Botox is the injection of very small doses of a protein called botulinum toxin into specific muscles. The protein temporarily reduces the signal sent from the nerve to the muscle and tells it to contract. The treated muscle contracts less, so the wrinkles caused by its movement soften.

Many facial wrinkles come from expression. Raising your brows creates horizontal forehead lines, frowning creates vertical lines between the brows, and smiling creates crow’s feet at the corners of the eyes. Over the years, the lines start to show even at rest. By easing the muscle movement behind them, Botox softens existing lines and slows their deepening.

Botox has also been used for many years to treat excessive sweating, migraine, teeth clenching and some muscle spasm conditions.

There is no fixed age for cosmetic Botox; what matters is the state of the expression lines and the strength of the muscles. Treatment may be considered once lines start to show at rest, and some people prefer low, preventive doses before lines deepen. Suitability and dose are decided at your consultation.

Botox is not a filler and does not add volume. Hollows and deep lines caused by volume loss are treated with dermal fillers, and the two are often combined in one plan.

Botox can be used on different areas of the face and body, depending on the goal. The Botox treatments most often done at our clinic in Istanbul are:

• Forehead, frown lines and crow’s feet: The most commonly treated areas for softening expression lines. For a micro-dose technique that keeps your expressions, see Hollywood Botox.
• Brow lift: The tail of the brow is lifted slightly to open up the eyes.
• Jawline and teeth clenching: Treating the chewing muscle may reduce clenching and slim a square lower face. See masseter Botox.
• Neck and gummy smile: For vertical neck bands and a smile that shows too much gum. See face and neck Botox.
• Excessive sweating: To reduce heavy sweating of the underarms, palms and soles. See Botox for sweating.
• Migraine: Injected at specific points in the treatment of chronic migraine. See migraine Botox.

The dose for each area is decided at your consultation.

Treatment starts with an examination. You will be asked to raise your brows, frown and smile so your doctor can see which muscles are working and how strongly. The injection points and dose are planned on that basis.

1. The skin is cleansed; numbing cream or cooling may be applied if needed.
2. The injection points are marked.
3. Botulinum toxin is injected at the planned points with very fine needles.
4. The area is checked. Small bumps and mild redness usually settle quickly.

The procedure takes about 10–20 minutes, and you can return to your day straight afterward. For a few days beforehand, stopping blood-thinning medicines and supplements such as aspirin, high-dose omega-3 and vitamin E, after checking with your doctor, may lower the risk of bruising.

Choosing the right dose and the right points is key to a natural result. Too much can make the face look frozen, and the wrong point can cause a drooping brow or eyelid. That is why Botox should be done with licensed products by a doctor who knows facial anatomy well. At our clinic, it is planned within Dr. Sevgi Ekiyor’s Facial Architecture (Yüz Mimarisi®) approach, which looks at the face as a whole.

A few simple rules help keep the product in the target muscles and the result natural:

• Don’t lie down or keep your head bent forward for long for the first 4 hours.
• Don’t massage or press the treated area; skip facials and massages on the first day.
• Avoid intense exercise, alcohol, saunas and Turkish baths for the first 24 hours.
• Try not to sleep face down on the first night.
• Waiting a few hours before applying makeup is enough.

Mild redness, small bruises and a mild headache on the first day may occur and usually pass quickly. A follow-up visit is planned around the second week to assess the result and make small touch-ups if needed.

Botox usually starts to work on day 3–5 and settles fully within 10–14 days, so the result is assessed about two weeks after treatment.

The effect is temporary and usually lasts 3–6 months. This varies with the area, the dose, muscle strength and metabolism. For masseter and sweating treatments, the effect may last longer.

With regular treatments, the muscles get used to contracting less and new lines form more slowly. If you stop, the muscles regain their strength and the face returns to how it looked before treatment; stopping does not make wrinkles worsen faster.