Facial expressions is one of the non-verbal ways of showing our emotions using the muscles of the face, that through time and continuous gestures mark the surface of the skin first as expression lines and then permanent marks called hyperdynamic wrinkles.

Botulinum Toxin is a biological product with many years of existence, widely used in medicine for different conditions such as blepharospasm, and hemifacial spasm, but it is also widely used in aesthetics for the treatment of these unsightly lines and wrinkles on the face and neck. 

 What do we want  with the use of the toxin? Is it the same to relax and paralyze?

  • Relax: is to reduce or decrease the force, the activity of contraction of the facial muscles, but continuing with a more controlled, more beautiful movement.
  • Paralyze: it is to completely stop the movement of the facial muscles without the ability to contract it again.

With Botulinum Toxin the key is to look for  modulation of muscle action, to relax but not disappear the contraction of the muscles and thus slow down the progression of dynamic wrinkles responsible for expression lines, angry face, or the drooping eyebrows.

Areas of Application:

  • Front.
  • Frown (frown).
  • The tail of eyebrows, to raise them.
  • Periocular area .
  • Nasal dorsum (bunny lines).
  • Nasal tip (lift it).
  • Angles of the mouth (raise them).
  • Chin (relax it).
  • Mandibular ridge (Nefertiti effect).
  • Platysmal bands (neck).

Other Application Cases:

  • Gummy smile.
  • facial paralysis 
  • facial asymmetries.
  • Masseter hypertrophy.
  • Hyperhidrosis of the hands, feet, and armpits.
  • Others.


  1. Simple, fast, and painless.
  2. Ambulatory procedure.
  3. It takes 20 minutes.
  4. It does not require anesthesia.
  5. It does not require rest, the patient can return to normal activities almost immediately.


The effect of muscle relaxation begins after 2-4 days, being maximum after 7-14 days and lasts for 3-5 months (exceptionally its relaxing effect  can exceed 6 months).

The relaxing action of Botulinum Toxin in the treated muscles is extremely beneficial but it is very important to understand that there are muscles near the worked areas that have not been treated and that can modify their contraction pattern, so it is essential to evaluate the patient to 8-12 days after treatment to analyze the results.

Before the Procedure:

  1. The first thing is consulting  a doctor trained in these application techniques, who knows the static and dynamic facial anatomy, and who has solid training in the injection technique.
  2. Evaluation  of facial expressions, age, muscle level, and skin flaccidity to determine the appropriate dosage for the patient, normally between 25 and 50 units are used depending on the areas to be treated and the brand of the product as they exist in different dosages. 


  1. The face is cleaned neatly and the hair is collected.
  2. Marking with a special pencil the areas to be treated by palpating the muscles to assess their thickness and strength, for example, the frown.
  3. Study the maximum muscle contraction. It is important to frown well, close your eyes tightly or force your lips forward while pursing them as much as possible to assess perioral wrinkles.
  4. It is not recommended to put local anesthesia injected on the areas to be treated, it is better to use local cooling devices to avoid pain.
  5. Application in each point (muscle) to be treated by placing the decided dosage through microinjections with a very thin needle.
  6. Thicker and more powerful muscles will require more TB units and men will require a higher dose than women since their contraction force is greater.

Post Application Recommendations:

  • After the treatment, it is recommended not to massage the application areas or rub the area, to prevent it from spreading to unwanted areas.
  • Do not  exercise during the first 4 hours after treatment.
  • It is recommended to stay in an upright position and not lie down for the first 4 hours after application.
  • You may notice a small reddish or swollen spot that will last about 2 to 5 hours, it is a normal reaction and will disappear. You do not need to take any medicine to control this reaction. 
  • Sensations such as headaches or local pains can also occur after application, especially after the first time, it occurs in very few cases as an infrequent and temporary effect. 


  • Neuromuscular diseases such as myasthenia gravis, multiple sclerosis. Active skin infections at injection sites.
  • Known hypersensitivity to albumin or egg proteins.
  • Pregnancy, breastfeeding.
  • Use of drugs such as aminoglycosides, magnesium sulfate, or quinine.