Treatment guides

Botox: how it works, suitability and aftercare

Botox softens expression lines by relaxing selected facial muscles. Understand how it works, how a treatment plan is chosen and what happens after the appointment.

SkinGenious editorial team

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Understanding the treatment

To start with, we would like to inform you that Botox, although used commonly, is actually a registered, trademarked brand name of Allergan pharmaceuticals. It is the name of their formulation of the botulinum protein (toxin). We mainly describe the cosmetic uses of botulinum on this page. There are other medical indications as well, including masseter jawline shaping and hyperhidrosis, or excessive sweating, which are also a dermatological indications.

Do you want to reverse moderate to severe wrinkles on your face?

Are you tired of using expensive creams without achieving desired results?

Do you want to get injected by the best skin specialists in the city?

Then Botox treatment or treatment with any other approved formulation of botulinum at SkinGenious is for you. The other brand most commonly available in Mumbai is Dysport by Ipsen Biopharm ltd.

There are cosmetic as well as medical indications for the use of botulinum protein. We briefly touch upon the medical indications here, but the page is intended to describe the use of the molecule in its anti aging application which is under the purview of dermatology. Anti aging: the use of botulinum to reverse wrinkles and fine lines provides highly satisfactory results. It is used to target facial wrinkles, namely crow's feet, frown lines and forehead lines. Apart from this particular cosmetic use, it is also used in the masseter muscles (jaw) to help with slimming the jawline and giving a more feminine appearance. Medical indications: The medical indications of botulinum include usage in cases of chronic migraine, adult spasticity (which is muscle stiffness in arms and legs), pediatric spasticity, cervical dystonia (abnormal neck position), overactive bladder, severe primary hyperhidrosis (excessive sweating, also a dermatological indication) and blepharospasm (eyelid spasm).

Botulinum toxin injections temporarily reduce the activity of selected muscles. In cosmetic practice they are mainly used for expression lines, such as frown lines, rather than to add volume or remove every wrinkle.

How it works

Wrinkles on the face are a function of the underlying mimetic muscles pulling down on your skin. With the aging and repetitive action of the muscles, the wrinkles start appearing more pronounced. Such wrinkles are usually referred to as dynamic wrinkles. The kind of botulinum used in the anti-aging treatment is botulinum toxin. The molecule is naturally produced by a kind of bacteria, clostridium botulinum. In a pharmaceutical environment, the specific components required are extracted and refined to make sure that the injectable molecule has very controlled and specific actions. What an injection of the molecule does is that it blocks the transmission of signals from the nerve ends to the underlying muscle. This makes the muscles relax and therefore the overlying wrinkles reduce in appearance. It works remarkably well even on moderate to severe wrinkles. You can see some images of before and after results in the relevant section of this page. It is also used across age groups and your gender or skin tone is not relevant to the effectiveness of this treatment.

The medicine acts at the connection between a nerve and muscle. Carefully placed injections reduce the muscle movement that repeatedly folds the skin.

Suitability and assessment

An assessment distinguishes movement-related lines from changes caused by sun damage, skin laxity or volume loss. Pregnancy, breastfeeding, neuromuscular conditions, infection and medicines need discussion before deciding suitability.

What happens during treatment

The clinician reviews facial movement, agrees treatment areas and marks injection points. Small amounts are injected with a fine needle, followed by individual aftercare instructions.

Step 1

In-person consultation

Like all our treatments, your botulinum treatment starts with meeting one of the top skin specialists in the city. The dermatologist will first understand your expectations and target areas. They will then share the exact details of the treatment with you after chalking out your plan. They will share with you, the exact botulinum product they plan to use for you and why. They will provide you with an estimate of how effective the treatment will be for you. They will do this after chalking out a plan for your face as to how many units of the product they will inject and in which areas.

Step 2

Topical anesthesia

For this procedure, anesthesia is applied in a cream form on the target areas of the skin. You will need to apply the cream and wait 15 minutes for it to take effect. This is done to numb the area so that you do not even feel mild discomfort from the injection.

Step 3

Injection

A very thin gauge needle is used for the procedure. The product is diluted in the required proportion and injected into the target areas. The injection step hardly takes 15-20 minutes. After this, you are good to go and will see the results starting 48 hours after the treatment which are expected to improve further over the next 7-14 days. The results last for 4-6 months.

Results and limitations

Changes develop over several days and are assessed after the treatment has settled. Effects are temporary and repeat treatment is a separate clinical decision.

Botox for Wrinkles

If our skin specialist went ahead for the treatment, it does mean that you were an ideal candidate and they had noticed dynamic wrinkles where they knew they could deliver significant results. After the treatment you can expect to start seeing a significant reduction in wrinkles starting 48 hours post procedure. Further improvement is expected over the next 14 days. The delivered change will last for 4-6 months. You can choose to repeat it or not. Most of clients do repeat considering the results are so stark.

Before and after results

These photographs come from the existing treatment and concern records. They illustrate individual outcomes. Your starting point, treatment plan and healing response affect your own result.

Before and after: Botox for Wrinkles — Botox for Wrinkles

Risks and recovery

Bruising, headache, asymmetry or a drooping eyelid can occur. Difficulty breathing, swallowing or speaking after an injection requires urgent medical attention.

Botox and dysport have been used for many years with very successful results. In the hands of an expert aesthetic dermatologist, the incidence of side effects is very low. However you must be aware of the same before you choose to go ahead.

Botulinum is FDA approved. The risk profile mainly comes into play when the treatment in not taken from a trained aesthetic dermatologist, which is a phenomenon in countries where the treatment is not very highly regulated, like even in the United states, where non-medical practitioners also perform the treatment.

In Mumbai, only medical practitioners are allowed to perform the treatment which helps great deal in lowering the risk profile. That said, you are required to sign a consent form given the unforeseen effects that the molecule can have even in the hands of a trained practitioner. We’ve already shared that pregnant/breastfeeding women and persons with neurological diseases are not considered ideal candidates.

The possible risks and side effects include:

Bruising at the injection sites is a possible side effect and resolves itself over 2-3 days in the minimal chances that it occurs, given the thin needle gauge
Eyelid drooping: This happens rarely. In most instances where it does occur, it happens when after care is not taken properly and the product moves to un-intended areas.
Headaches: again rare, and usually resolve in 24 to 48 hours when they do occur
Mild pain or swelling around the injection site
Crooked smile, drooling, eye dryness or severe tearing are possible, again when the product moves to unintended areas.
Numbness or weakness in nearby muscles
Upset stomach is possible

However, we would like to re-iterate that the chances of these risks are minimal in the hands of a trained practitioner. Also, the effects of the treatments last only 4-6 months, so none of this is permanent.

Preparing for treatment

Bring details of previous procedures, medicines, allergies and any change in your health. Ask which skincare products or activities need adjusting before the appointment. Do not stop prescribed medicines without advice.

Any change to prescribed medicines, including blood thinners, must be agreed with the prescribing clinician.

You should not go ahead with the botox treatment in case you are pregnant, breastfeeding, have had a past allergic reaction to the molecule or suffer from neurological diseases.
It is advisable to stop any blood thinners like aspirin prior to the treatment, because blood thinners lead to higher chances of temporary bruising.
If you stop smoking one week before the treatment, it will also reduce your chances of bruising from the injections.

Aftercare

After the procedure, do not rub the area for the next 12-24 hours so as not to spread the product.
You will be asked NOT to lie down for the next 3-4 hours (again so that product stays in the target area).
You may be asked to NOT undertake vigorous exercise for the next 24 hours.

Avoid rubbing or massaging treated areas unless instructed. Follow the clinician's advice on exercise, skincare and follow-up rather than adding treatments yourself.

Alternatives to consider

Static lines, volume loss and loose skin may need different approaches, including skincare, resurfacing or fillers. These options do not do the same job as a muscle-relaxing injection.

Planning treatment and maintenance

A good Botox result starts with how your face moves. Forehead lines, frown lines and crow's feet involve different muscles, and the aim is usually to soften the lines while keeping your expressions. Looking only at the depth of a crease misses part of the picture. Your dermatologist will also look at eyebrow position, eyelid movement, facial balance and whether a line remains visible when the face is at rest.

Botox and fillers solve different problems. If a fold is mainly caused by lost volume, relaxing a muscle may not give the change you are looking for. If the crease comes from repeated movement, adding volume alone may leave that movement unchanged. This is why the assessment matters more than choosing a treatment from a photograph.

Ask which product will be used, which areas are being treated and when the result will be reviewed. Units are specific to each botulinum toxin formulation, so a unit count from one brand cannot simply be compared with another. Keep a record of the product, treatment date and areas treated if you visit a different clinician later.

The result develops rather than appearing fully on the day. Let the treatment settle before judging symmetry or asking for additional injections. Maintenance depends on how long the effect lasts for you and whether you want to continue. Taking a break is an option; repeat treatment should be a considered choice, not an automatic booking.

What affects the cost

The area treated, the product or device, the treatment plan and the number of sessions influence the total. A useful estimate explains what is included, what follow-up involves and whether maintenance is likely. City pages provide the local service information.

Common questions

Is Botox treatment painful?

No, the needle used for the injection is very narrow gauge and topical anesthesia is applied over the target areas to ensure that there is no pain.

Is Botox permanent?

No, the results from botulinum injectables start showing 48 hours after the treatment and last for 4-6 months.

Are Botox injections a surgery?

No, Botox treatment is not a surgery. It is a minimally invasive injectable treatment.

At what age can I start Botox?

The approved age to start Botox cosmetic is 18 years. However, you would not want to start that early. Even if it is being used preventively, you may want to start in your late 20’s or early 30’s

What should I understand before choosing Botox?

What results should I expect?

Changes develop over several days and are assessed after the treatment has settled. Effects are temporary and repeat treatment is a separate clinical decision.

How do I compare this with other options?

Static lines, volume loss and loose skin may need different approaches, including skincare, resurfacing or fillers. These options do not do the same job as a muscle-relaxing injection.

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Botox: how it works, suitability and aftercare

Understanding the treatment

How it works

Suitability and assessment