Can Botox and Dermal fillers make you smile?

A pleasing smile uplifts your spirits. Beautiful smile not just involves your teeth, it is a function of beautiful teeth, attractive lips and surrounding facial features. Folds, wrinkles and thinning of peri-oral skin, can make your smile less attractive.

You may then ask, Doctor! what can enhance my smile?

Well, Botox and Dermal fillers can magically transform your smile and make you look beaming with energy.

What is BOTOX?

Botox is a neurotoxin, that is obtained from Botulinum Toxin (BT), produced by anaerobic bacteria, Clostridium botulinum.

BT has two commercial forms available for therepeutic purposes – BT A (Botox, Dysport) and BT B (Myobloc, Neurobloc)

Botox blocks the release of acetylcholine at the synapse site of neurons and thereby, produces a dose dependent weakening of the muscle activity. This neuromuscular transmission is re-established due to the sprouting of new axons. Therefore, this approach of therapy is palliative and not curative.

Results of the treatment are conspicuous within 4-14 days and lasts for 4-6 months. For effective results, it is recommended, to get it 2-3 times a year. Botox can be used for therapeutic as well as cosmetic purposes.

Botox serves multiple cosmo-therepeutic purposes, some of which are :

  • Masseteric hypertrophy
  • Temporomandibular joint dysfunctions
  • Trigeminal Neuralgia
  • Siallorhea (Exccessive salivation)
  • Bruxism
  • Treatment of forehead lines
  • Treatment of gummy smile
  • Treatment of Marionette lines (Sad or reverse smile)
  • Treatment of assymetric smile

Forehead Lines

Treatment is based on: Expressivity, Muscle mass and Symmetry (comparison between brow height and width)

Intensity of muscle contraction varies in muscle function across individuals and should be considered while deciding for the dose of toxin administered.

The points for injection are detected by light palpation over the area, while the patient actively raises and lowers the eyebrows.

The precise location for injection should be 1.5 – 2 cm above the brows to prevent lid ptosis. The treatment for frontalis muscle decreases the horizontal lines. The combination of the three muscles (Frontalis, Corrugator supercilli and orbiculares oculi) affects the eyebrow shape and height.

Gummy Smile

Display of >2 mm of gingiva is considered a gummy smile. It is more commonly observed in women, compared to men.

Gummy smile due to pue muscle hyperactivity is visible as a normal incised exposure at rest but excess gingival display during smiling.

These three muscles (Levator labii superiors, elevator labii superioris aleque nasii and Zygomaticus minor) determine the vertical level of lip line upon smiling.

Botox injection is given at the Yonsei point. This point is situated 10 mm lateral to the alar base and 30 mm above the commissure of the lips. It relaxes the muscles, which in turn, pulls the lip.

Bruxism and Masseter Hypertrophy

The hyperactivity of the Masseter muscle causes clenching of teeth together and is often associated with grinding of teeth. The various other treatment options for this are orthodontic appliances and physiological exercises. However, if nothing works, the palliative treatment option is botox injection. This relaxes the Masseter muscle and relieves the pressure on the posterior teeth.

The cosmetic aspect of this is that the Masseter Hypertrophy creates a square face. The female face demands softer features. Botox relaxes the taut muscle and creates an oval face.

Botox doses differ with different treatment plans. All effects are reversible and last for 4-6 months.

Botox is a relatively safe practice. However, there maybe some reactions like

  • Allergic skin rash
  • Itch
  • Headache
  • Nausea
  • Diarrhoea
  • Loss of apatite
  • Neck and back pain
  • Muscle stiffness
  • Inadvertent weakness of muscles involved in swallowing and speech.
  • Sore throat
  • Ringing in ears

These reactions are injection site specific, more common with lateral pterygoid muscle, palatal and tongue muscle injections and are also dose dependent problems.

What are Dermal Fillers?

Dermal fillers are used to treat the signs of aeging, non surgically. These fillers contain ingredients that can be placed below the skin, and they re-plimp the thinned facial regions. The effects are short lived and last between 6 months to 2 years.
i. Needle is placed intradermally; ii. Fillers are injected; iii. Fillers plump up and smooths the skin

These fillers contain:

  1. Calcium hydroxyapatite
  2. Hyaluronic acid (Treating fine lines, wrinkles, acne scars, marionette lines and smoker lines)
  3. Polyalkylamide (Transparent gel)
  4. Polylactic Acid (Stimulates the skin to produce more collagen)
  5. Polymethylmethacrylate microspheres (A semisynthetic filler used to plump thin lines)

The Botox treatment aims at preventing muscle contraction, thereby bringing about a smooth and relaxed appearance.

Botox is also used for therepeutic applications.

Dermal fillers are substances that are placed below the skin, which swell up to fill in the superficial furrows of the skin and make it look healthier and supple.

Dermal fillers do not have any therepeutic applications.

What to expect?

The dermal fillers give almost immediate and natural results. However, slight redness can be expected 24-48 hours following an injection. Some patients might also experience a bruise at the site. These fillers can be felt under the skin for a couple of weeks, following an injection.

It is suggested that medicines like aspirin be avoided just before the appointment, as these medications are potential blood thinners and increase the risk of bruise and redness.

Fillers are mouldable under the skin and any physical activity that applies pressure on the face should be avoided for a couple of days. Tight ski goggles, swimming gear and the likes should be avoided. However, washing the face and applying makeup do not have enough force to cause any deformation.

It is important to understand that aeging is a dynamic process and cannot be stopped by means of any treatment. These are cosmetic treatments that are temporary and need to be repeated over a period of time to make the skin look smooth and supple. Having said this, opting for these treatments does not make you age faster. When the effects wear off, the eye is so used to looking at a flawless, smooth skin that the normal wrinkles seem to appear more.

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