Botox ( Botulinum Toxin )

Botox for wrinkles and excessive sweating

Facial wrinkles are due to an intimate combination of aged, sun-damaged skin and the chronic action of the underlying muscles. Many treatments are available for renewing the skin, but no solution is completed without relaxing the underlying overactive muscles.
Through a series of precise, usually painless, injections, Botox will relax the facial musculature, especially in areas such as the forehead, frown lines (between the eyebrows) and around the eyes. The result is softening or disappearance of wrinkles. This concept has revolutionized treatment of wrinkles in the upper third of the face. In the neck and lower face Dr Touma uses Botox to reduce unsightly vertical neck bands(Nefertiti lift) and tighten the jaw line and restore the oval shape of the face especially in people who grind their teeth, who also find that they no longer need their mouth guard Botox is sufficient in most cases, but in many patients cases it is used with skin resurfacing or fillers to optimize results especially when there is irreversible damage to the skin. Botox is one of the most popular methods of facial rejuvenation in the world today. It reduces the appearance of worry lines, which are often unconscious, and allow people to have a fresh, positive, rested face, nicely affecting the energy that they exude around them.

How does Botox work?

Botox works by selectively and temporarily paralyzing the muscles into which it is injected. It selectively inhibits the action of muscles in hyperdynamic(or hyperhidrosis, which affects the axillae or underarms, hands and feet)  areas (like the forehead), this in turn will eliminate or soften the wrinkles which are caused by that muscle action. In the case of excessive sweating, Botox normalizes sweat production. Also recently, Botox has been shown to improve the bad odor associated with sweating in some people.

Botox for the crow's feet. Dany Touma, M.D


How long do the Botox injections last and are additional treatments required?

The effect of one Botox treatment usually lasts 3 to 4 months, but often 6 months, after which re-treatment is required. After three to four simultaneous treatments, however, the Botox effects become more long lasting, as the muscles that cause the wrinkles begin to lose their strength and develop atrophy. Minimizing the use of treated muscles by controlling animation and wearing large dark glasses will help Botox last longer. The best time to re-treat is as soon as the muscle is starting to move. In the case of excessive sweating, re-treatments are usually needed after 6-9 months, and in many cases, the effect may last much longer.
Dr Touma does not advise the frozen look that is achieved with high doses of Botox. 
Instead he prefers a very natural softening of the deep lines with normal movements of the brows and smile.


What are the possible side effects?

Temporary bruising is possible and is minimized by icing immediately before injections and taking Arnica capsules and by avoiding aspirin-like products and Vitamin E for 1 week before injections and alcohol for 3 days before injections. Headache may develop, and is generally relieved by paracetamol.
The spread of Botox into neighboring muscles is exceedingly rare. Dr. Touma uses the original Botox (not competitive products) to ensure the safest and best results. He also uses Dysport and Xeomin in selected cases, both of which are FDA approved products.


The art and science of Botox injection and a word of caution.

 A good Botox result is the culmination of knowledge of anatomy, facial expressions, and a superior sense of natural beauty. ‘Me-too’ injectors and cheap productions of Botulumin toxin abound and have become a health risk due to the large member of complications related to them.   Dr. Touma has experience in treating over 10,000 patients with Botox and can help you achieve consistent and natural results. In addition, and in order to obtain the most of non-invasive facial rejuvenation, he will advise you on other techniques to optimize your rejuvenation treatment, as well as a home skin care regimen. 

Botox to the chin. Dany Touma, M.D.

Are there any post-Botox precautions?

You should keep your head elevated for 3 hours if you have the frown lines treated (so pick up your bag while bending at the knees, after treatment). It is important to more the treated area for the first 3 hours to help the drug diffuse well. Mild exercise is allowed hours after the treatment.

How quickly does it act?

Botox works within 2-4 days. The maximum benefit is seen at 14 days, after this time a touch-up may be needed.

Before and After Botox for excessive sweating
(only the right hand was treated). Dany Touma, M.D.

Does it hurt?

We use the smallest possible needles and ice to maximize patient comfort. Most people tolerate Botox extremely well. When treating palms and soles for excessive sweating, numbing creams and a nerve block may be needed.


 Will I need a touch-up?

 One in five patients may need a minor adjustment to the first treatment, in order to optimize results. This is typically done at 2 weeks after the treatment.


Dr Touma has been expertly using Botox since 1997! Having treated thousand of patients, he can achieve the most natural results while avoiding side effects and a frozen look.


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