Facial muscle balance: discover the power of neuromodulators

Jonathan J. Redeker, MD

September 13, 2024

What is the power of neuromodulators?

From skincare products to surgical procedures, people have been looking for ways to enhance their beauty and combat the signs of ageing for centuries. In the ultimate search for better and less invasive treatments, advances in neuromodulators – known by the brand Botox® – have revolutionised aesthetic medicine. Their breakthrough has reduced the need for invasive surgical procedures, and they have become a huge success because they deliver significant results with no downtime and low risk. This blog looks at how neuromodulators are enhancing beauty and helping people around the world look rejuvenated and refreshed.

What are neuromodulators?

Neuromodulators, approved in Europe under brand names such as Bocouture®, Vistabel®, Azzalure® and Alluzience®, are muscle-relaxing drugs that contain botulinum toxin. They are generally used to treat wrinkles, e.g. frown lines and crow’s feet.

Production and effect

The botulinum toxin obtained from Clostridium botulinum, a special strain of bacteria, acts directly on the communication between nerves and facial muscles, causing them to relax and gradually smoothing the skin over them. The toxin interrupts the release of acetylcholine at the neuromuscular junctions, temporarily inhibiting muscle contractions. By modulating muscle activity, botulinum toxin effectively reduces the appearance of fine lines and wrinkles for a more youthful and refreshed appearance.

Dosage and safety

The impressive success of neuromodulators lies in their ability to safely smooth wrinkles, lift facial structures and rejuvenate skin texture when used in very low doses. High doses of botulinum toxin can be fatal if ingested through spoiled food. However, the extremely low doses used in cosmetic medicine pose no health risk whatsoever. Note that the total annual world supply of botulinum toxin in powder form is no larger than an aspirin tablet.

What are the indications?

There are various indications for the injection of neuromodulators.

Wrinkle treatment

Botulinum toxin effectively reduces wrinkles caused by facial muscle movements such as frowning.

Prejuvenation

More and more people in their late twenties or early thirties are opting to use neuromodulators as a preventive anti-ageing treatment (prejuvenation) to prevent the formation of deep wrinkles and maintain a youthful appearance.

Non-surgical brow lift

Skillful injections can subtly lift the eyebrows, making the eyes appear more open and fresh.

Lifting of the midface and corners of the mouth

Advanced injection techniques allow for a quantifiable lift of the mid-face region, the lateral cheeks and the corners of the mouth.

Neck lift

Known as the Nefertiti lift, injections into the platysma muscle of the neck can significantly reduce bands and improve the contour of the neck and jawline, with some additional positive effects on the lower face.

Gummy Smile

Reducing the gummy smile with botulinum toxin can often prevent invasive surgical procedures.

Lip flip

A lip flip with neuromodulators gives the lips a subtle optical fullness.

Teeth grinding and facial slimming

Neuromodulators offer a non-invasive way to reduce the size of the masseter muscle, slimming the lower half of the face while reducing harmful teeth grinding.

Hyperhidrosis treatment

In addition to the cosmetic benefits, neuromodulators also combat hyperhidrosis (excessive sweating) by blocking sweat-inducing signals.

Migraine

Finally, migraine and tension headaches can be effectively treated with neuromodulators in selected patients.

Are the injections painful?

Treatment with botulinum toxin is usually associated with minimal pain. If desired, a local anesthetic or laughing gas can be administered before treatment to further reduce any pain.

What happens after the treatment?

Onset of action

The effect is noticeable after 2 to 4 days, and the final result can usually be seen within two weeks of treatment.

Duration of effect

The duration of the effect depends on the dosage and your metabolism. Although a higher dosage can extend the duration of the effect, it also increases the risk of complications and unnaturally rigid facial expressions. The effect usually lasts between 3 and 6 months.

Downtime

Although bruising can occasionally occur, there is virtually no downtime after an injection.

Post-treatment

I recommend not rubbing the treated areas and avoiding sports and saunas immediately after the treatment to prevent the toxin from migrating to unintended areas.

The art of achieving a natural result

Neuromodulators have gained popularity primarily because they provide almost immediate results with no downtime. When performed by experienced practitioners, these treatments can enhance your beauty while preserving your individual facial expressions and features. To achieve natural results with botulinum toxin, consultation with an experienced professional such as a dermatologist or plastic surgeon is essential. The bad reputation that neuromodulators sometimes have as “poison” is more to do with poor results from overdose than the name.

Customised treatment

In-depth knowledge of facial anatomy, muscle dynamics and a personalised treatment plan can avoid the rigid look that results from “one-size-fits-all” prescriptions and dilutions. I will assess your facial structure, understand your aesthetic goals and develop a personalised treatment approach that meets your needs. The goal is to achieve a subtle and refreshed look and avoid a harsh or unnatural appearance.

For further details or inquiries, please feel free to contact me!

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