The injection of Botox for facial lines was pioneered in 1988 by doctors Jean & Alistair Carruthers…”

B otox (Botulinum Toxin) is a medicine produced by the bacteria that very rarely causes Botulism food poisoning. Botox is not alive but is a protein which weakens and inactivates muscles. Botox is a potent toxin that blocks neuromuscular transmission in the area into which it is injected. In other words it can stop messages from being sent from a neuron to a muscle, or a sweat gland and therefore, it can stop the muscle or gland from functioning fully.

First Clinical Uses of Botox

In 1973 Botox was used as a treatment for patients with squint. By weakening the overactive muscles this treatment provided an alternative to surgery. After this ‘breakthrough’, Botox quickly gained acceptance for other ophthalmological disorders including nystagmus and blephospasm (involuntary spasm of the eyelids).

Neurologists have explored possible indications for Botox therapy for their patients. It has now become the mainstay of non surgical therapy for spasmodic neck muscles, writer’s cramp, tremors, tics, multiple sclerosis, cerebral palsy, post stroke states, spinal cord injuries, nerve palsies, Parkinson’s disease and facial spasms.


Whilst Botox is very potent in high concentrations, it is used in very small quantities with high margins of safety. After an area is injected, its first effects are not seen for 48 hours and the complete effect may not be seen for 2 weeks.

Background to the cosmetic use of Botox

The injection of Botox for facial lines was pioneered in 1988 by doctors Jean & Alistair Carruthers, a Vancouver ophthalmologist and dermatologist. The ophthalmologist noticed that the wrinkles disappeared in her patients with eyelid spasms who were treated with Botox. This lead to further research which confirmed the effectiveness and safety of Botox for improving wrinkles due to overactive muscles of the face. Significant improvement was noted in both forehead frown lines and crow’s feet. No significant side effects were noted beyond the expected injection discomfort. The length of effective improvement for the forehead frown lines was approximately 17 weeks.

Facial lines are caused by the repeated use of facial muscles in a particular manner. Just as a freshly ironed shirt will become severely creased at the elbow, as a result of the bending arm, so likewise our facial lines form wherever we frown, squint or smile. Some people have a distinctive facial habit – grimacing, raising eyebrows, and using one side of the face more than the other – and they will in time see a set of facial lines appear which reflect this individual habit.

Lines can be softened, or in some cases erased, by means of filler injections or surgical peeling treatment. These processes vary in how effective they are and how long they last; however, they all have one common characteristic – the effect is being treated, rather than the cause. The damage has already been done, and continues to be done.

The hibernation treatment is different in that it is a preventative treatment. Injections are given, usually to the forehead frown area, which temporarily puts the frown muscles to sleep for a period of 3-4 months. This freezing of the muscles is always temporary and can never be permanent; this is why the treatment is called ‘The hibernation treatment’ as the muscle temporarily hibernates.

The am is to break the habit of frowning, and educate the patient in his or her facial movement so that one ‘forgets’ how to frown. Usually patients have several of these injections over a year or two until the frowning habit is broken.

Apart from the ‘habit breaking’ aim, other positive benefits are:

  • While the muscle is temporarily immobilised, the forehead is at peace, and the frown line is not being created or reinforced.
  • Most patients notice that their existing frown lines do soften out because the forehead is completely relaxed.

Many would agree that frowning is an unpleasant habit which tends to spoil the serenity and beauty of the face. After the treatment, although all the many other facial muscles can still be used normally, the forehead is still and calm and thus the face appears more serene. Patients have often commented that they feel the calmness within themselves

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Between the eyebrows, the vertical frown lines result from over-active muscles. These muscles are also used when concentrating. By drawing the eyebrows inward, one expresses anger, confusion or anxiety. Repeated often enough, permanent skin creases develop and even when relaxed, these frown lines remain Neutralisation of these overactive brow muscles helps eliminate these negative appearances.

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Wrinkles radiating from the corner of the eyes caused by smiling, laughing or squinting are especially distressing in some individuals. Previously, no reasonable medical or surgical intervention could improve this problem due to the strong underlying muscles. Even with the deepest chemical peels or laser resurfacing techniques, rapid recurrence of these lines around the eyes is inevitable. Botox has proved to be effective at preventing the recurrence of wrinkles by inhibiting the underlying muscles.

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Some individuals use different muscles for raising the brows; others ‘talk’ with their forehead. A more dilute toxin is used when treating the horizontal forehead lines.

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Botox has recently been shown to help in reducing localised sweating. This can be administered to hands, feet, axillae (underarms) and the face. This involves up to 15 injections into the palm, or 15 per axilla.

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For an immediate consultation, or simply to learn more about our range of facial aesthetics treatments, please contact us

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