Dr. Mark Lim
September 1, 2022
3 mins

Is botulinum toxin becoming obsolete?

Fine lines, wrinkles, saggy skin – these are just a fraction of age-related concerns aesthetic medicine can treat.

In the past, patients were limited to just a handful of treatments – think botulinum toxin, conventional dermal fillers and even plastic surgery (i.e. facelifts). 

Today, we’re spoiled with newer, sexier treatments all seemingly marketed to do the same things botulinum toxin can, and even more (yes, it’s all about collagen biostimulation these days). 

Does this zeitgeist signal the end of botulinum toxin's era? Is botulinum toxin truly replaceable? Let’s find out. 

What is botulinum toxin, and how does it work?

Botulinum toxin are neurotoxins, and the primary aim is to block nerve activity in the muscles and relax them. 

What can botulinum toxin treat?

Botulinum toxin is commonly used for; 

  • Relaxing facial muscles to reduce wrinkles and dynamic lines in areas like the horizontal forehead lines, frown lines, crows feet[1]
  • Slimming the face (from relaxing and shrinking the jaw muscles over time)
  • Improving the jawline from platysma treatments.
  • Treating hyperhydrosis (e.g. sweaty palms, sweaty armpits)
  • Body contouring; specifically the shoulder and calves 
  • Reducing oily skin and refining pores 

Aesthetics aside, botulinum toxin is also FDA-approved for treating migraines and overactive bladder syndrome. 

Botulinum toxin vs fillers: Which is better?

This is a very commonly asked question. Botulinum toxin and fillers are 2 very different treatments.

The role of a filler is to fill or replace volume. If injected superficially, fillers act as skinboosters to provide hydration (lack of moisture) and can help with skin texture concerns such as fine lines or open pores.

In this instance, skinboosters and botulinum toxin can address similar problems. However, ONLY botulinum toxin helps with dynamic /movement lines whereas fillers can improve the appearance of static lines (lines present at rest) 

Here are a few common indications and how botulinum toxin and/or fillers come in: 

  1. Jaw slimming and body contouring – only botulinum toxin can address this. 
  2. Frown lines – As areas with frown lines are considered high risk areas for filler treatment, these areas are best addressed with botulinum toxin. 

With that said, there are a few areas both treatments can overlap, such as skin texture improvements i.e. smoker lines, crow’s feet, static forehead lines. Your doctor will be able to advise whether combining both treatments work better for you. 

How about other anti-aging treatments?

When choosing between other popular anti-ageing treatments and botulinum toxin,  patients tend to be wary of botulinum toxin due to their perceived “negative social stigma” oh she’s got botulinum toxin she’s so fake etc . 

Fact is, botulinum toxin is a safe and very effective treatment with no long term or life-threatening adverse effects[2]. It doesn’t require any loading (more sessions at the start) and results can be natural if done by an experienced injector.

As mentioned, botulinum toxin can prevent the development of static lines in the forehead, glabella (Frown area) and crow’s feet. It does not change the shape of your forehead. 

‘Stiff’, ‘expressionless’, and ‘frozen’ are common terms associated with botulinum toxin use. Understandably, these unpleasant side effects came from a time when patient and physician education was lacking.

Today, the notion of having a frozen upper face is no longer in vogue. Experienced injectors are using lesser toxins per treatment and often combining other treatments to allow patients to retain some facial expression. This can be in the form of skinboosters, collagen stimulators and even energy-based devices (Picosure Pro, Potenza) 

Can botulinum toxin be used long term?

Yes! While there has been some adverse events (botulism) noted from botulinum toxin for medical use (i.e to treat spastic muscles and large amounts are being used per session), such side effects are very unlikely in cosmetic use. 

When you stop doing botulinum toxin, the muscles gradually regain their action. Your skin condition may gradually return to its normal state but it will be less severe compared to a botulinum toxin naive patient. 

As we age, we lose collagen/elastin in the skin, our bone structure changes, we lose fat/ volume as well. With these changes come wrinkles, hollows and change in the shape of our face. Holistic treatment involve a variety of treatments including filler injections to recreate our youthful appearance.

To sum up

Botilunum toxin when used appropriately can be very effective depending on your concerns. What’s more important, however, is choosing an experienced doctor who can advise on the best treatment for you, individualise treatment to your needs and administer that treatment safely. 

Any questions? Feel free to drop me a message and I’ll be happy to help. 

Consult our specialists
From The Artisan Fue Hair Clinic in Singapore

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