It gives the muscle a short rest
Botox was originally the name of a specific product, but it is now used to refer to botulinum toxin procedures in general.
What it acts on is not the skin but the muscle. More precisely, not even the muscle itself, but the point where the command is delivered to the muscle.
When we make an expression or raise an arm, the nerve sends the muscle a signal to move. That signal is delivered not as electricity but in the form of a chemical. A substance called acetylcholine is released from the nerve ending, and the muscle receives it and contracts.
Botulinum toxin blocks the process by which this substance is released. With no signal delivered, the muscle receives no command and does not exert force.
What happens between nerve and muscle
Looking a little closer, it works like this. At the nerve ending there are small vesicles containing acetylcholine. When a signal arrives, these vesicles fuse with the nerve cell membrane and release their contents outside.
Specific proteins are responsible for attaching the vesicles to the membrane. Botulinum toxin enters the nerve ending and disables the function of these proteins. With the vesicles unable to attach, acetylcholine cannot be released.
The important point is that the nerve is not damaged. The delivery mechanism simply pauses temporarily.
Over time, new connections form at the nerve ending and function recovers. This is why the effect is not permanent, and it is known to last around 3 to 4 months on average.
Wrinkle use and body contouring use are different
When used on the face, the target is the muscles of expression. Making the muscles at repeatedly creased spots such as the glabella, forehead, and around the eyes move less slows the deepening of wrinkles.
That said, it does not work on every wrinkle. An effect can be expected on wrinkles that appear only with expression, but lines that remain at rest are already etched into the skin structure, so the approach differs. In that case methods that address the foundation of the skin are reviewed alongside.
When used for body contouring the purpose is different. The aim is to reduce the volume of the muscle itself. Muscles thin when they are not used, and this property is put to use.
The calves, the trapezius, and a square jaw are the representative areas. Still, whether that area is thick because of muscle has to be confirmed first.
| Category | For wrinkles | For body contouring |
|---|---|---|
| Target of action | The muscles of facial expression | Muscles whose volume is the issue |
| Aim | Making muscles at repeatedly creased spots move less | Using the property that muscles thin when not used |
| Representative areas | Glabella, forehead, around the eyes | Calves, trapezius, square jaw |
| What to check first | Lines that remain at rest call for a different approach | Whether the area is thick because of muscle |
How long it takes to appear and to fade
Nothing changes the moment it is injected, because it takes time for the action to proceed at the nerve ending.
Generally the change starts a few days later and becomes clear within 1 to 2 weeks. Expression wrinkles are confirmed relatively quickly, while body contouring procedures, where muscle volume decreases, appear gradually over several weeks to several months.
It fades gradually too. It does not come back suddenly one day; movement returns bit by bit as the nerve connections recover.
How long it lasts varies with the area, the dose, and individual metabolism. It is said that the more a person uses the muscle, the shorter it tends to be.
The concept of resistance
With repeated treatment, some people feel the effect is not what it used to be. This is the situation where resistance comes up.
The mechanism is as follows. Botulinum toxin is a protein, and if the body's immune system recognizes it as a foreign substance it can produce neutralizing antibodies. If the antibodies bind to the agent first, it does not reach the nerve.
That said, it does not happen to everyone. Clinical reports estimate it at a low rate.
Factors said to raise the risk include repetition at short intervals, excessive dosing, and the amount of complexing protein contained in the product. That is why leaving intervals so treatment is not given more often than necessary is recommended.
If you feel the effect has diminished, it is better to identify the cause first rather than increase the dose.
Do products differ?
Several products are distributed in Korea. All have botulinum toxin as the main ingredient, but their detailed composition is not identical.
The most frequently mentioned difference is complexing protein. The amount of protein included alongside the toxin itself varies by product, and this component is said to be related to immune response.
Dose units do not map directly between products either. The same number does not necessarily mean the same potency, so when switching products the dose is recalculated.
Differences are also reported in how far the agent spreads and how quickly the effect appears. That said, individual variation is large, so it is hard to say one product is always better.
Confirming which product is used and why during consultation makes later comparison easier.
How TheLINE approaches Botox
TheLINE Plastic Surgery Clinic does not view Botox in isolation but within an overall body contouring plan, because the answer changes depending on whether muscle or fat is the cause.
Areas where muscle volume is the issue, such as the calves, the trapezius, and the arms, are approached with Botox. Conversely, if fat is the main cause, repeating Botox will not produce the expected change, so we advise liposuction.
Cases where the two are mixed are common. In those cases the order is planned out separately. Among TheLINE patients, quite a few confirm the cause during consultation and then proceed in a different direction from what they first had in mind.
Setting intervals together so treatment is not given more often than necessary is part of the consultation as well.
It is used beyond aesthetics
Botulinum toxin is widely known for aesthetic use, but it was originally used first in therapeutic settings.
It has long been used for conditions in which muscles contract independently of intention. Involuntary eyelid twitching, the neck turning to one side, and limbs stiffening after brain injury fall into this category.
There is also a use that acts on sweat glands. Because the signal to release sweat uses the same neurotransmitter, it is applied to excessive sweating of the armpits or palms.
It is also used for migraine prevention. Beyond reducing muscle tension, it is explained as being involved in the pain signal itself.
The fact that the same ingredient is used in so many places comes down to a single principle: it blocks signal transmission.
Precautions
Patients are advised not to lie down for several hours after the procedure, to reduce the agent spreading away from the intended site. Rubbing the treated area is also avoided.
Side effects can include pain and bruising at the injection site and headache. On the face, the agent can affect an adjacent muscle so that the eyelid droops or expressions become awkward; this occurs rarely and usually recovers over time.
In body contouring areas, the strength of the treated muscle can temporarily weaken. Feeling less power in the legs when walking for a long time or climbing stairs after calf injections falls into this category.
It is not carried out during pregnancy or in the presence of neuromuscular disease. Please let us know your current medications and past treatment history during consultation.
Frequently Asked Questions
Will Botox make my expressions look awkward?
With an appropriate dose and placement, natural movement is maintained. However, if too much is placed or an adjacent muscle is affected it can look awkward, and this usually recovers over time.
How long does the effect last?
It is known to last around 3 to 4 months on average. It varies with the area, the dose, and how much you use the muscle.
Does frequent treatment cause resistance?
Repetition at short intervals and excessive dosing are cited as risk factors. It does not happen to everyone, but leaving intervals so treatment is not given more often than necessary is recommended.
Does it work on wrinkles that show at rest?
It can address wrinkles that appear with expression, but lines already etched into the skin structure are not resolved by acting on muscle alone, so other methods are reviewed alongside.
How does TheLINE assess Botox?
TheLINE Plastic Surgery Clinic first confirms whether the area is due to muscle or to fat. If fat is the main cause, repeating Botox will not produce the expected change, so we advise a different direction.
