Botox

Botox has become a household name in recent years primarily due to its popularity in cosmetic usage. Botox has been used in the medical field for many years to treat medical conditions such as cervical dystonia, chronic migraine, eye twitching and lazy eye. In this article, we are going to focus on cosmetic usage of Botox.

Before we go into the details, we need to be clear that “Botox” generally means Botulinum toxin A. As of now, there are 4 approved brands of Botulinum Toxin A to be used in Singapore for medical and cosmetic purposes – Botox, Dysport, Xeomin and Neuronox. For the purpose of discussion, we will use the term Botox because it is a common household name. It is like how we refer to all portable cassette devices as Walkman (if you are old enough to know this) and all diapers as Pampers.


What can Botox do?

Improve Facial Wrinkles

Botox works by blocking certain chemical signals from nerves that cause muscles to contract. By doing so, it can reduce the appearance of facial wrinkles caused by excessive facial expressions. The most common use of Botox injections is to temporarily relax the facial muscles that cause wrinkles on the upper part of the face. 

Some examples of commonly treated areas are:

Forehead wrinkles – Lines that appear on your forehead when you raise your eyebrows.

Frown lines – Wrinkles between your eyebrows that make you appear unfriendly or unhappy.

Crows feet – Wrinkles that appear at the corner of your eyes when you smile.

Bunny lines – Fine lines that appear when you scrunch up your nose.

Chin wrinkles – Wrinkles at your chin that make your chin appear to have multiple small dimples.

Marionette lines – Wrinkles at the corner of your mouth that make you appear sad.

Perioral lines – Fine lines around your mouth (google Helen Hunt for an example).

Each treatment result with Botox can typically last for about 3-4 months, after which repeated treatments will be required. 


Jaw Shaping

Botox is commonly used in the cosmetic field to improve the appearance of a squared or broad jaw. Treatment is also sometimes known as jaw reduction or jaw slimming. This treatment is more commonly done for women. However, due to the popular K-pop culture, we are also seeing a rise in male patients having this treatment done. In K-pop culture, a smaller or more feminine male’s face is perceived as looking more attractive.

If you dislike the fact that you are blessed with a broad muscular jaw due to large jaw muscles (also known as masseter muscles), Botox treatment can help reduce the broad jaw appearance.

Once Botox is being injected into the masseter muscles, it will reduce the muscle activity and muscle contraction. The muscles will then shrink in size gradually over a few weeks, the same way as how your biceps shrink over time if you do not work out. This way, you will observe a gradual reduction in your broad jaw appearance. 


Excessive Sweating (Hyperhidrosis)

Botox has the ability to temporarily block the secretion of the chemical that is responsible for activating the sweat glands. This way, it can “switch off” sweating at the area where it has been injected.

Areas that are commonly treated with Botox for excessive sweating are underarms, palms and forehead. After injection, improvement can be seen within 1-2 weeks. The effect of sweat reduction can last for about 4-6 months, after which repeated treatment will be required to maintain the efficacy of the treatment.


Teeth Grinding (Bruxism)

Botox can be used to improve excessive teeth grinding, the same way as how it helps with jaw reduction. 

Most people with bruxism have no symptoms and are not aware they are doing it. Some may experience facial pain and headaches especially when they wake up in the morning. If you wake up every morning with a headache, you may well be suffering from bruxism. By injecting Botox into the masseter muscles, it reduces the muscle contraction and shrinks the muscles over time. This way, it also reduces the severity of bruxism. 


Skin Lifting

Botox, in particular Dysport brand of botulinum toxin A, can be used for a skin lifting procedure known as Dysport dermalift. Dysport dermalift is a unique non-surgical face lifting technique invented by a renowned plastic surgeon in South Korea, popularised by its efficacy, immediate and long lasting result.

This treatment involves multiple micro-injections of Dysport into the skin at specific points on the face. This stimulates the fibroblast cells in the skin to produce more collagen. It also stimulates cellular cytoskeleton of the skin cells to bind to more elastin and collagen. These changes result in an instant skin tightening and face lifting effect which improves in the next 1-2 weeks.


Body Parts Slimming

Although not popular in this part of the world, Botox can be used to slim body parts such as calves and upper arms. Botox, when injected into specific areas of calf or upper arm muscles, can effectively shrink the bulk of the muscles and make the calf or upper arm appear slimmer over a period of time. The slimming results can usually last for about 4-6 months.

However, this procedure can only be performed by highly trained doctors because of the risks involved. 


In summary, besides treating wrinkles, Botox can also be used to treat many other conditions. It is very important to note that in Singapore, Botox can ONLY be administered by professionally trained doctors. Botox treatment is safe but is not without risks. Therefore, if you wish to get Botox treatment done, please remember to discuss with your doctors in detail before the treatment.

As social media becomes an increasingly larger part of our social lives, be it group photos taken at events, or selfies that we post onto our own profiles, we are also increasingly pressured to look the way we have portrayed our digital avatars. 

PHOTO EDITING, SELFIES AND BEAUTY APPS

Photo editing used to be available to only the highest echelons of society, mainly in the form of airbrushed pictures and videos seen in the media.

The advent of beauty and social apps such as Meitu, Instagram and Snapchat in recent years have vastly changed this. Now, every social class in society who has access to a smartphone has the ability to use the various facial filters and editing options to edit their photos and make adjustments to facial features to control the image they portray online. This has redefined the perception of beauty and has allowed us to enhance and beautify our facial and body features in a few clicks and swipe. It has allowed us to take control of our public face in the virtual realm. As a result, wide ranges of “selfies” have since populated the vast social media, ranging from minor edits to completely unnatural looking photos such as the infamous “snake man” from China.

FAKE PIC?

However, despite the now-common phenomenon of photo editing, the advent of these tools has also fuelled new insecurities, such as “what if people noticed?”, “oh, that must have been an edited picture”, “he does not look like that in real life” etc. Also, there is often a fear of not putting your best foot forward – for example, not getting a job or not getting the second date for not looking like the photo in your CV or profile. These have as a result fuelled both insecurities as well as aspirations to look more like our digital images or avatars. 

In the last decade or so, the once-taboo topic of having aesthetic procedures done is now increasingly becoming more mainstream and better accepted socially. Indeed, the acceptance of cosmetic and facial plastic surgery has increased and it is an increasingly common sight to see people discussing what they had done at dinner events, or even overhear discussions about trips to foreign countries for aesthetic and plastic surgical procedures. It is also more common for people to turn up in aesthetic and plastic surgery clinics requesting to look like their app-edited selfies. 

JUST VAIN OR “SNAPCHAT DYSMORPHIA” AT PLAY?

The phenomenon, as it becomes more common, is also attracting more discussions and opinions. Singaporean media TODAY published an opinion recently discussing how doctors in aesthetic and plastic surgery clinics are getting an increasing number of patients requesting to look more like their app-edited selfies, and the concern of how much mental health issues such as body dysmorphia disorder and low self-esteem is at play when it comes to wanting to improve one’s looks.

Rightly so, aesthetic treatments will not treat a fundamental psychological problem and patients who truly have body dysmorphia disorder will not attain satisfaction from aesthetic treatments and in fact may go down a slippery slope of repeatedly seeking enhancements without ever getting satisfaction. 

CAN I LOOK LIKE MY SELFIE?

The desire to enhance one’s look is not new. Selfie-editing apps, however, have now brought the idea of editing how one looks to the masses. After seeing enhanced versions of themselves, people want to be able to control how some of their facial features look. Of course, most people will only want minor improvements, such as a smoother complexion, sharper-looking features, removing their eye bags or dark circles, a more lifted face. Realistic requests and expectations are usually achievable although people also have to be prepared to accept some deviation from their desired results occasionally. 

WHAT CAN BE DONE

With aesthetic and plastic surgery procedures receiving more acceptance, the million dollar question is now whether achieving one’s desired look is possible. 

There are a host of treatments to address particular concerns, and when used in combination, they can generally achieve the ‘wants’, albeit minor deviation from the desired results occasionally. 

Patients who want a clearer complexion may undergo treatments to improve skin texture and tone such as light based therapies the likes of Intense Pulsed Light (IPL) treatments and lasers, chemical peels, rejuvenation injections such as Rejuran and skin boosters as well as botox and fillers to lighten the appearance of wrinkles. People with acne scars may consider lasers, peels and injection based treatments such as Rejuran S to lighten and ameliorate the scars over time. 


Read More: Look Refreshed with Restylane Skinbooster

To alter facial features however, a combination of skin tightening treatments, contouring treatments, fillers, thread lifts, botox, or even the more invasive plastic surgery may be used to enhance features such as a higher nose bridge, more defined jaw, slimmer face, higher cheekbones, or even fuller lips; and to reduce the appearance of undesirable features such as a double chin, sagging jowls, deep smile or laugh lines, frown lines, crow’s feet etc. By enhancing the aesthetically pleasing features and reducing the appearance of undesirable features, aesthetic doctors can often rejuvenate and freshen up one’s appearance.

One other common concern is tired eyes. Although most people put this down to having insufficient sleep, the factors causing this is much more complex than that. Tired looking eyes is usually due to a combination of pigmentation in the under eye area, lax skin around the eye, venous congestion as well as herniation of the fat pad under the eye that becomes worse with age. To achieve the ‘eye bag’ function that face editing apps achieve, a combination of treatments including light based therapies such as lasers, fillers and polynucleotide injections, chemical peels, topical skin care as well as addressing age related volume loss in the cheek area, are typically employed to rejuvenate the eyes. 

Read more:
Rejuran i – Everything You Need to Know

As evident from above, there are many options and ways of dealing with particular aesthetic concerns. However, the perception of beauty and facial features varies greatly, not only between cultures, but also between individuals. This is also the reason why customization and tailoring a personalized treatment plan to each individual is so important. 

THE PRICE OF BEAUTY

All these however come at a price. In an ideal world, everyone will want every treatment that can keep them looking like they were in their 20s. However, as with any procedures, there will be a cost to it. The cost of cosmetic procedures have always been perceived to be high and only accessible to the highest echelons of society. 

In Singapore, the growing aesthetic market has attracted the attention of multiple stakeholders. Over the past decade, the number of aesthetic providers have been steadily increasing. With the increased numbers of providers, costs have been on a downward trend over the past decade. Average prices for procedures have fallen over the years and consumers are having an increasing number of choices in terms of providers as well as treatment options. 

Despite this however, misled by the outdated perception that procedures in medical clinics are costly, some people have unwittingly attended unscrupulous beauty parlours that provide aesthetic procedures illegally, sometimes with dire consequences such as infections, blindness, skin necrosis, disfiguring scars etc. 

There are also people who travel abroad to countries like Thailand or South Korea for cosmetic surgical procedures. While people often get satisfactory results, cosmetic surgeons and practitioners in Singapore are often left to manage complications or revisions from botched surgery overseas. 

WHERE DO I START?

Everyone has a different motivation in wanting to improve their appearance. The first and foremost important question to answer is if that motivation is warranted and valid. Beyond that, other things such as invasive vs. non-invasive procedures, expectations, desired results also make important considerations. Although reading up from validated websites is also a good way to start, readers will have to be cautious of the source, quality and truth of the information they obtain, as every individual responds differently to treatments and there is a lot of misleading half-truths on the world wide web. Having friends who have done it first-hand to speak to will also be helpful and the final step will be to speak to one or even two trusted doctor to understand the procedures, the possible outcomes, risks and treatment plan to definitively address the aesthetic concern before embarking onto the journey of looking like your selfie. 

See also: rejuran, rejuran healer

Author: Dr Kwan Yuan Dong

Dr Kwan is a medical aesthetic doctor in S Aesthetics Clinic, Singapore. He is passionate in educating the public about medical aesthetic procedures, skin care and anti-ageing treatment.


*DisclaimerInformation provided in this article is for reference and educational purposes only. It does not replace actual medical advice and consultation with your doctor.