There are many opinions on and applications for botulinum toxin. Older patients want to regain a youthful appearance, while younger ones would like to prevent fine lines and wrinkles. With continued advancements in products and procedures promising a more youthful glow, it’s safe to say that prevention remains a key focus. Dr Alek Nikolic shares his thoughts on botulinum toxin as part of a thorough skincare regime.
I often say that when it comes to cosmetic procedures, it’s vital to strike a balance between achieving visible results and avoiding going too far.
As a professional in this field, I’d like to share my insights on how botulinum toxin can be integrated into a comprehensive skincare regime.
Introduction to botulinum toxin
Botulinum toxin and dermal fillers are often confused, yet they serve different purposes in cosmetic treatments. Dermal fillers are used to add volume to specific areas, while botulinum toxin – a product derived from the Clostridium botulinum bacterium – works differently.
When injected, it blocks nerve receptors in the muscles, reducing muscle function, which in turn helps to smooth out lines and wrinkles. Botulinum toxin does not address skin pigmentation, texture or the like – this is where your skincare routine and professional treatments come into play to complement and enhance your botulinum toxin results.
It’s important to note, particularly in South Africa, that regulations prohibit the mention of specific brand names of scheduled medications, such as botulinum toxin, in consumer publications or aesthetic journals like Aesthetic Appointment.
Despite a common tendency to refer to all botulinum toxin injections under a single term (you know the one), it’s essential to recognise that there are three distinct brands available in the country. These brands include products from Allergan, Ipsen, and a more recent option from Merz. For detailed information about these brands and to understand which product your doctor is using, it’s advisable to have a direct conversation with your healthcare provider.
Different products for different areas
These products are particularly effective for lines or wrinkles caused by repetitive facial expressions, such as frowning, crow’s feet, and forehead lines. They are also used for treating migraines, eye twitches, and pain from temporomandibular joint disorders like teeth clenching or grinding.
What you should know
Botulinum toxin treatments are non-surgical but must be administered by a qualified medical doctor to avoid mistakes, which can result in temporary muscle drooping or unwanted results. It’s crucial for patients to verify their doctor’s qualifications and be aware of the costs involved before committing to a treatment plan.
For those in their 20s noticing early signs of ageing, botulinum toxin can be an excellent preventative measure. Performed by a trained doctor, this procedure is safe, with minimal downtime (some slight swelling or bruising).
However, excessive use of these products, especially at a young age, can alter natural features and result in an unnatural appearance. It’s essential for patients to follow professional guidance.
A preventative approach
For those with early sun damage or a genetic predisposition to deep wrinkles or fine lines, preventative botulinum toxin can be part of a larger skin treatment plan. I advise patients to assess their family’s ageing patterns and consider factors like genetics, age, lifestyle habits, and long-term goals before proceeding with treatments.
A holistic approach to skincare
Most doctors will advise patients to focus on a holistic approach to skincare that looks after the overall quality of skin and skin health. This includes a proper skincare regime that includes chemical exfoliation, daily use of SPF, and the correct lifestyle and nutrition habits.
Botulinum toxin treatments are performed every four to six months and should be seen as complementary to one’s topical regime to improve and maximise the results that can be achieved. Serums that contain vitamin C and retinol can only achieve a specific effect on the skin, and the best results on lines and wrinkles will be achieved when combining this with botulinum toxin treatments.
Unfortunately, there are no products or skin ingredients that will prolong the result, as this is determined by the dosage used and the time it takes for a new neuromuscular junction to be created, allowing muscle movement to start again.
Having an effective skincare routine will be very beneficial down the line, saving money on costly anti-ageing treatments in the future. There are also in-practice treatments that can be used alongside botulinum toxin to provide optimal results, like soft tissue fillers, chemical peels, needling devices, and intense pulsed light (IPL).
As the most researched drug globally, botulinum toxin has applications across various medical fields, including studies indicating its effectiveness in reducing depression. Looking ahead, we can expect to see new formulations with added synthetic ingredients to enhance absorption and prolong effects.
MBBCh (WITS) ATLS (ACS) MBA (UCT)
Dr Alek Nikolic is a doctor with a special interest in aesthetic medicine and is at the forefront of the latest developments in his field. With a focus on skin care, skin ingredients, and cosmetic dermatology treatments such as lasers, chemical peels, Botulinum toxin, and Dermal Fillers, he has performed over 20 000 procedures to date and is responsible for training many medical practitioners both locally and internationally. After receiving his MBBCh from the University of the Witwatersrand (1992) he went on to do an MBA at the University of Cape Town (2000). With over 24 years in private practice, he has lectured and performed live demonstrations across the globe, including Bangkok, Rome, Paris, Monte Carlo, Prague, and Warsaw. Some of his accolades include: Owner of Aesthetic Facial Enhancement, Owner of online skincare store SkinMiles.com, Owner and formulator of Skin Ingredients (sk.in): www.skiningredients.com, Founding member of the South African Allergan Medical Aesthetic Academy, Advisor to Allergan Local Country Mentor in Facial Aesthetics, EXCO Member of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA), and is an Associate Member of the American Society of Laser Medicine and Surgery (ASLMS).