Botulinum toxin Injections, Wrinkle Treatments

Wrinkle removal and gaining young look can be reached without surgical treatment, with no scars by application of Botulinum toxin type A. It is a cosmetic form of product of bacterium Clostridium botulinum. It can be used for treatment of wrinkles on the forehead, root of the nose, outer corners of eyes and by reduction of wrinkles on the neck. The treatment takes 5-10 minutes, it is an outpatient procedure without anesthesia. The final effect stays for 3 months, application can be repeated after some time.

What is botulinum toxin and how does it work?

Botulinum toxin or “sausage poison” is a substance produced by the bacterium Clostridium botulinum. At first it was used in ophthalmology and neurology. That's when it was discovered the toxin could be used to diminish wrinkles and stop sweating. The amount of applied substance in cosmetology is 1000 times lower than the toxic dosage. The actual effect of botulinum toxin consists of the blockage of nerve-endings; the muscle is de-nerved and no nerve impulses can affect the area. It is practically “numb,” although over time the muscle does regain its nerve impulses. The effect of botulinum toxin is not permanent.

Are you a good candidate for wrinkle removal using botulinum toxin?

The two barriers to receiving a botulinum toxin application are pregnancy and lactation. Although most moms probably aren't too worried about wrinkle removal. If you suffer from any nerve diseases, certain allergies and hemophilia also prevent you from using botulinum toxin.

The botulinum toxin procedure

Botulinum toxin is an out-patient procedure that takes several minutes. The actual application takes 5-10 minutes. It is performed without anesthesia but the treated area may be cooled with a frozen compress. The solution is applied with a thin needle under the skin in the specific wrinkled area. The most common place to receive botulinum toxin is the forehead and the area around the base of the nose and around the eyes. An experienced surgeon is able to work in small areas, and to treat even the beginning of wrinkles in the area of the upper lip.

After the botulinum toxin procedure

Folowing your botulinum toxin application, you should not lie down for four hours after the procedure. This is so the toxin won’t, for example, get in the eyes and perhaps cause drooping eyelids. The patient should also not wear cosmetics, visit a solarium, receive a massage, etc.

Does botulinum toxin ever not work?

Yes, in rare cases, the botulinum toxin does not have any effect. These patients may have developed antibodies in the past through a small intoxication of the poison. There are also documented cases of antibodies being created by very frequent applications. In these cases, another type of botulinum toxin might work.

How long does botulinum toxin last?

The effect of the substance after the first application lasts approximately three months, after the second one around half a year and after the third application approximately 9-12 months. The more the substance is applied the longer the effect lasts. However, the effect of botulinum toxin can't be guaranteed for more than a year. Many clients return once a year, or even better, learn not to use specific muscles and therefore the period between the treatments is prolonged. Boutulinum toxin application in the same area is not recommended more than twice a year (except in the first year.) In case of very deep wrinkles or defected collagen fibres, total wrinkle removal cannot be expected, but only a wrinkle reduction. Here it is possible to combine the botulinum toxin with a suitable filling material, for example collagen or hyaluron acid.

Botulinum toxin


  • Reduction of laugh wrinkles

  • Relaxation of frown wrinkles

  • Reduction of fan wrinkles

  • Relaxation of an unwanted facial expression (e.g. turned-down corners of the mouth)

  • Treatment of hyperhidrosis – excessive sweating (axillae, palms, soles and face)

Duration of the effect:

Temporary (3 – 9 months).

Duration of the treatment:

Maximum of 10 minutes.

What is botulinum toxin?

Botulotoxin A (BoNT - A) is a substance that relaxes muscles. It has been used in medicine for a number of years now and is the most important component of both botulinum toxin. A special feature of these substances, which are applied by injection, is that they act directly on the cause of wrinkles, namely muscular activity. When botulinum toxin is injected into a muscle, it temporarily blocks the nerve impulse that causes muscle contraction. The substance therefore acts more effectively against mimicry wrinkles than skin implants do. In addition, it prevents the formation of new wrinkles. The wrinkles become less apparent or disappear completely. Although botulinum toxin do not have a permanent effect, the treatment can be repeated without difficulty.

The treatment

The application of botulinum toxin is completely painless. The doctor uses a thin injection needle to introduce the substance into the muscle that causes the wrinkle or unwanted facial expression. The injection produces only a slight burning sensation. Immediately after the treatment, the skin is slightly reddish and swollen. These effects disappear after about an hour. You don’t need to take any time off work and can appear in public almost immediately after the treatment.


The results of the treatment appear after three to six days. The skin is visibly relaxed and the wrinkles are shallower. The effect is optimal after fourteen days, and lasts three to four months. The more frequently the treatment is repeated, the longer the effect (from six to nine months.)

This text has been created with the kind assistance of Pavel Krejzlik, M.D.

Updated: 2019-07-19

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