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Botox: More Than Just a Wrinkle Eraser

There is a confusion and misinformation among the general public regarding aesthetic injections, often incorrectly referred to as “botox”. This misnomer has led to the association of botox with images of unnatural, overly inflated faces. It is important to recognize that various injection-based treatments exist, each serving distinct purposes and delivering different outcomes.

This widespread misconception can be attributed, in part, to a lack of understanding about the true nature of botox and its mechanism of action. So, let’s delve deeper into the topic and explore botox and its diverse range of applications.

What is botox and how does it work?

How botox works | RJ CLINIC

Botox, or botulinum toxin, is a neurotoxin that is produced by the bacteria Clostridium botulinum. When injected into a muscle, it blocks the release of acetylcholine, a neurotransmitter responsible for muscle contraction. This prevents the muscle from contracting and causing wrinkles or other unwanted movements. Another common injection, filler, on the other hand, is injected to add volume and plumpiness, filling in hollow areas and smoothing out wrinkles.


While it is often known for its ability to diminish wrinkles and fine lines on the face, botox offers a broader range of cosmetic and even medical uses beyond that.

Uses for botox | RJ CLINIC

Treat dynamic lines

Botox is most commonly used to treat dynamic wrinkles, which are caused by repetitive muscle movements, such as frowning, squinting or raising eyebrows. These wrinkles can create an older or fatigued appearance. By temporarily paralyzing and weakening the muscles involved for these movements, botox helps smoothen the skin and rejuvenate the face, resulting in a more youthful and revitalized look.

Face slimming

Botox can also be used to contour the face. An increasingly popular treatment is the use of botox injections to target the masseter muscles, aiding in slimming and refining the jawline, ultimately leading to a more feminine and aesthetically pleasing appearance. This treatment is particularly popular in Asian countries, where a V-shaped or heart- shaped face is considered more desirable than a square-shaped face.

Jaw Slimming with Botox | RJ CLINIC

The masseter muscle, a prominent muscle running along the side of the face, serves a pivotal role in the processes of chewing and jaw clenching. However, in certain individuals, various factors such as teeth grinding or clenching, chronic stress, or even genetic predisposition can contribute to the enlargement of the masseter muscle. This enlargement can lead to a more square-shaped jawline, which is often perceived as a characteristic associated with a masculine aesthetic.

To address this concern, botox injections are strategically administered to the masseter muscles, causing a temporary relaxation of the muscle fibers. By doing so, the injections effectively reduce the bulkiness and hypertrophy of the masseter muscles. The treatment helps to sculpt and contour the jawline, resulting in a softer and more feminine appearance.

The cosmetic benefits of botox injection for the masseter muscles extend beyond slimming and contouring the jawline. The procedure can also contribute to a more balanced and proportionate facial profile, enhancing overall facial harmony. Moreover, botox injections for masseter muscle reduction are known for their non- surgical and non-invasive nature, making them a popular choice among individuals seeking subtle yet effective facial enhancements.

Brow lift

Another application of botox involves the enhancement of the brow area, commonly known as a brow lift. By injecting small quantities of botox into the muscles responsible for pulling down the eyebrows, it becomes possible to achieve a lifted appearance and create a more defined, arched shape. This technique proves particularly beneficial and effective for individuals with naturally droopy eyebrows, as it helps to rejuvenate and revitalize their overall facial expression.

Treat gummy smile

Gummy smile treatment with botox | RJ CLINIC

Furthermore, botox offers a solution for those troubled by a gummy smile, a condition characterized by the excessive display of gum tissue when smiling. This aesthetic concern arises from hyperactive muscles that elevate the upper lips, resulting in the exposure of a significant portion of the gums. Thankfully, botox provides an effective treatment option for this condition. By temporarily relaxing the muscles responsible for elevating the upper lips, botox reduces the excessive display of gum tissue, thereby improving the harmony and balance of the smile.

Nose tip lift

Botox can also enhance the appearance of the nose tip. It is possible to relax the muscle responsible for pulling the nasal tip downward with botox injection, and effectively creating a “lift” for the nose tip. This technique proves advantageous for individuals seeking subtle changes to the shape and projection of their nose, without resorting to invasive surgical procedures.

Treat dimpled and receding chin

Dimpled chin treatment with botox | RJ CLINIC

Botox also offers a solution for those with a receding and dimpled chin caused by an overactive mentalis muscle. The mentalis muscle, when hyperactive, can result in a chin that appears dimpled and receded. Botox induces temporary relaxation, hence allowing for increased chin projection and reducing the appearance of dimpling.

Nefertiti Lift

The Nefertiti Lift is a cosmetic procedure names after Queen Nefertiti, an ancient Egyptian queen known for her elegant and defined jawline. The procedure involves the use of botox injections to rejuvenate and contour the neck and jawline, resulting in a more youthful and sculpted appearance.

Nefertitit lift treatment with botox | RJ CLINIC

The Nefertiti Lift primarily targets the platysma muscle, which is located in the neck and plays a significant role in supporting the lower face and neck. When platysma muscles are strong, it can create a downward pull, obscuring the jawline and forming vertical neck bands. This can result in an aged and less defined appearance. Nefertiti lift aims to counteract the downward forces caused by the muscle, thereby providing a lifting effect, creating more defined jawline and improved appearance of the neck.

“ Why is it that after multiple botox injections, I no longer see the same improvement that I saw with my initial injections?”

There are many brands of botulinum toxin A or botox available, with Dysport, Botox, and Xeomin being the most widely recognised, and then there are newer brands like Daxxify or Jeauveau.

Types of botox in malaysia | RJ CLINIC

The proteins present in botulinum toxin act as antigens, thereby provoking an immune response from the body, which results in the development of antibodies against the toxin. Consequently, with repeated treatments, the efficacy of botulinum toxin injections wanes, owing to the presence of these antibodies, which block the effect of the toxin.

There is an exception for this case, which is Xeomin. Xeomin was FDA-approved in 2011 and is often advertised as the “cleanest product” of Botox injections because Xeomin does not contain complexing protein that causes antibody formation.

Of course, there are also other factors that can affect the efficacy of botox injections, including changes in the dosage and injection technique.

Why is botox not permanent?

Botox effects only last 3 to 6 months because of neuronal plasticity, wherein fine nerve fibers emerge and reinnervate the muscle fibers, leading to recovery of muscle strength. On top of that, body can also form new connections between the nerve fibers and muscle fibers, known as motor end plates. Formation of new motor end plates can further aid in the restoration of normal muscle function.

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Microbotox or mesobotox

Microbotox is a specialized form of botox injection that involves the use of diluted botox solutions to target a larger area of the skin with multiple injections. This technique allows for a more widespread, subtle effect on the skin’s surface while maintaining natural facial expressions.

The microbotox technique is used to reduce sweat, sebum (oil) and minimize pores due to the effect on sweat glands, sebaceous glands (oil glands) and erector pili muscle.

Medical uses of botox

In addition to its cosmetic uses, botox has a variety of medical applications. It can be used to treat chronic migraines, blepharospasm (involuntary eyelid twitching), cervical dystonia (neck muscle spasms), hyperhidrosis (excessive sweating), and spasticity (muscle stiffness and spasms)

Botox or fillers?

There are some common misconceptions about botox that need to be addressed. Firstly, it is important to understand that botox and fillers are two distinct treatments. While fillers work by filling in static lines and restoring lost volume, botox is used to relax muscles that cause wrinkles and dynamic lines.

Botox and filler comparison | RJ CLINIC

Botox works by temporarily paralyzing the muscles that cause wrinkles and fine lines, primarily in the upper part of the face, such as forehead and around the eyes. Results typically last for three to 6 months.

Dermal fillers are a popular cosmetic treatment used to address wrinkles and lines that are present even when the face is at rest. These lines, also known as static lines, develop as a result of a combination of factors, including aging, sun damage, loss of collagen and elastin and repetitive facial expression over time. Unlike dynamic wrinkles that appear with facial movement and are treated with botox to relax the underlying muscles, static lines are formed due to the loss of volume and skin elasticity. This is where dermal fillers come into play to help filling in the static lines and reducing their prominence.

While hyaluronic acid fillers can be dissolved by injecting hyaluronidase if there are any issues, there is no such solution available for botox. Therefore, if there are any undesirable outcomes from botox treatment, you have to wait for the effects to wear off naturally.

Do facial exercise work?

Facial exercises | RJ CLINIC

Facial exercise is a technique in which specific facial muscles are targeted and exercised in order to improve their tone and strengthen them. The aim is to make the face look firmer and more youthful, and to reduce the appearance of wrinkles and fine lines.

Proponents of facial exercise argue that by stimulating blood flow and circulation to the face, these exercises can help nourish the skin and promote a healthy glow. Some also claim that facial exercise can help release tension and stress and improve overall relaxation.

Facial exercise can involve a variety of movements and techniques, such as puckering the lips, raising the eyebrows, and performing certain facial expressions. Some people also use tools like facial massage rollers and gua sha stones to enhance the benefits of facial exercise.

However, there is currently NO strong scientific evidence to support these claims. In fact, overly vigorous facial movements can actually exacerbate wrinkles and fine lines.

One reason for this is that repeated facial movements can cause the muscles in the face to contract and pull on the skin, leading to formation of new wrinkles over time. Additionally, excessive stretching and tugging of the skin can damage its elasticity and contribute to the breakdown of collagen and elastin fibers, which are important for maintaining a smooth and youthful appearance.

If you are looking to reduce wrinkles and fine lines at home, it is generally recommended to focus on lifestyle habits like using sunscreen, eating healthy diet and staying hydrated, as well as using skincare products with proven anti-aging ingredients like retinol or retinoids and antioxidants.

Your anti-aging skincare

Anti Aging skincare | RJ CLINIC

Speaking of retinol and retinoids, they are well known and widely used as skincare for their antiaging benefits. However, there can be some confusion about the distinctions between them.

Retinol is a specific type of retinoid. Retinoids are a class of compounds derived from Vitamin A, and retinol is one of the forms. In comparison to prescription-strength retinoids or retinoic acid such as tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac), retinol is considered milder and available for purchase over the counter.

Retinol is available in various skincare products without the need for a prescription. Retinol is 20 times less potent than prescription-strength retinoids. It serves as a precursor to retinoic acid, which is responsible for the anti-aging effects when it undergoes conversion by the skin. Retinoic acid is the only form of ingredient that is bioavailable to the skin. To put it simply, retinoic acid does not require conversion by the skin to become effective- it starts working instantly.

Retinol, on the other hand, takes more time to produce visible results. However, this does not mean that OTC retinol is ineffective. The notion that “stronger is better” is a common misconception. The slow conversion of retinol makes it more tolerable for individuals with sensitive skin, while prescription-strength retinoids have higher potential for side effects such as skin irritation, dryness, and increased sensitivity.

Ultimately, both retinol and retinoic acid are effective; the difference lies in the time it takes for visible effects to appear, which varies based on individual tolerance. Along with retinol, retinyl palmitate and retinaldehyde are also considered to be less potent forms of retinoids.

These substances offer several benefits for the skin, including:

· Reduced wrinkles and fine lines: They stimulate collagen production, which helps improve skin elasticity and reduced the appearance of wrinkles and fine lines.

· Improved skin texture: Consistent use of retinol or retinoids can lead to smoother skin by promoting cell turnover and facilitating exfoliation.

· Reduced acne: Retinoids possess anti-inflammatory properties and can effectively clear out clogged pores, making them beneficial for treating acne.

As previously mentioned, retinol and retinoids can cause skin sensitivity, redness, dryness and flakiness, especially during the initial stages of use. To minimize these effects, it is advisable to begin with a low concentration and gradually increase it as your skin becomes more tolerant. You can also start by applying 2 to 3 times per week and then gradually increase the frequency to daily use, based on your skin’s tolerance. Additionally, it is important to incorporate daily sunscreen use when using retinol or retinoids since they can heighten the skin sensitivity to the sunlight. This precaution helps protect your skin from potential sun damage.

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