Botulinum toxin

Botulinum toxin, popularly known as Botox, is one of the most commonly used substances in aesthetic medicine, primarily aimed at reducing facial wrinkles

Botulinum toxin – what is it?

Botulinum toxin, popularly known as Botox, is one of the most commonly used substances in aesthetic medicine, primarily aimed at reducing facial wrinkles – which are in many cases responsible for the menacing, tired or sad appearance of the face. Importantly, when done well, the treatments are quick, painless and safe, and provide a natural rejuvenating and relaxing effect to the entire face. Botulinum toxin is also a very effective treatment for hyperhidrosis, a problem that causes great discomfort in both men and women.

The popular term “Botox” comes from the proper name of the first botulinum toxin preparation registered for use in aesthetic medicine, which has simply become common over the years. However, there are several botulinum toxins on the market that are approved for aesthetic treatments, which we also use in our clinic. These are products such as Botox, Azzalure/Alluzience, and Bocouture. Choosing an original, medical preparation is very important, because there are many “toxins” of unknown origin on the market, which may not work or give unpredictable effects. In our clinic, we use only proven products registered as drugs.

What exactly is Botox? It is botulin, a toxin which, when administered in small concentrations, has a therapeutic effect and has been used in medicine (e.g. in ophthalmology) for several decades now – well studied and registered as a drug.

Get to know botulinum toxin treatment better

The procedure involves relaxing the muscles responsible for the formation of mimic wrinkles – botulinum toxin, administered by small injections, blocks the neurotransmitters released from nerve endings, which inhibits neuromuscular transmission. This prevents the muscle from tightening and “creasing” the skin into lines and wrinkles. Therefore, it is advisable for people with pronounced, disadvantageous facial expressions to have the treatment performed preventively before wrinkles become deeper and more permanent. In the treatment of hyperhidrosis, the toxin inhibits the release of acetylcholine from nerve endings, leading to a block in sweat secretion.

Botox has also been successfully used to alleviate the symptoms of migraines, fix gummy smiles, and treat bruxism (excessive clenching of the teeth).

The treatment can be performed on areas such as:

  • face (usually around the eyes and forehead),
  • armpits, hands, feet, scalp (treatment of hyperhidrosis).
  • horizontal forehead wrinkles,
  • wrinkles between the eyebrows, the so-called glabella lines,
  • wrinkles around the eyes, the so-called crow’s feet,
  • wrinkles in the lower part of the face, running from the outer corners of the mouth down the cheek and chin line, the so-called marionette lines,
  • wrinkles above the upper lip, the so-called smoker’s wrinkles,
  • wrinkles on the nose, the so-called bunny lines,
  • gummy smile,
  • the so-called cobblestone chin,
  • hyperhidrosis.

The effect of smoothing facial wrinkles lasts about 4-6 months, while the inhibition of sweating lasts slightly longer – about 6-9 months.

You will need to wait about 7 days for the full effect of botulinum toxin. During this time, the muscles are gradually relaxed, which results in shallowing and smoothing facial wrinkles. It is important to keep the effect natural – the aim is not to completely straighten out the wrinkles. Patients should look relaxed and rested after the procedure, but with natural facial expressions and mobility. Usually after 4 weeks we invite patients for a follow-up visit – then we can decide, for example, whether it’s worth injecting a little more of the product to enhance the effect.

Duration of the procedure

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The procedure is instant, usually taking about 15-30 minutes.

Pain intensity

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The procedure is virtually painless and in most cases does not require anaesthesia (except for cooling). You may only feel some tiny stings, like after a mosquito bite.


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The procedure does not require recovery; you can return to your daily activities immediately afterwards. However, you will need to follow the post-treatment recommendations.

Botulinum toxin – how does the procedure work?

The procedure is always preceded by a medical consultation and drawing of the precise areas of Botox administration on the face. It is very important because each patient has a slightly different anatomy, which can affect the results. Botulinum toxin is administered with a very thin needle. The procedure is quick and virtually painless. Finally, we apply a protective cream or foundation. 

In the case of treatments for hyperhidrosis, the procedure is preceded by a so-called Minor test (iodine-starch test), which allows the doctor to accurately determine the areas of excessive sweating. It involves spreading iodine on smooth, shaved skin and sprinkling it with potato starch. After a few seconds, dark spots appear on the skin, showing the areas of excessive sweating.

Botulinum toxin – how to prepare for the procedure?

The treatment does not require any special preparation, but a few days before the procedure, avoid taking anti-inflammatories that can reduce blood clotting (such as the popular Aspirin), as they can increase the risk of bruises and haematomas after the injection, Do not consume coffee or alcohol on the day of the procedure. If you are prone to herpes, it is recommended to take protective medication as a preventive measure.

“Botulinum toxin is literally a magic wand in aesthetics! The short and almost painless procedure can make a person who looks perpetually tired, menacing, puzzled or saddened suddenly regain a cheerful, fresh and rested facial expression. I can’t imagine the work of an aesthetic physician without botulinum toxin.”

Dr Barbara Jerschina

Botulinum toxin – recommendations after the procedure

The skin after the procedure may be slightly reddened, and small bruises may appear, but usually the symptoms are almost invisible and easily concealed with makeup. There is no swelling typical of filler treatments, for example. However, the administration of botulinum toxin requires absolute adherence to post-treatment instructions, thus avoiding complications and unwanted side effects, such as eyebrow drooping. Thus:

  • to avoid displacement of botulinum toxin, do not lie down or bend over for a minimum of 4 hours after treatment,
  • do not massage or apply pressure to the skin at the Botox injection site,
  • do not get on an airplane for 24 hours (the pressure difference could also cause the product to shift),
  • avoid the gym, swimming pool and intense exercise for a few days,
  • as well as high temperatures, i.e. exposure to the sun, saunas or tanning beds,
  • also, do not drink alcohol (even a glass of wine) for 3 days, as it may cause the botulinum toxin to be deactivated (it will stop working).

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FAQ – frequently asked questions about botulinum toxin

Botulinum toxin is one of the most popular aesthetic medicine treatments, which perfectly complements the effects of other medical and cosmetological methods. As we always emphasise, proper cleansing and refreshing of the skin with Silk Peel, Aquapure, Hydrafacial or Geneo is recommended. The good skin condition is the basis of a nice appearance, and if you do not take care of it, the removal of wrinkles will not provide the desired effect. After botulinum toxin administration, we usually wait about 2-3 weeks before performing other treatments. Come in for a consultation with Dr Barbara Jerschina, who specialises in anti-ageing programmes and will carefully plan a treatment programme for you so that it is safe and effective.

If unskillfully administered, yes, it can! Just look at the many Hollywood stars who cannot move their eyebrows or forehead, giving them an artificial appearance. For this reason, it is advisable to have treatments performed by experienced physicians who have a thorough understanding of facial anatomy and expressions, as well as the effects of botulinum toxin, so that the results are natural and rejuvenating. Come in for consultations and treatments with Dr Barbara Jerschina!  

Mesobotox is a combination of hyaluronic acid mesotherapy and botulinum toxin in one treatment. This immediately offers two benefits: moisturising and smoothing the skin, thus improving its overall appearance. In addition, patients observe reduced sebum secretion, so the procedure is well-liked by young people and during the summer. The dose of botulinum toxin here is smaller than in a traditional procedure.

Indeed, by using botulinum toxin regularly we wean the muscles from working, so to speak, which may result in longer-lasting effects in some patients. Usually, however, the treatment needs to be repeated every 4-6 months. Yet, it cannot be done earlier than 3 months, because then antibodies can develop and the Botox will simply stop working.

Many patients desire such an effect, and indeed it can be achieved by injecting Botox into the central part of the forehead. However, the procedure must be performed very carefully and requires a great deal of experience so that no undesirable effects occur, such as a demonic eyebrow lift (known as Mephisto sign) or drooping of the upper eyelids.

  • Pregnancy and breastfeeding
  • Inflammation of the skin at the treatment site
  • Active herpes
  • Cancer diseases
  • Unregulated autoimmune diseases
  • Advanced diabetes
  • Keloid scar tendencies
  • Allergy to the ingredients of the preparation
  • Taking medications that reduce blood clotting
  • Therapies with steroids or immunosuppressants
  • Epilepsy
  • Acute arthritis and muscle disease
  • Heart or kidney failure

If properly performed, the procedure is safe and carries very little risk of adverse effects. Bruises rarely appear, and if they do, they are small and easy to conceal. Most patients are concerned about unwanted aesthetic changes, such as eyebrow lifts, asymmetry, and frozen facial expressions. That is why we invite you to treatments with Dr Barbara Jerschina, who is very experienced in the use of botulinum toxin and makes sure that the treatments give a natural and simply beautiful rejuvenation effect. At our clinic, you will also get precise instructions on how to care for your skin after the procedure – it is also very important for getting the desired results. We encourage you to visit us!

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