Botulinum Toxin

Botulinum toxin is a medical aesthetic treatment in which very fine needles are used to inject the facial expression muscles, relaxing them temporarily and softening expression lines on the forehead, between the brows and around the eyes. The appointment takes about 30 minutes, the effect starts within a few days and usually lasts 4–6 months. At our clinic it is given by a doctor after an examination.

What does botulinum toxin treat?

Botulinum toxin is most often used for dynamic lines, which form as muscles contract again and again. These are most visible on the upper half of the face:

• Forehead lines: horizontal lines that appear when you raise your eyebrows.
• Frown lines: vertical lines between the brows when you frown.
• Crow's feet: fine lines at the outer corners of the eyes when you smile.
• Bunny lines: lines across the bridge of the nose when you scrunch your face.

The same mechanism can be used in other areas where appropriate: masseter Botox when the chewing muscle has become bulky, and Botox for sweating for excessive perspiration. For the history of Botox, its uses and common questions, see our detailed Botox guide; this page explains how the treatment is carried out at our clinic.

Why does the difference between static and dynamic lines matter?

Botulinum toxin works best on dynamic lines, which show when the face moves. Deep, established lines that are visible even at rest are partly related to skin quality and volume loss. Toxin alone may not be enough for these, and it can be combined with fillers or skin renewal treatments. At the examination your facial movements are observed to judge which line will respond best to which method.

How is the treatment done?

It is a short outpatient procedure that usually follows these steps:

• The doctor assesses your face at rest and in motion and asks about your medical history and any medicines you take.
• The skin is cleansed and the injection points are marked according to your muscle pattern.
• Small amounts are injected into the marked points with a very fine needle. Anaesthesia is usually not needed; you feel a brief pinprick.
• Including the examination, the appointment takes about 30 minutes, and you can return to your daily routine afterwards.

Dose and injection points are tailored to you. The aim is not to freeze your expression but to soften lines while keeping natural movement.

When does it start working and how long does it last?

The effect usually begins within 2–3 days and is fully settled in about two weeks. It lasts 4–6 months on average, varying from person to person with muscle strength, the treated area and lifestyle. As it wears off, the muscles regain their movement and the treatment can be repeated. The timing of the next session is agreed with your doctor based on how long the effect lasts for you.

What should I do after the treatment?

• Do not lie down or massage the treated area for the first few hours.
• Avoid strenuous exercise, sauna, steam baths and alcohol for the first 24 hours.
• Mild redness and small bumps at the injection points settle quickly.

For more detailed advice, read our guide on what to do after Botox.

Is it safe and what are the possible side effects?

When given by a trained doctor at the right dose and in the right places, botulinum toxin is a widely used medical aesthetic treatment with well-described effects. The most common reactions are mild redness, swelling, small bruises at the injection sites and a temporary headache. Less often, a temporary drooping of the eyelid or brow or some asymmetry may occur; these resolve as the effect wears off. At our clinic in Etiler, assessment and treatment are carried out by our dermatologist Dr. Selin Zehra Uçar, who has trained in botulinum toxin and filler treatments.

Who should not have it?

• Pregnancy and breastfeeding
• Neuromuscular disorders such as myasthenia gravis
• Known allergy to botulinum toxin or any ingredient of the product
• Active infection or inflammation in the treatment area
• Some antibiotics and muscle relaxants can interact with it, so always tell your doctor about your medicines

If rare symptoms such as difficulty swallowing or breathing, slurred speech or marked muscle weakness appear after treatment, seek medical help without delay.

For fine lines caused by declining skin quality rather than movement, XXL Lifting, which aims to support collagen production, can also be added to the treatment plan.

Frequently asked questions

Is botulinum toxin the same as Botox?

Yes. Botox is the everyday name for products that contain botulinum toxin. The substance and the way it works are the same.

Does it hurt?

Because the needles are very fine, most people feel only a brief pinprick. Anaesthesia is usually not needed, and the area can be cooled beforehand for sensitive patients.

When will I see the result?

The effect usually begins within 2–3 days and is fully settled in about two weeks. It is best not to judge the result before then.

Will my face look frozen?

With the right dose and injection points, lines soften while expressions are preserved. The aim is not to stop the face moving but to reduce excessive muscle activity.

How often should it be repeated?

As the effect lasts 4–6 months on average, repeat treatments are usually planned within this range. Because it varies from person to person, you decide the timing together with your doctor.

This content is for information only and does not replace a medical examination. For information about botulinum toxin treatment, please get in touch with us.