Botulinum Toxin (Botox) Treatment

Dr Vivian Appiah is certified by the DGBT for aesthetic botulinum toxin treatments and has many years of experience in the use of Botox. She also successfully applies botulinum toxin for therapeutic indications, such as relieving bruxism (teeth grinding and jaw clenching), hypersalivation, and excessive sweating in the underarm area or other parts of the body.

Botulinum toxin type A, widely known under the brand name Botox®, is a medically wellestablished active substance used for the treatment of facial wrinkles and excessive sweating. The protein is derived from the bacterium Clostridium botulinum and works by selectively blocking signal transmission between nerves and muscles. This leads to a temporary relaxation of the treated muscles.

In aesthetic medicine, botulinum toxin is primarily used to treat dynamic facial wrinkles, for example on the forehead, between the eyebrows (frown lines), and around the eyes (crow’s feet). By relaxing the facial muscles, existing lines are smoothed, and the formation of new wrinkles may be slowed. The result is a refreshed and more relaxed facial appearance.

In addition to its cosmetic applications, botulinum toxin has been used for many years in medical therapy, for example in the treatment of muscle spasms, migraine, and bruxism (teeth grinding). It is also effective in cases of excessive sweating (hyperhidrosis). The active substance blocks the nerve impulses responsible for sweat production, thereby significantly reducing perspiration.

• A short, minimally invasive treatment using very fine injections; topical anaesthesia available on request (in most cases not necessary, please ask in advance)
• Treatment duration: approximately 15–30 minutes; hyperhidrosis treatment / Skinbooster up to 60 minutes
• In general, no downtime in daily life
• Targeted treatment of the desired muscle areas

• First effects become noticeable after a few days
• Full results after approximately 10–14 days
• Duration of effect is typically around 3–6 months
• To maintain the results, the treatment should be repeated at regular intervals

• Local redness, swelling, allergic reactions
• Bruising
• Asymmetrical results (can usually be corrected at a follow-up appointment)
• Insufficient treatment effect
• Visual disturbances, eyelid drooping (ptosis)
• We will discuss these with you individually before any treatment

Unlike filler treatments with hyaluronic acid (which can remain in the body for up to 7 years), botulinum toxin is completely broken down by the body.The two treatments also serve different purposes.

• Pregnancy and breastfeeding
• Neuromuscular disordersn
• Acute illnesses / inflammation in the facial area

Before treatment

• Alcohol consumption should be avoided.
• Make-up will be removed from the treatment areas prior to the procedure.

After treatment

• You can return to work and social activities immediately.

For at least 4 hours:

• Do not lie down or bend forward for prolonged periods
• Avoid jogging or light physical activity

For at least 12 hours:

• Avoid alcohol
• Avoid applying make-up

For approximately 1–2 days:

• Avoid strenuous physical activity
• Do not touch or massage the treated areas
• Avoid heat exposure (direct sunlight, sauna, thermal baths, etc.)

For approximately 7 days:

• Avoid facial massages, peels, fruit acid treatments, or similar procedures

Reason: Alcohol may increase the risk of bruising. Heat, massage, and physical activity can accelerate the breakdown of the active substance and potentially shorten the duration of effect.