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Botulinum Toxin

What is botulinum toxin?

Botulinum toxin is a compound that addresses aesthetic concerns that are caused or exacerbated by muscular contraction.

How does it work?

Botulinum toxin temporarily reduces muscle activity. Repeated muscle contraction is the underlying cause of frown lines and crow’s feet.

How long does the treatment last?

In general, the clinical effects of botulinum toxin begin to appear in one to three days, peak in one to four weeks, and gradually decline after three to four months. Some patients, particularly those who have received repeated injections in the same area, may experience benefits for six months or longer.

What can botulinum toxin do?

Botulinum toxin has been used cosmetically in a number of clinical settings, ranging from the simple treatment of facial lines to more advanced facial sculpting. Examples of conditions that have been treated successfully with botulinum toxin include:

  • Wrinkles at the root of the nose
  • Horizontal lines on the forehead
  • Crow’s feet
  • Depressed brow
  • Small palpebral aperture
  • Bunny lines
  • Nostril flare
  • Drooping nasal tip
  • Nasolabial folds (selected patients)
  • Vertical perioral wrinkles
  • Mouth frown
  • Gummy smile
  • Marionette lines
  • Horizontal crease on the chin
  • Peau d’orange chin
  • Horizontal neck lines
  • Platysmal bands on the neck

It can also be used for:

  • Migraine headaches
  • Facial nerve palsy

What can I expect?

The toxin is injected into the desired area. The injection feels like a pinch. Numbing cream may be applied prior or an ice pack placed after to reduce the discomfort.

After the treatment to minimize excessive spread of the toxin, we instruct patients to remain upright for at least two to four hours after injection and recommend that they avoid pressing or rubbing the treated areas for 24 hours. We also tell patients to contract and relax the treated muscles as much as possible for two to three hours after the procedure. In theory, contracting muscles may facilitate uptake of the toxin by neurons, accelerating the appearance of clinical benefit.

Am I a candidate for botulinum toxin therapy?

You may be a good candidate for botulinum toxin if you:

  • Are physically healthy
  • Don’t smoke
  • Have a positive outlook and realistic goals in mind for the improvement of your appearance
  • Are committed to maintaining good skin health

What are the adverse effects?

When patients are appropriately selected and proper dosing and injection technique are utilized, the use of botulinum toxin for cosmetic indications appears to be relatively safe. Side effects are usually mild and transient and most commonly include swelling or bruising at the injection site, mild headache, or flu-like symptoms. Undesired impairment of muscle function may also occur.

Is botulinum toxin treatment right for me?

Botulinum toxin is effective for aesthetic concerns that are caused by underlying muscle contraction. Individuals with other signs of aging, such as textural changes, and skin laxity often require additional cosmetic procedures to achieve satisfactory rejuvenation.


The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.


  1. Kane, Michael AC, and Gary Monheit. “The practical use of AbobotulinumtoxinA in aesthetics.” Aesthetic surgery journalsuppl_1 (2017): S12-S19.
  2. Cohen, Joel L., and Nicolo Scuderi. “Safety and patient satisfaction of AbobotulinumtoxinA for aesthetic use: a systematic review.” Aesthetic surgery journal 37.suppl_1 (2017): S32-S44.
  3. Meaike, Jesse D., et al. “Noninvasive Facial Rejuvenation. Part 3: Physician-Directed—Lasers, Chemical Peels, and Other Noninvasive Modalities.” Seminars in plastic surgery. Vol. 30. No. 03. Thieme Medical Publishers, 2016.

Small, Rebecca. “Aesthetic procedures in office practice.” Am Fam Physician 80.11 (2009): 1231-7.

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