Give Me Clinic

Contour and lines

The lines relax, your expression stays yours

BOTULINUM TOXIN

We ease the muscles that fold the skin

We inject the forehead, between the brows and around the eyes, the places that fold again and again when you make an expression. The muscle starts to lose strength 3 to 4 days after the injection. The effect settles at around two weeks. While the muscle moves less, the folds that had been forming smooth out. The effect lasts 3 to 6 months.

AT A GLANCE

  • Procedure timeAbout 10-20 min
  • IntervalReviewed after 2-4 weeks
  • AnaesthesiaNone
  • DurationAbout 3-6 months
  • 4typesBotulinum toxin preparations we choose from after the examinationCoretox, Xeomin, Allergan, Korean botulinum toxin
  • 5stepsThe order we work through before setting a doseExpression, muscle, history, planning, review
  • 2weeksWhen you come back so we can check the responseWhether a top-up is needed is judged then

INFORMATION

Treatment overview

Method
The dose is divided across injection points in each area
Preparations used
Korean-made and imported preparations, chosen after the examination
Facial areas
Forehead, between the brows, eye area, mouth corners, jaw, chin dimpling, neck lines
Body areas
Trapezius, upper arms, thighs, calves, salivary glands, heavy sweating, underarm odour
Return to routine
You can wash your face, wear make-up and go to work the same day
Repeat treatment
Decided at a further examination, once the effect starts to fade

PRODUCTS

Products

The botulinum toxin preparations we choose from after the examination.

  • CoretoxA Korean-made preparation produced with the non-toxic accessory units removed. It is designed to lower the chance of antibodies forming.
  • XeominA formulation with the accessory proteins removed. We consider it where a previous treatment gave a reduced response.
  • AllerganA preparation with a long clinical record and a body of data behind it. Reports on how long it holds in repeated treatment are comparatively numerous.
  • Korean botulinum toxinA botulinum toxin type A preparation licensed by the MFDS. We consider it according to the area and the maintenance cycle.

Click to enlarge

Front-facing portrait image marking the areas covered in a facial consultationForeheadBetween browsEye areaNasolabial, mouthJawNeck lines

FACE

Where we inject on the face

We inject the forehead, between the brows, around the eyes, the nasolabial folds, the mouth area, the jaw and the neck lines. Each area uses a different muscle pulling in a different direction. Reduce the strength of one area and a neighbouring muscle can take over, making another line more visible. So we look at the whole face first, then set the dose for each area.

Full-body portrait image marking the body areas covered in a consultationTrapeziusUnderarm odourUpper armsThighs, calvesHeavy sweating

BODY

Where we inject on the body

We inject the trapezius, the upper arms, the thighs and the calves to reduce muscle bulk. For heavy sweating and underarm odour we inject to reduce the signal reaching the sweat glands. Muscle thickness and depth differ from area to area, so we work out the injection depth and the spacing of the injection points again each time.

HOW THE TOXIN ACTS

How botulinum toxin acts on muscle

What happens in the body after the injection, and how long it lasts.

  • It reduces the nerve signalIt reduces the release of acetylcholine from nerve to muscle. A muscle that receives less signal moves less for a period of time.
  • We inject the face and the bodyOn the face we inject expression lines on the forehead, between the brows and around the eyes. On the body we inject well-developed muscles such as the jaw, the trapezius and the calves. For heavy sweating and underarm odour we inject to reduce the signal reaching the sweat glands.
  • Strength drops from day 3 to 4There is no change right after the injection. The muscle starts to lose strength from day 3 to 4, and the effect settles at around two weeks. That is why we check the response at two weeks.
  • Movement returns in 3 to 6 monthsDepending on the area and the person, movement returns to how it was over 3 to 6 months. To keep the effect, you need another treatment.

PROCESS

We look at the muscle before setting the dose

Even in the same area, muscle size and strength and the habit of holding an expression differ from person to person. Here is the order we work through during the examination.

  1. 01We watch the expressionWe look at your face relaxed, then while you make an expression. We separate a fold caused by muscle from a shadow left by lost volume. If volume is the cause, we point you to a different treatment instead of botulinum toxin.
  2. 02We check muscle size and strengthFor bulkier muscles such as the jaw and the trapezius, we check thickness and borders by hand while the muscle is engaged. It is not unusual for the two sides to differ in size.
  3. 03We go through your treatment historyWe check when you were treated, with which preparation, and how many units. We also check whether the effect has ever seemed reduced. This is the basis for choosing the preparation and setting the interval.
  4. 04We plan the dose and the injection pointsWe set the number of units each area needs, along with the number and depth of the injection points. Where the two sides are not symmetrical, the dose is set differently on each side.
  5. 05We treat, then reviewThe procedure takes 10 to 20 minutes. Come in at two weeks and we check the response, and top up with a small amount if it is needed. We do not give a large dose from the start. We check first, then add.

RECOMMENDED FOR

When we inject botulinum toxin

Even if none of these apply, we will look into the cause with you at the examination.

  • If lines form on your forehead, between your brows or around your eyes when you make an expression
  • If a well-developed jaw muscle makes the lower face look angular
  • If a thick trapezius makes the neck look short and the shoulders heavy
  • If you would like the muscle contour of the calves or upper arms to look softer
  • If sweating and odour make daily life uncomfortable
  • If a previous botulinum toxin treatment wore off sooner than it used to
  • If a long recovery is difficult and you need to be back in your routine the same day

CAUSE & CARE

We match the treatment to the cause

  • Fine lines → skin boosters and regenerative injectionsBotulinum toxin does not work on fine lines that come from thin, less dense skin rather than from muscle. We check the skin type first, then decide which preparation suits.
  • Sagging → lifting treatmentsSometimes the lower facial line looks blurred because of sagging rather than muscle. In that case we plan jaw botulinum toxin and lifting separately.
  • Two treatments on one area → spaced out, one at a timeWe separate the steps and leave intervals so the recovery response can be read. The order and the intervals are set at the examination.

AFTERCARE

Recovery after the procedure

  1. Day 0Straight afterRedness and slight swelling can appear at the injection sites. It usually settles within a few hours. Stay upright for about four hours, and do not rub or massage the treated area.
  2. Days 1-3Normal routineWashing your face, wearing make-up and light activity are all fine. Avoid saunas, hard exercise and alcohol on the day of the procedure and the day after.
  3. Days 3-7The change beginsMuscle movement gradually decreases. The change at this point is not the final result. Judge it at two weeks.
  4. Week 2Response checkThis is when the effect settles. Come in and we check the balance between the two sides and any movement that remains, and top up with a small amount if it is needed.
  5. Months 3-6Follow-up consultationDepending on the area and the person, the effect fades. When it does, we examine you again and set the timing and the dose for the next treatment.

FAQ

Frequently asked questions

Will my expressions look unnatural?

We do not stop the expression muscles as a whole. The dose is divided so that it reduces the strength only of the muscles being overused. We start with the smallest dose needed. At two weeks we look at the response and add more if it is not enough.

Is it true that you can build up resistance?

Botulinum toxin is a protein preparation, and neutralising antibodies can form with repeated exposure. Frequent treatment at short intervals and excessive doses are the risk factors. We talk through keeping to the intervals and using a preparation with the accessory proteins removed.

Can I wear make-up straight after?

On the day of the procedure, avoid rubbing the injection sites. From the following day, washing your face and wearing make-up as usual are both fine.

Can I have this while pregnant or breastfeeding?

We do not inject during pregnancy or breastfeeding. It is also not possible if you have a neuromuscular condition, are taking related medication, or have an infection at the treatment site. Please tell us at the examination.

The effect is not what it used to be. Should I just increase the dose?

We look into the cause before increasing the dose. The interval, the preparation used or the injection sites may be the reason. The cause may not be muscle at all, but a change in volume or in skin firmness. Depending on the cause, we change the preparation or suggest another treatment alongside it.

Can I combine this with other procedures?

Where the causes differ, we sometimes plan them together. Lines caused by muscle and fine lines caused by the skin call for different treatments. We confirm the cause at the examination, then set the order.

What side effects are there?

Pain, bruising and swelling can occur at the injection sites, and a temporary headache is possible. A drooping eyelid, asymmetry of expression and temporary weakness of neighbouring muscles have been reported rarely. Most settle with time. Please contact us straight away if you notice anything unusual.

CONSULTATION

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Treatment options and devices can change. We confirm the details with you at your consultation.

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