Botox in Tunisia

Botulinum toxin is a substance that reduces the contraction of muscles as it acts at the neuromuscular junction (muscle relaxant action).

Since 1975, the Botox has been used by doctors to correct the squint of the child, the facial tics and involuntary blinking of the eye.

In practice, Botox is typically indicated in the field of aesthetic medicine to correct the frown lines, forehead and crow's feet wrinkles.

The three main indications of Botox are forehead, frown lines and crow's feet wrinkles.

Often used for its relaxation properties on the muscles, Botox aims, in most cases of its use, to reduce the contraction of the muscles that are found in the forehead and eyebrows areas. This will help to reduce both horizontal wrinkles that vertical wrinkles caused by contraction.

Thus, by releasing the tension of the muscles, the use of Botox allows obtaining a rejuvenated face by smoothing the skin, it is a facelift without surgery.

More generally speaking, eyebrows are positioned based on a balance between two opposing forces that are; lowering muscles (being in the eyebrow area), and levator muscles (ranging in forehead, frontal muscle).

When the forehead muscle, which is a reliever, contracts, it causes development of horizontal wrinkles. Vertical wrinkles are caused by a contraction of the lowering muscles,.

The goal of this Botox injections treatment is diminishing wrinkles and fine lines in the resting position but not to prevent the contraction of the muscle.

What will decide the outcome is the final appearance of the wrinkles at rest.

Furthermore , Botox injections generates a kind of balance between the depressor and lift muscles because it reduces the action of a muscle group , therefore, it causes wrinkles by action and clears the antagonistic muscles actions: the intention is in the treatment of muscular balance and obtaining a result of the face’s harmonization.

Keep in mind that Botox is done little by little over time: so it will be suitable to perform a progressive treatment and avoid the trap of doing too much for the first few injections.

It will be better to settle for a first reasonably efficient rather than a too efficient results: so you mustn’t ask to have the best result in the first injection session.

On this basis, the cosmetic surgeon deems necessary to conduct many sessions of injections in order to find the best possible product that adapts to each patient.

The most conventional areas concerned by Botox injections are:

• Forehead wrinkles,
• The frown lines,
• The crow's feet wrinkle.

Botox can also be injected, less often, in other areas: the lips, chin, nose, cheeks, neck cords platysmal...

It is not necessary to make a special preparation.

It is also unnecessary to present fasting on the day of the injection session.

Women are required to appear without makeup or remove make-up before the injections.

Preferably, and in order to minimize the risk of bleeding in the treated areas, the patient (s) should stop taking aspirin before and after 15 days of the intervention.

Botox injections are ill-advised in the following situations:

• Some neuromuscular diseases such as myasthenia gravis.
• Botox injection session must certainly be rescheduled in case of pregnancy, even if it is just a few days long. A potential feeding should be discontinued.
• Sensitivities known against botulinum neurotoxin A or serum albumin and against treatment with aminoglycosides (family of antibiotics which includes notably Amiklin and Gentalline) contraindicating the botulinum toxin.
• You follow treatment with botulinum toxin injections to treat pathological spasms, if it happened to you before an episode of paralysis of the muscles of the face, if you have a neuromuscular disease or clotting problems. All these disorders should be reported to your doctor to take you on for Botox injections. This should be in consultation with your doctor about the advisability of injections on you and the way he will proceed.
• If during the period before or during the injections, you treat yourself with anticoagulants treatment or aspirin or antibiotics, or if you have a health problem regardless of it (especially infection, flu, dental abscess ...). These disorders require that you talk to your doctor before the injection.
• Generally, you should tell your doctor about any health problems you have encountered to well estimate the injections dates. On the same note, do not hesitate to ask your cosmetic surgeon, Dr. Shiraz Bouzguenda all the questions that you need to ask and inform her about the treatments you received before or those you are currently under.

The injection of Botox does not require anesthesia.

Following the practice you’re accustomed to with your aesthetic physician, the treatment will be carried out either at the doctor's office or in the aesthetic clinic.

The Botox treatment is achieved by multiple injections in the treatment area of the face. These injections are characterized by their fine needles and are somewhat painful.

The Botox injection session lasts just a few minutes.

After the first two hours after the injections, it is not advisable to practice intensive sport as it is also recommended to not lie down.

It is also best to avoid handling the face or conduct pressure massages for the 24 hours following the injection.

Efforts must be made during the fifteen days preceding the injection and another fortnight following them; to minimize the bruising and bleeding risks of the treated areas (this will prevent the risk of the product’s infiltration to the peripheral muscles causing side effects).

Moreover, during the three days following the injections, the patient (s) are required to perform an exercise in contraction of muscles treated three times a day for at least 5 seconds per muscle.

Usually, the side effects of the Botox treatment are simple. The swelling of the treated areas lasts for about 20 to 30 minutes and then disappears.

Daily activities are included in a normal way after the injections.

Rarely, some side effects can occur. They are transitory, not permanent and they consist of:

• Redness : This redness is localized at the points where injections were made and have been rarely reported to have lasted for a period of 3 to 6 days.
• Bruises (blue): rarely observed after treatment of the affected areas and lasts for just a few days after the injections.
• Edema : If swelling is observed, it will be apparent around the eyes and can sometimes lasts for 4 to 5 days after the treatment starts and decrease in days to weeks.
• Discomfort sensitivity:a change in the sensitivity to the treated areas is often associated with a feeling of hardening that can last a few days as well as a feeling of tension in the forehead, mouth or neck according to zones which have been treated.
• Eye or facial transient pain :it is very rarely to trace pain in this area treated with the injections.

Do not hesitate to report anything that you can have as follow ups to the injections from your doctor.

After three to fifteen days after the injections, the wrinkles are reduced and small movements are kept.

You can view the final result in the first few days following injection. But all along about the first two weeks, the effects may be changing: sometimes we can see an asymmetry that will eventually stabilize.

The result obtains the patient after the first session persists for 3 to 6 months and after they pass you can resume the injection procedure.

This treatment usually aims to improve the current appearance of wrinkles, not improve it. Thus, we keep realistic expectations; the patient should be very pleased with the result of the injections.

To achieve stability of the result, injections are practiced different times separated by intervals of 3 to 6 months. In the second injection, results last longer in comparison with the first injection (6-8 months) .Thus; it will be suitable to perform injections again every 3 to 6 months.

It is not advisable to shrink the time between injections of less than 3 months to prevent causing resistance produced by a "vaccine effect".

The stabilization of the result is generally carried out more than 3 injections, however, some cases need to use minimum 8-10 injections to promote the production of a certain stabilization of the result.

However, when stopping the injections, we find that the function of the treated muscle returns to its original state before the injections treatment.

For your Botox injections in Tunisia, Dr Shiraz Bouzguenda uses either Botox or Dysport.

During the Botox injection session, you can also do the following acts, as part of facial rejuvenation:

• Reduces wrinkles by hyaluronic acid injections (dermal fillers),
• Mesolift face,
• A chemical peel,
• PRP injections (Platelet Rich Plasma).

In some cases, there may be some "local" imperfections (persistence of small wrinkles) that do not really make real complications. These imperfections are usually due to the original appearance of the skin, before treatment with injections, which may contain a «breakout» unchanging due to the advanced age of the wrinkle.

The result can also, in some cases, be a failure or asymmetry in the final appearance of the wrinkle: this fact is usually due to the nature of our muscles that are more or less powerful and often asymmetrical.

Usually, the doctor treats these abnormalities by injecting additional Botulinum Toxin after one month from the date of the first injection.

When we see that the result of additional injections of Botox is best to perfect the result, the physician must perform after the flow of at least 15 days for the balance of muscles (the balance between muscle groups) needed, can be established within 15 days.

Before injecting the Botox, the patient often presents with both sides of asymmetrical face and larger wrinkles on one side of that face then the other.

The muscle behind the wrinkle can have two different sides with one being stronger than the other. The doctor studied this before the injection and follows a suitable technique, slightly different from the regular method by treating both sides of the muscle responsible for the wrinkle differently. However, even when the doctor adapts this technique, residual asymmetry is still likely to appear and may eventually require an additional injection.

These interventions of aesthetic medicine aim to satisfy you and meet your needs in realistic proportions. However, if such interventions do not attain the desired effect, it can increase, pre-existing psychological disorders. Patients’ response after Botox injection can change from one patient to another, even when having the same result.

Keep in mind that Botox injection will result in a reduction or even disappearance of some facial expressions. The doctor will assess this aspect with you to prevent the risk of disappointment especially if you are an actor, presenter, etc...

Complications related to the Botox injection fortunately have a very low chance of occurrence. Random complications encountered to date are:

Headache: head pain starts when the first injections begins to fade and stops after a few hours to days.

Eyebrows Ptosis: after the injection of the forehead, eyebrows may go down slightly. This descent is usually caused because the original eyebrow position before the injection was already down. Usually, after a few weeks, the patient will notice that the slight lowering of the eyebrows reduced.

Eyelid ptosis: there is a very low risk of partial collapse of the upper eyelid when conducting an injection of frown lines. This fall will last between 4-8 weeks. This risk is very rare and has a chance of occurrence of less than 1% of cases. It disappears after few weeks.

Discomfort with the smile and the swallowing: the patient may experience discomfort to smile or small abnormal movements in the injection into the lips. Difficulty in swallowing can also occur during the injection in the neck.

Dry eye: by reducing tear secretion that can cause keratitis, especially more in patients who wear contact lenses (it is preferable, in this situation, to ensure moisturize the cornea).

Paradoxical contraction of a muscle disorder and mimicry: a few days after the injection, the patient can see the emergence of some spontaneous movements of contractions in the muscles treated (paradoxical motion) without gravity.

They are quite unusual:

• The patient may have an allergic reaction: skin rash, urticaria, general allergy.
• Nausea, dizziness
• Feeling weak, fever, flu syndrome
• Drought in the skin or in the mouth.

In addition to these proven risks, unknown risk of the occurrence of hazards that are associated with all medical procedures and estimation of the duration and aspects remains unpredictable.

In overview, we must seek to learn about the risks of the procedure of aesthetic medicine without giving them more scope than they deserve.

The price of Botox injections in Tunisia depends on the number of areas to be treated. To get a quote, please contact Dr. Chiraz Bouzguenda. Anyway, the price of Botox injections in Tunisia is quite affordable and cheap.