Botulinum toxin

Botulinum toxin is an injectable substance that temporarily reduces the activity of certain facial muscles. The public most often knows it by a brand name — Botox is the most widespread — but it is first and foremost a medicine, and that is what strictly governs its use.

A medicine subject to restricted prescription

For aesthetic purposes, botulinum toxin falls under a marketing authorisation that reserves its prescription and administration to certain medical specialities. This framework is set by the French National Agency for Medicines and Health Products Safety (ANSM): it depends neither on the practice nor on the practitioner’s wishes, and it applies in the same way throughout France.

This information is rarely given to patients, although it explains a great deal: it says why not every aesthetic physician offers this procedure, and why the question is worth asking before booking an appointment.

What this means in practice

The procedure can be carried out at the Clinique Phénicia, where I practise. The indication, the areas concerned, the injection technique and the possible alternatives are assessed and discussed in consultation — and it is also during that discussion that the practitioner authorised to perform the procedure is specified.

A prior consultation is therefore necessary in every case, and it may conclude that the procedure is not indicated.

What botulinum toxin does

Expression lines arise from the repeated contractions that accompany facial movement; by easing this muscular activity, the injection aims to soften their relief, without freezing or suspending the expressiveness of the gaze. The effect remains temporary and fades gradually; both its onset and its duration vary from one person to another.

The areas concerned lie mainly in the upper part of the face: the forehead, the region between the eyebrows — commonly called frown lines — and the outer corners of the eyes, the crow’s feet. Other indications may be discussed according to the clinical examination. This approach addresses lines linked to muscular contraction; it is not suited to every request, and some situations call for different management, or for no procedure at all.

Precautions, contraindications and after-effects

Contraindications are checked for systematically, in particular in the case of pregnancy, breastfeeding, certain neuromuscular conditions or certain ongoing treatments.

After-effects may occur at the injection points: redness, swelling, bruising, a feeling of tightness or headaches, the intensity and duration of which vary from one situation to another. Other effects, such as an asymmetry or the lowering of an eyebrow or an eyelid, may also occur and are set out during the prior consultation, together with the taking of consent.