Neurotoxins – Botox® and Dysport®

Botulinum Neurotoxin Type A

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Botox® Your Solution for a Youthful Appearance

Botulinum neurotoxins (BoNTs) are neurotoxic proteins produced by the bacterium *Clostridium botulinum*. Botox® (onabotulinumtoxinA) and Dysport® (abobotulinumtoxinA) belong to the Type A class of botulinum toxins. These agents are commonly used in both aesthetic and therapeutic settings for their ability to temporarily inhibit neuromuscular transmission.

Mechanism of Action

Botulinum neurotoxins act at the presynaptic neuromuscular junction by cleaving SNAP-25 (Botox®) or synaptobrevin (Dysport®), key components of the SNARE protein complex. This inhibits the exocytosis of acetylcholine from cholinergic nerve terminals, resulting in temporary chemodenervation and muscle paralysis. Onset typically begins within 3–5 days post-injection, with peak effect observed around 10–14 days. The duration of effect lasts approximately 3–4 months.

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Glabellar Lines
The '11' lines between the brows, known as glabellar lines, can give a stern or fatigued appearance. Injectables relax the muscles responsible for frowning, softening these lines and brightening the expression.
Forehead Lines
Horizontal forehead lines can be smoothed out with injectables, resulting in a more serene and relaxed forehead appearance. The treatment relaxes the muscles, diminishing the visibility of these lines during facial expressions.
Masseters
Treatment in the masseter muscles not only provides facial contouring, which can create a more defined jawline, but also offers relief from TMJ discomfort. Injectables here can reduce muscle bulkiness and alleviate associated pain.
Botox Treatment Area

Aesthetic Indications

Neurotoxins are used to selectively weaken muscles responsible for dynamic rhytids (wrinkles formed by facial expression). Common treatment areas include:

  • Glabellar complex (frown lines)
  • Frontalis (horizontal forehead lines)
  • Orbicularis oculi (crow’s feet)
  • Nasalis (bunny lines)
  • Depressor anguli oris (downturned mouth corners)
  • Mentalis (chin dimpling)
  • Platysma bands (neck)
  • Masseter (facial slimming, bruxism)

Clinical Considerations

Appropriate dosing and injection technique vary based on muscle mass, gender, age, and metabolic rate. Dysport® has a higher diffusion profile than Botox®, which may be advantageous or disadvantageous depending on the treatment area. Patients should be screened for contraindications including neuromuscular disorders (e.g., myasthenia gravis), active infection at the injection site, and known hypersensitivity to botulinum toxin or formulation components.

Side effects are generally mild and transient and may include localized bruising, edema, ptosis, headache, and temporary asymmetry. Re-treatment is typically performed every 3–4 months to maintain results.

Summary

Botox® and Dysport® are advanced neuromodulators that offer safe, effective, and minimally invasive options for aesthetic facial rejuvenation. When administered by experienced clinicians, they can achieve natural-looking, refreshed results while preserving facial expressiveness.

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