Micro botox. Dermalift. Baby botox. 2022 Singapore | A regional literature review

Halfway into 2022, and we notice attaining tighter brighter skin to be one of 2022’s hottest aesthetic request. And what can be done to achieve this? From Profhilo, Gouri, Sculptra, HIFU to microbotox, these simple injectibles help to turn your skin more youthful and healthier. Today, we dive deep into a growing baby botox trend.

What is the difference between Botox and Microbotox | Baby botox?

Microbotox is a very good preventative treatment, while botox is FDA proven for dynamic wrinkle line reduction. The major difference between micro-Botox and Botox lies in the plane of injection and the dilution.  Micro-Botox is only injected at a superficial level into the layers just beneath your skin. Botox is delivered into the muscle group of concern on the face to block nerve activity and reduce muscle action.

What is Microbotox?

Microbotox is the injection mini-droplets of super-diluted neurotoxin into the dermis of your skin. It requires an experienced injector with steady hands and eyes.

How long does Microbotox last?

3-4 months in majority of cases.

How long does Microbotox effects show?

Peak results should occur by the 2 week mark.

Is every part of the face suitable for microbotox? Any “no go zone“?

Principle

¨   Works in which layer? – dermal layer

¨   Works where? – on your sebaceous and sweat glands

¨   What happens? – gland atrophy and skin contraction

¨   Contraindication – similar to botox contraindications.

And here is the clinical evidence.

How does microbotox help for Acne and oily face (seborrhoea)?

Rho, N.-K.; Gil, Y.-C. Botulinum Neurotoxin Type A in the Treatment of Facial Seborrhea and Acne: Evidence and a Proposed Mechanism. Toxins 202113, 817.

¨    Lit review was conducted in 2021. Here is the summary of the findings of both In vitro and in vivo studies > 60 studies in total.

¨    BoNTA blocks cholinergic transmission and other neurotransmitter pathways of SG activities.

¨    Facial seborrhea in overactive SG may be more susceptible to cholinergic regulation than normal or dry skin.

¨    Exacerbation of acne is related to activation of the stress response through cholinergic signaling – Ach

¨    Patients  who smoke, frequently show an increased sebum secretion

¨    Human SGs strongly express nAChRa7 => glandular function is under the regulation of cholinergic signals

Does microbotox help in Skin tightening, facial lifting?

Atwa EM, Nasr MM, Ebrahim HM. Evaluation of Intradermal Injection of Botulinum Toxin A for Facial Lifting. J Clin Aesthet Dermatol. 2020 Dec;13(12):22-26. Epub 2020 Dec 1.

 Here is a summary of the abovementioned study.

¨   METHODS: Twenty-five female patients with mild symmetrical facial skin laxity were enrolled in this study. All patients were treated with BTXA in one side of the face while the other side was injected with normal saline.

¨   RESULTS: A highly significant difference was found between the side injected with BTXA and the saline injected side (control) (p<0.001).

¨   Facial lifting was achieved in 58.66 percent of the sides injected with BTXA.

¨   Forty-four percent of patients were very satisfied.

¨   Older patients showed better improvement than younger patients, with results lasting up to 16 weeks. 

Iranmanesh B, Khalili M, Mohammadi S, Amiri R, Aflatoonian M. Employing microbotox technique for facial rejuvenation and face-lift. J Cosmet Dermatol. 2022 Jan 22.

Here is a summary of the abovementioned study.

¨    Methods: Lit review. We conducted a search in Pubmed, Embase, Web of Science, and Google Scholar databases from conception until October 2021 with keywords “microbotox” OR “mesobotox” OR “intradermal injection” AND “botulinum toxin” AND “rejuvenation” AND “wrinkle” AND “face-lift.”

¨    Conclusion: Microbotox is an efficient and attractive method for facial rejuvenation, mid-lower face-lifting

¨    fine wrinkles reduction in forehead, periocular, and cheek regions, especially in younger-aged subjects.

¨    Furthermore, it is a suitable treatment for neck rejuvenation and recontouring of lower mandibular border, particularly in older subjects with marked skin laxity.

How botox and microbotox work

Does microbotox help with widened Pores?

Ahmed El Attar Y, Nofal A. Microbotox for the treatment of wide facial pores: A promising therapeutic approach. J Cosmet Dermatol. 2021 May;20(5):1361-1366

study of widened pores

 

 Here is a summary of the abovementioned study.

¨    Methods: Thirty-five patients with wide facial pores received a single session of microbotox. Objective measurements regarding improvement of pore size (0-4 scale) were recorded by two-blinded dermatologists. The improvements were confirmed by dermoscopic examination.

¨    Results: After a single treatment session, the total average of improvement was 87.2%.

¨    Conclusions: A single treatment session of microbotox appears to be safe and effective for the reduction of facial pore size.

¨    Improvement of skin texture and oiliness was also observed.

 

Which part of the face is good for microbotox treatment?

It depends on the age of patient. Generally,

¨ In young patients

¨   – good for acne, pores, oily skin, sweat, fine wrinkles

¨   In older patients

¨   – good for skin tightening, mild face lifting, esp over lower face and neck


If we have microbotox on the forehead is it any different with regular botox injection?

¨   – Intradermal vs intramuscular injection

¨   – Less dose into muscle with microbotox

¨   – Dose focused on dermal skin for oil + sweat control and skin tightening

¨   – Depends on muscle bulk, so those with strong muscle bulk will have less result with microbotox

¨   Forehead lines showed a higher degree of improvement in (52%) of patients compared to improvement in the glabellar lines (32%)

Atwa EM, Nasr MM, Ebrahim HM. Evaluation of Intradermal Injection of Botulinum Toxin A for Facial Lifting. J Clin Aesthet Dermatol. 2020 Dec;13(12):22-26. Epub 2020 Dec 1.

¨    facial lifting – suitable for a select group, those with?

¨    Intradermal BTXA seems to be more suitable for patients with flat and weaker muscles often associated with loose skin and older patients

¨    It can soften wrinkles; however, it was unable to improve glabellar lines. Because muscles are stronger, hence glabellar lines require adequate dose of intramuscular toxin.

Does microbotox effectively and consistently produce facial lifting?

We will discuss the following areas

¨   1. lower face

¨   2. neck and double chin

¨   3. midface + chemical browlift (in younger patients)

Midface

In a Thai study,

¨    Dr Petchngaovilai injected 261 patients with intradermal BTXA for mid-face lifting.

¨    A greater improvement of 24.90 percent of cases was achieved in cheek lifting with smoothing of the nasolabial folds and recontouring of the face

Is Dermalift a proven treatment?

Question

¨   Why is distribution lateral? To avoid facial muscle weakness.

¨   Is it effective or is it saline effect?

¨   Is it safe? Yes, in experienced hands.

What is the best non invasive aesthetic treatments for skin tightening?

What is the best non invasive treatment for heavy sweating?

What is the best non invasive treatment for acne and seborrhoea?

¨   1. For Skin tightening, options include microbotox vs HIFU vs Threadlift. Gold standard is HIFU.

¨   2. For sweat control, gold standard for axillary hyperhydrosis is neurotoxin.

¨   3. For acne and seborrhoea, gold standard is the use of retinoids.

Botox treatment FAQs

Botox® is one of the most popular and well-established injectable substances that practitioners use to successfully reduce wrinkles in patients. While many patients fear the frozen and completely overdone Botox® jobs, there have been many more cases of natural-looking, amazing results. The key? Get an experienced doctor.

What is Botox®?

First of all, Botox® is just the brand name of a certain neuromodulator, called “Botulinum Toxin Type A” but Botox® refers to an injectable cosmetic treatment used to effectively reduce fine lines and wrinkles on the face. It is completely safe to use (it has been FDA approved since 1989), but only by a licensed medical professional. There are also other well-known brand names for the same type of product, such as Dysport® or Xeomin®.

Which wrinkles on my face can I treat with Botox®? 

Cosmetic Botox® is FDA approved for use on dynamic lines

  1. Crow’s feet around the eyes
  2. Horizontal lines on the forehead
  3. Wrinkles between the eyebrows

Is botox painful? 

Any injection can hurt, but the needles used for Botox® injections are very small, so pain is usually minimal.

Will botox make my face look unnatural?

Receiving too much Botox® in the wrong places, can make your face look “frozen” or expressionless. The key is thwe right dose in just the right places, to make you noticeably more youthful and refreshed!

How much botox will I need?

The amount of Botox® you’ll need depends entirely on a few contributing factors. These include: 

  1. The type of wrinkles you’d like to treat
  2. Your aesthetic goals
  3. The degree of muscle movement in your face
  4. The number of times you’ve had Botox® in the past 
  5. Your health history

What’s the difference between Botox® and dermal fillers?

People easily get these two types of injectables confused all the time, but here’s an easy way to distinguish between the two: Botox® is for limiting muscle movement, fillers are for building volume.

Botox® reduces the activity of muscles in the face that cause wrinkles. Facial fillers, however, fill the trouble areas with a gel made up of hyaluronic acid, which helps to plump and lift the skin to replace volume loss.

How does botox work to prevent wrinkles? 

Explained simply, when injected directly into the muscle, Botox® blocks the muscle’s nerve signals and temporarily relaxes it. When the muscle is relaxed, dynamic wrinkles caused by muscle movement soften, dissipate, or disappear completely.

Are there any side effects with botox? 

Common side effects of any injectable include:

  1. Muscle weakness near the injection sites
  2. Slight bruising
  3. Bleeding
  4. Redness
  5. Swelling

How long does botox last? 

In general, Botox® injections are meant to last 3-4 months. To keep results going, you could need a follow-up treatment. After that, you should be able to expect your treatments to begin lasting longer.

References

Wanitphakdeedecha R, Ungaksornpairote C,
Kaewkes A, et al. The comparison between
intradermal injection of abobotulinumtoxin A
and normal saline for face-lifting: a split-face
randomized controlled trial. J Cosmet Dermatol.
2016;0:1–6.

Petchngaovilai C. Mid face lifting with
botulinum toxin: intradermal technique. J
Cosmet Dermatol. 2009;8:312–316.

Chang SP, Tsai HH, Chen WY, et al. The wrinkles
soothing effect on the middle and lower face
by intradermal injection of botulinum toxin
type A. Int J Dermatol. 2008;47:1287–1294.

Wolffles TL. Microbotox of the lower face
and neck: evolution of a personal technique
and its clinical effects. Plast Reconstr Surg.
2015;136:92S–100S.

Kapoor R, Shome D, Jain V, Dikshit R. Facial
rejuvenation after intradermal botulinum
toxin: is it really the botulinum toxin or is it the
pricks? Dermatol Surg. 2010;Suppl 4:
2098–2105.

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