Botulinum Toxin

When smiling, frowning, or raising the eyebrows, the skin repeatedly moves along the same lines. Over time, these expression lines can become increasingly visible, even at rest.

Botulinum toxin can temporarily reduce the activity of selected muscles.

This is not about making the face as immobile as possible.

At Clinic Selnau in Zürich, we plan treatment so that disruptive expression lines are softened, while expression and individual facial features are preserved as much as possible.

Our Approach

A botulinum toxin treatment does not begin with the number of areas to be treated.

What matters is which muscles are responsible for the visible change, and how they interact with adjacent muscle groups.

For this reason, we assess the face both at rest and during movement.

We consider muscle activity, brow position, symmetry, facial proportions, and individual expression.

Only from this does it become clear which muscles should be treated, and which should deliberately remain untouched.

The aim is not less expression. It is a more balanced expression, in which natural movement is preserved.

How Does Botulinum Toxin Work?

Botulinum toxin temporarily influences the transmission of signals between nerve and muscle.

When precisely introduced into a muscle, its activity is reduced for a limited period.

The overlying skin is then folded less intensely.

Expression-related lines can soften, and the face can appear more relaxed.

The effect is temporary. Over time, muscle activity gradually returns.

Which Areas Can Be Treated?

Botulinum toxin can be used in different areas of the face. Common treatment areas are:

• Forehead
• Frown lines
• Crow's feet
• Eyebrow area
• Nose region
• Chin
• Perioral area
• Jawline
• Neck

Not every visible line, however, is a suitable indication for botulinum toxin. What matters is whether muscle activity is actually the main cause of the change.

Forehead

Horizontal forehead lines are caused by the activity of the frontalis muscle. This muscle simultaneously raises the eyebrows.

Treatment must therefore always consider the relationship between forehead lines and brow position. If the forehead muscle is reduced too strongly, brow position can change in an unwanted way.

For this reason, it is not about removing every forehead line entirely. A natural forehead is allowed to move. What matters is how much movement suits the face and individual anatomy.

Frown Lines

The lines between the eyebrows arise from the interplay of several muscles.

With pronounced activity, the area can appear tense or stern, even at rest. Targeted treatment can reduce this muscle activity.

We consider not only the visible line, but also brow position and its interplay with the forehead muscles.

Crow's Feet

Fine lines to the side of the eyes develop particularly when smiling and squinting.

Botulinum toxin can reduce the activity of the responsible muscles and soften more pronounced lines. Completely eliminating movement is not the goal. The eye area, in particular, contributes significantly to natural facial expression.

Brow Position

Brow position results from the balance of different muscle groups.

Some muscles lift the brows, others pull them down. Through a targeted change to this balance, brow position can be subtly influenced in selected cases.

This effect is limited, however, and not comparable with a surgical brow lift or forehead lift. Where relevant excess skin exists on the upper eyelid, it should additionally be assessed whether an upper eyelid lift is the more suitable, anatomically appropriate treatment.

Chin & Lower Face

Pronounced muscle activity can also intensify certain changes in the lower face.

These can include, for example, a dimpled chin surface or certain muscle-related patterns of downward pull.

Treatment here differs considerably from the classic treatment of the forehead or frown lines. Particularly around the mouth and chin, many muscles are closely involved in speech, expression, and function. Precise dosing is therefore especially important.

Jawline

In patients with pronounced chewing muscle activity, botulinum toxin can, in selected cases, be used to reduce the activity of the masseter muscle.

Over time, this can also change the contour of the lower face. The treatment, however, is not suitable for every broad jaw contour. Bone structure, fat tissue, and other anatomical factors can likewise be responsible for facial shape.

For this reason, it should first be clarified which structure actually determines the visible contour.

Neck

Certain muscular structures of the neck can be treated in a targeted way with botulinum toxin.

Here, in particular, the activity of the platysma is the primary focus.

Such treatment, however, cannot correct relevant skin laxity or pronounced structural changes of the neck. With significant skin and tissue laxity, a surgical neck lift can be the more appropriate treatment.

Dynamic & Static Lines

Not every line arises exclusively through movement.

Dynamic lines are primarily visible during facial expression. Over time, these lines can also remain present at rest and become static lines.

Botulinum toxin reduces the muscular component of these changes.

If a line is already deeply established in the skin, it can improve, but does not necessarily disappear completely. In such situations, skin quality can additionally play a role.

Treatments from the areas of medical cosmetics, biostimulation, or laser skin resurfacing can, depending on the starting point, address other aspects.

Botulinum Toxin or Dermal Filler?

Botulinum toxin and dermal filler perform different functions.

Botulinum toxin influences the activity of selected muscles.

Dermal fillers are used when volume, contour, or structural support need to be changed.

An expression-related forehead line, therefore, requires a different treatment than a volume deficit in the midface.

It is not the visible line alone that determines the treatment. What matters is why it developed.

Botulinum Toxin or Biostimulation?

Biostimulation, too, follows a different treatment principle.

While botulinum toxin influences muscle activity, biostimulating treatments target skin quality and the body's own regenerative processes more strongly.

Both methods can, with suitable indication, be part of a broader treatment concept.

They do not, however, replace one another.

Natural Results & Dosage

The appropriate dose depends on muscle strength, anatomy, sex, facial expression, and the desired result.

A higher dose does not automatically produce a better result. Likewise, a particularly low dose is not inherently more natural.

What matters is the effect that should be achieved within the individual muscle group.

A natural result does not come from using as little botulinum toxin as possible. It comes from choosing a dose that matches the individual muscle activity.

Symmetry

No face is completely symmetrical.

Muscle activity and brow position, too, frequently differ between the right and left sides of the face.

Botulinum toxin can help balance certain muscle-related asymmetries. Perfect symmetry, however, can neither be promised, nor should it be the treatment goal.

Your individual expression should be preserved.

When Does the Effect Begin?

The effect of botulinum toxin does not occur immediately after the injection.

It develops gradually over the days following treatment. The result should therefore not be assessed directly after the injection.

Only once the effect has developed can the change in muscle activity be meaningfully evaluated.

How Long Does Botulinum Toxin Last?

The effect is temporary.

How long it lasts differs individually and depends, among other things, on the treated muscle group, muscle activity, dosage, and personal factors.

Over time, the effect gradually diminishes and the original muscle activity slowly returns.

A further treatment can be performed once the effect has sufficiently worn off, and a wish for treatment still exists.

The Treatment

Before treatment, we analyse the face at rest and during different facial movements.

The intended injection points and dosage are determined according to individual muscle activity.

Botulinum toxin is then precisely introduced into the selected areas using fine needles.

The treatment itself usually takes only a short time.

After Treatment

Temporary mild redness, swelling, or small bruises can occur at the injection sites.

Most patients can return to their daily routine shortly afterward.

Specific aftercare recommendations are discussed individually.

Since the effect only develops over time, the result should not be assessed immediately after treatment.

Risks

Botulinum toxin is a medical treatment and can cause unwanted effects.

Alongside local reactions, temporary functional or aesthetic changes can occur, depending on the treated area. These can include, for example, asymmetries or an unwanted change to adjacent muscle activity.

Precise knowledge of anatomy and an adapted dosage are therefore essential components of treatment.

Possible risks are discussed before treatment, according to the respective area.

Prevention or Treatment?

Botulinum toxin is sometimes used before pronounced static lines have developed.

The concept of preventive treatment, however, should not mean that every visible expression should be reduced early.

Expression is a natural part of the face.

Treatment makes sense when a particular muscle activity, or its visible consequences, is genuinely experienced as disruptive.

Not every line needs to be prevented. Treatment should have a specific reason.

A Long-Term Treatment Concept

The face changes over time.

Muscle activity, skin quality, volume, and tissue position do not develop in the same way, or at the same pace.

For this reason, botulinum toxin should not be viewed in isolation as a permanent standard treatment.

For some patients, it remains the only treatment they want. For others, dermal fillers, biostimulation, treatments from skin & laser, or surgical procedures can become appropriate over the course of time.

The aim is not to combine as many treatments as possible. It is to treat the structure that is actually responsible for the desired change at any given point.

The goal is not an unmoving face. It is a precise balance of muscle activity in which your natural expression is preserved.

Consultation

During your personal consultation at Clinic Selnau in Zürich, we analyse your facial anatomy and expression.

We assess which muscle groups are responsible for the disruptive lines or contours, and how treatment can influence the surrounding structures.

We discuss which changes are realistically possible with botulinum toxin, and where other techniques may be more sensible.

Where volume or contour is the primary concern, a dermal filler can be more suitable. Where biostimulation is more relevant, it can be considered. For structural changes to the skin, medical cosmetics or skin & laser can serve a different purpose.

The aim is not an unmoving face. It is a targeted balance of the muscles, in which your natural expression is preserved.