Botox Injections (Botulinum Toxin Type A)

Known Symptoms

Targeted effects: Reduced muscle contraction (smoothing of wrinkles, decreased spasticity). Diminished sweat production (in hyperhidrosis).
Common side effects: Mild pain, bruising, or edema at the injection site. Temporary asymmetry (e.g., eyebrow ptosis, uneven smile).
Red flags (rare but serious):
- Systemic spread: Dysphagia, dysphonia, generalized muscle weakness, or respiratory compromise (symptoms of botulism).
- Allergic reaction: Urticaria, anaphylaxis.

Known Causes

Etiology:
- Cosmetic use: Dynamic wrinkles (e.g., glabellar lines, crow’s feet) caused by repetitive muscle contractions.
- Therapeutic use: Conditions involving muscle hyperactivity (e.g., cervical dystonia, blepharospasm) or autonomic dysfunction (e.g., hyperhidrosis, overactive bladder).
Mechanism: Binds to presynaptic cholinergic nerve terminals and cleaves the SNAP-25 protein, preventing vesicular acetylcholine release. Effects are dose-dependent, reversible, and localized to injection sites.

Care

Prevention: Avoid massaging injection sites for 24 hours to prevent diffusion. Use experienced injectors to minimize risks. Gradual dose titration in new patients.
Follow-up: Effects typically begin within 2–3 days, peak at around 2 weeks, and last 3–6 months. Schedule reinjection before full effect dissipation. Document injection patterns and doses for consistency. Monitor for late-onset side effects or diminishing efficacy.
Note: Botox is contraindicated in patients with hypersensitivity to botulinum toxin or albumin. Caution required in those taking aminoglycosides or anticoagulants. Emergency protocols should be in place for anaphylaxis or systemic toxicity.

Known Symptoms

Targeted effects: Reduced muscle contraction (smoothing of wrinkles, decreased spasticity). Diminished sweat production (in hyperhidrosis).
Common side effects: Mild pain, bruising, or edema at the injection site. Temporary asymmetry (e.g., eyebrow ptosis, uneven smile).
Red flags (rare but serious):
- Systemic spread: Dysphagia, dysphonia, generalized muscle weakness, or respiratory compromise (symptoms of botulism).
- Allergic reaction: Urticaria, anaphylaxis.

Known Causes

Etiology:
- Cosmetic use: Dynamic wrinkles (e.g., glabellar lines, crow’s feet) caused by repetitive muscle contractions.
- Therapeutic use: Conditions involving muscle hyperactivity (e.g., cervical dystonia, blepharospasm) or autonomic dysfunction (e.g., hyperhidrosis, overactive bladder).
Mechanism: Binds to presynaptic cholinergic nerve terminals and cleaves the SNAP-25 protein, preventing vesicular acetylcholine release. Effects are dose-dependent, reversible, and localized to injection sites.

Care

Prevention: Avoid massaging injection sites for 24 hours to prevent diffusion. Use experienced injectors to minimize risks. Gradual dose titration in new patients.
Follow-up: Effects typically begin within 2–3 days, peak at around 2 weeks, and last 3–6 months. Schedule reinjection before full effect dissipation. Document injection patterns and doses for consistency. Monitor for late-onset side effects or diminishing efficacy.
Note: Botox is contraindicated in patients with hypersensitivity to botulinum toxin or albumin. Caution required in those taking aminoglycosides or anticoagulants. Emergency protocols should be in place for anaphylaxis or systemic toxicity.

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Plastic Surgery

Plastic Surgery

Our Department of Plastic, Reconstructive & Microvascular Surgery offers comprehensive care for both functional and cosmetic needs, handling routine aesthetic procedures as well as complex reconstructions that other centres may refer to. Our surgeons are trained in microvascular “free tissue transfer” for head and neck reconstruction. We treat congenital differences, trauma and burns, cancer-related defects, hand conditions and complex vascular problems, and provide a full suite of cosmetic options from rhinoplasty and eyelid surgery to liposuction and non-surgical skin treatments. Supported by a craniofacial unit, dedicated burn services, lymphedema care and specialist operating theatres, the team works closely with oncologists, ENT, maxillofacial and rehabilitation specialists to plan each case.

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