Dr. De Fazio Plastic Surgeon :: Procedures :: Face :: Removing crow's feet and face wrinkles using botulinum toxin fillers

Botulinum toxin


Botulinum Toxin is a neurotoxin, which has been used for about 10 years in both Ophthalmology to treat Strabismus and Neurology to cure Hemifacial Spasm.
Some years ago the use of Botulinum Toxin has become a standard and its use in cosmetic medicine and surgery has been authorized by the Ministry of Health to treat frown lines, in particular the ones between the eyebrows.

a few minutes

The procedure

The injection of Botulinum Toxin is an outpatient treatment, which does not require local anesthesia in the area to be treated.
The effect of the Botulinum Toxin is to weaken the affected muscles by peripheral facial nerve palsy (paralysis), and, as a consequence, the muscle cannot contract and the overlying skin is stretched.
The effect of the injection is temporary. It appears 3-7 days after the injection and can last from 3 to 6 months.
It is an outpatient treatment consisting of small injections.

After the procedure

The Botulinum Toxin procedure is a minimally invasive and outpatient treatment, giving a very good result in smoothing frown lines, especially wrinkles in the upper third of the face (glabellar lines, horizontal forehead lines and crow's feet).

Contraindications (conditions to withhold the treatment)

Absolute Contraindications:

  • Known hypersensitivity to any of the components (botulinum toxin, human albumin, sodium chloride)

  • Neuromuscular diseases (such as myasthenia gravis, etc...)

  • Patients treated with aminoglycoside antibiotics or Spectinomycin

  • Presence of infections or inflammation in the area to be treated

  • Pregnancy and breastfeeding

Relative contraindications:

  • Coagulopathy, including the anticoagulant therapy

  • Low patient's compliance

Possible complications

The side effects are normally minimal: occasionally swelling and small hematomas in the injection site might occur, but they subsidize within a few days.

In rare cases, the adjacent muscles can be also weakened, causing a small Ptosis (one eyelid slightly more closed than the other), but this condition is reversible within a few weeks (2-5). Sometimes, the eyebrows might become slightly asymmetric, but they can be corrected with the same filler.

Recovery time (back to social life)

Immediate. After the injection, it is important not to massage the treated areas for at least 4 hours, not to exercise on the day of treatment, avoid lying down or bend the head downwards for about three hours after surgery.