Botulinum Therapy

Botulinum therapy involves injections of botulinum toxin type A products that relax individual facial expression muscles. When a muscle contracts less strongly, the skin above it stops creasing and wrinkles smooth out. At Medest, the procedure is performed by cosmetic dermatologists: they first assess your facial expressions and skin condition, then mark the injection points and determine the dose.

Common concerns

• horizontal lines and creases on the forehead;
• frown lines between the eyebrows and on the bridge of the nose;
• crow’s feet at the corners of the eyes and fine lines on the cheekbones;
• lines around the mouth, downturned corners of the lips;
• asymmetry of the eyebrows and facial expressions;
• excessive sweating (hyperhidrosis).

Botulinum therapy works on wrinkles caused by muscle activity. If a fold is related to volume loss or sagging skin, the doctor may suggest a different method, such as facial contouring with fillers or biorevitalization, or a combination of procedures.

How the product works

Botulinum toxin temporarily blocks the transmission of nerve impulses to the muscle in the injection area. Facial expressions are not switched off completely: the face stays mobile and expressive, movements simply become softer, and the skin creases less.

Over time, new nerve endings form and muscle tone gradually returns, which is why the effect is temporary. The effect usually becomes noticeable within a few days, and the final result is assessed after about two weeks. On average, the effect lasts 3–4 months, and in some patients up to 6 months or longer. How long it lasts depends on the area, muscle strength, dose, and individual factors.

What the procedure involves

• the doctor asks about your health and any medications you take, and asks you to frown, raise your eyebrows, and smile to see which muscles are more active;
• marks the injection points and calculates the dose for each area;
• the skin is cleansed and treated with an antiseptic;
• the product is injected at several points with a very fine needle;
• after the procedure, the doctor gives recommendations for the next few days.

The sensations are usually tolerable: just brief needle pricks. Redness and small bumps at the injection points usually fade quickly; occasionally a small bruise may remain. For the first few days, patients are usually advised not to massage the injection area, not to bend over for long periods, to avoid baths and saunas, and to postpone intense workouts. The doctor gives exact recommendations after the procedure.

How many sessions and when to expect results

One procedure is usually enough to smooth expression lines. Once the effect wears off, it can be repeated. How often to repeat it and what dose to use is decided by the doctor at the consultation, based on how your muscles responded last time.

Who performs the procedure

Sona Vaganovna Harutyunyan — dermatologist and cosmetologist with 20 years of experience. She graduated from Mkhitar Heratsi Yerevan State Medical University and completed a clinical residency in dermatocosmetology. She is a certified specialist in botulinum therapy.

Marina Eduardovna Shishmanyan — dermatologist-venereologist, dermatocosmetologist, and chief physician of the clinic, with 18 years of experience. She graduated from Mkhitar Heratsi Yerevan State Medical University.

How to prepare

• tell the doctor about any chronic conditions and medications you take, especially antibiotics;
• let the doctor know whether you have had botulinum therapy before and how long the effect lasted;
• if you have a cold or inflamed skin in the injection area, it is better to reschedule;
• it is best to avoid alcohol the day before and on the day of the procedure.

Learn more in our blog articles: botulinum therapy for excessive sweating and botulinum therapy after 60.