Botox makes wrinkle-free skin a reality

Maria Endah Hulupi, The Jakarta Post, Jakarta

Smooth, youthful wrinkle-free skin is everyone's dream. And thanks to botox injections, it may no longer be just a dream.

The treatment which is very popular in the United States, has also gained popularity among celebrities and beauty conscious people here.

"Botox has become a popular treatment since it's effective to smoothen wrinkles, has minimal side effects and the injection technique is also uncomplicated," said Jakarta Skin Center director Aryani Sudharmono during a recent seminar, held at Sari Pan Pacific hotel, Central Jakarta.

For two centuries, Botox, short for botulinum toxin type A, has been known to cause botulism, a fatal food poisoning that can lead to muscle weakness, paralysis, impaired vision and death. However, small dosages of Botox have been used in ophthalmologic and neurologic therapies to treat muscle spasms over the past 20 years.

For cosmetic purposes, Botox is injected into the skin to prevent the formation of wrinkles by minimizing contraction of the upper facial muscles caused by expressions like frowning, blinking and squinting. As time goes by, those facial expression lines will become tangible wrinkles and creases that appear in the forehead, frown lines and at the outer corner of the eyes, known as crow's feet.

Injecting facial muscles in those particular areas will help paralyze the muscles and several days after the Botox injection, wrinkles will gradually fade away while the creation of new ones is inhibited.

Aryani, a dermatologist herself, explained that Botox works by inhibiting the release of acetylcholine, a substance required in muscle contraction.

The targeted upper facial muscles for this treatment are the frontalis muscle (which enable brow elevation, leading to horizontal forehead lines), corrugator superciliary (that pull eyebrows medially, causing frown lines), procerus (that lower eyebrows, causing glabellar frown lines) and orbicularis oculi (that lead to crow's feet).

During the injection, doctor presses the area near the injection site to prevent the fluid from running to unwanted sites.

"The treatment will take about 10 to 15 minutes and after several days, the patient can notice the difference," Aryani said.

Several hours after the procedure, a patient should occasionally contract the treated muscle, or attempt to frown in order to enable the injected Botox to bind and internalize into the target muscles. The patient also has to remain in a vertical position, like sitting and avoid lying down or massaging the area to prevent the diffusion of the liquid to the surrounding areas.

"The effect (of the Botox injection) lasts for six months and can be repeated when needed," Aryani added.

Botox, she said, is particularly effective to smoothen wrinkles at the upper face area, commonly caused by hyper muscular contraction that can lead to the creation of fine lines, regardless of a person's age.

"But it won't help much for wrinkles that occur due to the thinning of the epidermis and dermis layers," said the dermatologist.

Potential side effects following the procedure include temporary swelling or redness in the injected sites, and a rare incidence of double vision. While unlikely, undesired results include loss of facial expressions, lid ptosis (a drooping of the upper eyelid), brow ptosis, like brow droop or quizzical brows that resemble those of sci-fi Startrek movie character Mr. Spock, which can be corrected or may disappear naturally after several weeks.

However, to avoid side effects and undesired results, a specialist performing the injection has to have thorough knowledge of the dosage, must handle Botox properly to maintain its potency and must to be able to understand the complex facial muscle anatomy, she explained.

"Given the complexity of the upper face muscles, it is advisable to seek professional help or find credible clinics to avoid those undesired effects," Aryani said.