkle is already etched in and doesn’t go away anymore. So here I am, I slept 12 hours, I’m calm, happy, I won the Mega-Sena, and yet I’m like this, with my muscle contracted. Look, no, I’m really happy; it’s my muscle that’s contracted. This happens when you leave that muscle contracted for too long. And it’s not just the muscle: the skin there will already have gone through some atrophy and will be left with a depression there. So at that point it’s no use paralyzing that muscle, the little wrinkle will still be there. That’s why it’s so important. So, this procedure is done in the office; it’s a few little pricks. Sensitivity varies a lot from person to person, but people generally find the procedure very easy, right? You go home; for the next four hours you can’t lie down, that same day you can’t exercise, and after that it’s back to normal. If a bruise appears, you can apply some ointment or gel, and you should also avoid sun exposure, but these are usually transient things. Okay? The follow-up visit at the office is usually one to two weeks later. Why? Because since so many forces are involved here, sometimes when you do this, raise your eyebrow, one side may lift a little more, and we place an extra little injection in that spot. Okay? Well, it’s a medical procedure, and every procedure carries a risk of complications. That’s why it’s very important to have it done by someone extremely qualified for it. We have our muscles that make the smile and make our expressions, but deep inside we have muscles that move our eyelid, for example, the muscle that lifts our eyelid, or the muscles that move our eyes. And if, for example, you exercise before the recommended time, or if the toxin is injected in a spot that isn’t exactly the right one, it can migrate to muscles we didn’t want it to reach. So a person can end up with a slightly droopy eye like this, or, for example, with double vision for a while. When we inject around the lips, it can cause some asymmetry of the smile: the person smiles more on one side than on the other. That’s something that can happen. Some small asymmetries can happen even when the technique is correct, because the human body isn’t an exact science; it’s not as if you inject here and 100% of patients will have it in exactly the same place. Well, let me think if I forgot anything. I think that’s it, the procedure is very straightforward. If anyone is interested in scheduling this procedure, send a message to the clinic’s phone number in the profile; we can find a day for your consultation, and it can even be done the same day, it doesn’t require any special preparation. Well, that’s it. Any questions, leave your question here on the video, or DM me, and I’ll come here to clarify further. Okay, everyone? So that’s it. Good night and a kiss to everyone. Good night, or good morning, if you’re watching during the day, good afternoon, a kiss.

Dr. Caroline consults in English. Book your consultation by clicking the button below.

Originally published on Instagram on 06/02/2020: https://www.instagram.com/p/B8PpXhLgsKl/