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BOTOX:  A friend told me that her friend who is not a doctor,

apply Botox, and very Cheap. Let's analyze the risks

by Doctor Luis Carlos Moreno

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Botox (onabotulinumtoxinA), which is how the treatment is popularly known, is actually a trademark  of botulinum toxin that was the pioneer in the production of botulinum toxin type A, for cosmetic uses. The real name of the treatment is application  Botulinum toxin.  But what is botox really?  


It is a neurotoxic protein (that damages the nerves of the muscles) that is produced by the bacteria known as Clostridium botulinum, bacteria that cause the disease known as botulism.


This toxin is processed, purified and prepared for use for cosmetic purposes, an application that was approved since 2002, to reduce wrinkles on the forehead, peri-ocular, crow's feet, chin and neck wrinkles. Since 2004 it has been approved for the treatment of axillary and hand hyperhidrosis, which is the excessive sweating that occurs in some people.

Ancla 1

The toxin once applied blocks nerve transmission to the muscle, causing flaccidity or paralysis of the muscle.  By paralyzing the muscle or reducing its strength, the wrinkles that these muscles can produce in the skin are smoothed or disappeared.


The muscles of facial mimicry can have effects of raising the eyebrows or depressing the eyebrows, so by controlling these muscles it is possible to raise the eyebrows in patients who have drooping due to aging. The effect of botulinum toxin is reversible since over the months the nerve recovers and the innervation of the muscle is reestablished, recovering all its function.

For the effect of applying botulinum toxin type A to be adequate, the strength of the muscle and its effect on facial wrinkles must be assessed.  The effect of the toxin on the muscle is dose dependent, that is, not all muscles require the same dose of toxin to have a good and lasting effect, and not all patients require the same dose of application in each muscle.  


This dose is determined by the physician by evaluating the various muscles of the patient.

Riesgos del Botox mal aplicado, Doctor Luis Carlos Moreno

Another factor that influences the result is the degree of dispersion of the toxin at the time of its application.  

Dispersion is the displacement of the toxin from the site of application to another neighboring muscle.  

The dispersion has been determined to depend on several factors:  the type of botulinum toxin used, the dilution and the volume applied. Botulinum toxin type A is sold in crystallized form and stored at temperatures of at least -5 degrees Celsius or lower.  

The toxin is heat labile, that is, it is affected by an inappropriate temperature.  Storing the toxin at temperatures above -5 degrees Celsius produces inactivation and therefore poorer and shorter-lasting results.  

The dose applied also affects the result and duration of the effect. A low dose for what the patient needs will give a poor result and a very short duration. Before applying the toxin, it must be reconstituted with normal saline without preservatives. The dilution is always recommended by the manufacturer.   

Altering this dilution will produce less strong effects, of short duration and may induce a greater dispersion of the toxin, affecting neighboring muscles that we do not want to be affected.

Riesgos del Botox mal aplicado, Doctor Luis Carlos Moreno

Once Upon a time

But the most important thing is that, if by ignorance the botulinum toxin is applied in a blood vessel, be it arterial or venous, the effects of the toxin will be produced in distant muscles, which can even compromise the life of the patient. How can a person who is not a doctor know the location, depth, effect of a specific muscle that he wants to treat? Ignorance of anatomy  by the person who applies the botulinum toxin is a serious factor and of great irresponsibility  for the damage it may cause to the patient. Even a doctor who is not trained or qualified to apply cosmetic treatments is also risky and can cause unwanted complications of the treatment.


Treatment with botulinum toxin A produces excellent results, which rejuvenate the patient's skin, which, although temporarily, application every six months, maintains the results for a long time. But for this to happen, the application must be done by  qualified medical personnel trained in these techniques. Therefore, the application of botulinum toxin,  It is the most performed non-surgical cosmetic procedure in the world.

Riesgos del Botox mal aplicado, Doctor Luis Carlos Moreno
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