Botox is applied earlier, preventively, and with pleas of naturalness

I once heard from a dermatologist: “if you don’t stop moving your forehead so much while talking, I’m going to have to put Botox!”. Before the threat, she had advised me to leave a mirror on my desk so I could police my facial expressions — that was before the Covid-19 pandemic, when we didn’t keep an eye on every detail of our faces during meetings. virtual.

I left the office 1) very uncomfortable with the suggestion that I should change the way I express myself, as if this were desired or even possible, and 2) enraged with the peremptory “I’m going to have to”, as if it were not possible to have wrinkles and not put Botox.

The fact is, there are fewer and fewer wrinkles out there. Botulinum toxin application is the main non-surgical procedure performed in the world (43% of the total), followed by injection of hyaluronic acid filler (28.1%), hair removal (12.8%), non-surgical fat reduction (3.9%) and photorejuvenation (3.6%), according to the annual survey on aesthetic/cosmetic procedures by Isaps (International Society of Aesthetic Plastic Surgery, in Portuguese). Data are from 2020 and were released in December 2021. About 85% of non-surgical procedures were performed on women.

A champion in clinics, Botox (trade name of the Allergan brand toxin) has been applied earlier, in a preventive way.

“The objective is to reduce the force of muscle contraction and make expression wrinkles not become permanent creases. There is no right age. Sometimes there are very young patients, in their 30s, and very expressive, with many marks, and there are older people who don’t tend to wrinkle. It is necessary to evaluate each one”, says Alessandra Romiti, advisor to the Cosmiatry department of the Brazilian Society of Dermatology.

According to her, thinner, lighter and dry skins are more prone to wrinkles.

“Today we know that the toxin modifies the excessive contraction of muscles and makes the aging process smoother. It is not trivializing the application, but understanding that it is better to prevent”, says dermatologist Rubens Pontello.

It is not just the indication of the right time to perform the procedure that has changed. The intensity of the application is lower, and according to dermatologists, there are even those who want to leave some wrinkles on purpose, to avoid exaggeration and leave the result more natural, almost unnoticed.

“There’s no way to leave the patient like a wax doll, a 70-year-old person with a fully stretched face. Today everyone wants to age with dignity. Patients tell me ‘I don’t want to change my face, I just want a little Botox’ or ‘you can leave my crow’s feet.’

According to Pontello, people are “afraid” of artificial results, as some have been “transfigured”. “Today, patients ask more to take the air out of tiredness than to get rid of all the wrinkles. We seek to soften rather than paralyze. The goal is to maintain the expression, the naturalness, the movement of the muscles”, he says.

According to the Brazilian Society of Dermatology, the toxin begins to show results between 7 and 14 days after application. This effect lasts for about three to six months until it gradually wears off, while muscle action returns.

After application it is possible to feel pain and even swelling may appear around the injection site, but care must be taken not to press or massage the area in the hours after the procedure. In rare cases, patients may develop temporary weakness of neighboring muscles, headache, in addition to a drooping eyebrow and/or eyelid, also temporarily.

Romiti recalls that botulinum toxin has risks, like any procedure. “What we do is minimize risks with an adequate environment, a specialist professional. Without a medical evaluation, errors can include the material used, the dose, the points where the product is injected and the dilution of the toxin. catch or complications such as asymmetry, drooping eyebrows or eyelids, crooked smile can occur.”

In January of this year, a case of misuse of the toxin became famous. A dental surgeon in Porto Alegre (RS) was arrested in the act for using an illegal product, according to the state’s Civil Police. During searches in the office, bottles with the inscription Israderm and the indication of Israel as the country of origin were located. The manufacturer is not registered with Anvisa (National Health Surveillance Agency) and its use is prohibited in Brazil.