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Wrinkle treatment with Botox | Botox Vienna

Botulinum toxin (better known as Botox) temporarily inhibits the transmission of stimuli between the nerve and the muscle. Wrinkle treatment with Botox can smooth and minimize expression lines on the face.

You look rested and relaxed.

Important Facts

What is Botulinum toxin and how does it work

Botulinum toxin is a substance that reversibly inhibits the transmission of signals from nerves to the facial muscles. In this way, the injection of very small amounts can specifically weaken certain muscles temporarily and reduce so-called expression lines.

Through regular and early application of very small amounts, botulinum toxin can prevent or at least significantly delay the development of deep expression lines, as the wrinkles are unable to form in the skin in the first place.

If the wrinkles are already so deep that they are visible even without tensing the muscles in question, further improvement may be achieved after Botox treatment by combining it with plasma or hyaluronic acid.

Dr Ilieva holds a certificate in aesthetic treatments with botulinum toxin from the Austrian Society for Dermatological Surgery.

Is Botox® dangerous

Strictly speaking, Botulinum toxin A is one of the most potent toxins known. It is a neurotoxin produced by a bacterium called Clostridium botulinum. However, the active ingredient is also one of the best-studied substances in medicine.

Botulinum has been used for many years in much higher quantities by neurologists as a drug to treat spastic conditions and is even approved for children for this indication. The dosages required for wrinkle treatment with Botox are many times lower.

In the skilled hands of experts, provided that the practitioner is appropriately trained and knows the correct dosage and injection technique, treatments with botulinum toxin are an excellent means of treating expression lines.

Which wrinkles can be treated with Botulinum toxin (Botox®)

Wrinkles caused by tension in the so-called facial muscles are best treated. The method is particularly suitable for wrinkle treatments in the upper facial area, but there are also some other indications:

Another application method is excessive sweating, as the sweat glands can also be temporarily inhibited by treatment with Botox. In my practice, I often treat patients who complain that they feel impaired in their professional and social lives due to excessive sweating.

For wrinkles caused more by a loss of volume (for example, the so-called nasolabial folds), Botox treatment is less suitable. In this case, wrinkle treatment with hyaluronic acid or thread lifting can usually achieve better results for patients than with Botox treatment.

My Patients' Experiences

How long does the effect of Botox® last

The effect of botulinum toxin (Botox®) occurs about 2-5 days after application and reaches its maximum after about 2 weeks. It then lasts between 4 and 6 months, although there are individual differences from patient to patient.

How does a Botox® treatment proceed

First, in a detailed consultation, your ideas and wishes will be discussed in detail. On the other hand, the specific anatomy of your face and your personal facial expressions will be analyzed in detail.

The skin is then cleansed. Now, using a syringe with an extremely thin needle, the corresponding botulinum units are injected into the facial muscles.

The treatment itself only takes a few minutes, but you should allow enough time for the initial consultation so that you can ask and discuss everything.

What should you consider after a Botox treatment

After the treatment, small reddening or hematomas may rarely occur at the injection sites, but these side effects quickly subside. Patients rarely report temporary headaches. However, there are also many patients who say that their migraines improve with Botox treatment because they then tense the muscles of the forehead less.

On the day of treatment with Botox, it is recommended to avoid sports, sauna, solarium or strong rubbing of the face to prevent the injected substance from diffusing into muscles where it is not desired by the doctor. Cosmetic treatments such as facial cleansing or lymphatic drainage should be carried out no earlier than seven to ten days after the Botox treatment.

The exact procedure, the possibilities, risks and side effects or any alternatives to Botox treatment will be discussed with you in detail in a consultation in one of my offices in Vienna or Baden.

What is the perfect Botox dose?

With the chosen dosage, it is generally recommended to maintain a certain residual activity of the treated facial muscles in order to avoid a mask-like appearance. The goal is to achieve a natural and relaxed expression in which no one suspects that a doctor is responsible for the result.

When should Botulinum toxin not be used

What can go wrong with a Botulinum toxin treatment

In order to get beautiful and safe results, it is essential to consult an experienced practitioner.

Rigid facial expression

If too much Botox is used, there is a risk of an unnaturally rigid, mask-like face that shows no facial expressions. It is better, especially the first time, not to use too much, so that a residual mimic is definitely retained. You should look rested, not completely immobile. Since a “too much” of Botox cannot be neutralized, it is better to make small corrections in a second session after about 14 days than to inject too high a dose in the first treatment. (It’s similar to cutting hair – you can always make it even shorter…)

Unintended asymmetries

Even more unpleasant than too high a dose is when the Botox gets into the wrong muscle group. This happens, for example, if the exact facial anatomy is not observed. This can also block muscle groups whose mobility you actually wanted to maintain. The consequences can be asymmetries such as a crooked smile or a drooping eyelid and are extremely unpleasant for those affected. To avoid something like this, it is also very important that no other cosmetic treatments such as lymphatic drainage or facial massages are carried out in the relevant facial area for at least 10 days after the treatment with Botox.

In addition, it should be mentioned that, on the other hand, it is also possible to at least partially improve any existing asymmetries of the face through skillful treatment.

What alternatives are there to Botox

When it comes to treating so-called expression lines, Botox is clearly the best alternative because it literally eliminates the cause of the problem.

However, I also offer you a variety of innovative and effective alternatives to Botox to reduce wrinkles and make your skin shine youthfully. Both in the event that the wrinkles that bother you are not suitable for Botox, and in the event that you simply do not want Botox treatment.

A popular method is hyaluronic acid filler treatment, in which natural hyaluronic acid is injected into the skin to restore volume and smooth wrinkles. Hyaluronic acid fillers are particularly suitable for deep wrinkles and contour improvement. They help to restore lost volume and plump up certain areas.

A lighter version of hyaluronic acid treatment also includes skin boosters and Profhilo; here, volume is not added so much, but rather the moisture content of the skin is increased, which provides more glow.

Microneedling is another effective alternative. Tiny needles are used to stimulate the skin and stimulate natural collagen production. This improves skin texture and reduces fine lines and wrinkles. If the treatment is also combined with PRP, which is also called a vampire lift, the regenerative effect is significantly enhanced.

Chemical peels are another option that can improve the complexion and reduce wrinkles by removing the upper layers of skin.

I will gladly help you find the right treatment for your needs and skin condition. Visit us and get individual advice to discover the best solution for your skincare goals.

Be mindful of who treats you

Be sure to choose a doctor who is an expert, has sufficient experience and also takes the time to inform you in detail and answer all your questions.

The good thing about Botox is that although the side effects will disappear after 6 months at the latest (this is the maximum duration of action of botulinum toxin), six months is a long time if you are not happy with the result.

Frequently Asked Questions About Botox (FAQ)

Botox is a drug that inhibits the movement of muscles. Thus, Botox is used to treat expression lines such as frown lines or forehead wrinkles.

Fillers, on the other hand, are substances that can give volume to the face. Hyaluronic acid fillers are used, for example, to restore lost volume in the midface or to plump up the lips.

Of course, the sensation of pain is always individual for patients, but overall, a Botox treatment is somewhat unpleasant, but not particularly painful. Most people only feel a slight burning sensation. Extremely thin needles are used. In addition, the affected area can also be made less sensitive by cold, or by small devices that send vibration impulses. In addition, the treatment really does not take very long.

When people think of Botox, most think of frown lines or crow’s feet. However, there are some other applications that skilled doctors can master and with which very beautiful and subtle results can be achieved:

  • Wrinkles on the nose (bunny lines or witch wrinkles)
  • Chin (so-called strawberry chin or cobblestone chin)
  • Drooping corners of the mouth
  • Botox Lip Flip (prevents the upper lip from rolling in when laughing)
  • Botox Brow Lift
  • Nofretete Lift and neck area
  • Gummy Smile (when the gums become too visible when smiling)
  • Another possible application of botulinum toxin is use against excessive sweating

Although no cases have been described in which Botox has caused damage to unborn children, Botox is not approved for wrinkle treatment during pregnancy and breastfeeding and should not be used in order to avoid any unnecessary risk to the health of mother and child.

By relaxing the facial muscles, the treated wrinkle can no longer be made. Deep wrinkles that are already deeply ingrained in the skin unfortunately do not disappear completely as a result. However, they are softened by regular treatments.

How early expression lines form is very individual and depends on genetics, lifestyle and the strength of the facial expressions. There is no general answer to this question. However, the best time to prevent the formation of deep wrinkles is when a wrinkle is just beginning to show as a fine line even when the face is relaxed.

Men can also be treated with botulinum toxin. Since certain facial features are generally perceived as more masculine or feminine, slightly different dosages of the toxin and slightly modified injection points are often chosen for men. Experienced doctors can achieve the optimal result here, taking into account the patient’s wishes, without it being immediately obvious that a treatment has been performed.

Yes, Botox can also be used for migraines. However, I recommend that my patients consult a specialist in neurology, because they have the appropriate training and experience to select the optimal therapy or combination of therapies for the migraine.

The effect of Botox usually lasts about 4-6 months. At the latest six months after the wrinkle treatment, the face looks like it did before the treatment. If you want to have the result of Botox permanently, you have to repeat the treatment about two to three times a year.

Yes. Botox can not only paralyze facial muscles, but also inhibit the sweat glands. This treatment is very popular with people who suffer from excessive sweating. For example, no more telltale sweat stains can form on your clothing.

Here, small amounts of Botox are injected into the upper lip muscles. This relaxes it and makes it look a little fuller. In addition, it prevents the upper lip from rolling inward when laughing. It is important to note that the result depends on the individual lip shape and the method is not suitable for everyone. Also, this procedure should only be performed by experienced doctors, as it can lead to very unpleasant side effects if applied incorrectly.

The name comes from the Egyptian queen Nefertiti, who was considered one of the most beautiful women of antiquity. Her famous bust shows a beautiful queen with a perfect chin and neck line. With the Nefertiti Lift, the appearance of the neck and lower jaw is tightened and rejuvenated with botulinum toxin.

Gummy Smile is when too much of the gums of the upper jaw is visible when laughing. A special treatment with botulinum toxin can make the smile a little more harmonious here.

In Austria, several preparations from different manufacturers are approved. Which one is used is usually the doctor’s personal preference. However, you should definitely not order botulinum toxin yourself on dubious sites on the Internet, as there is no guarantee what you will actually get.

The number of units you need for wrinkle treatment varies individually. On one hand, it depends on how strong your muscles are, and on the other hand, on how much residual movement you still want to have. While in the Anglo-Saxon region it is common to actually sell toxin by units, and providers really state the prices of the units, in Germany and Austria it is customary to give the costs for a region, even if there is a certain range in the required units. Additionally, you should know that in Austria there are several different providers of botulinum toxin preparations, and there are conversion factors here. In other words: one unit of toxin from one company does not correspond to one unit of toxin from another manufacturer.

No, after six months the effect of the toxin is gone and you look like you did before the treatment. However, it happens that patients get used to the effect and it seems to them as if the wrinkles are worse afterwards than they were.

Botox is in itself a neurotoxin and that sounds pretty scary at first. However, many long-term studies have shown that Botox does not cause any long-term effects and does not affect your health. The effect completely disappears after six months. However, muscles that are not active for a long time lose their strength, similar to the muscles on the arms and legs when we wear a cast for a long time. It is no different with the facial muscles, they also become weaker due to long periods of immobilization.

Botox prevents signal transmission from the nerve to the muscle at the so-called motor end plate. This means that while the signal for executing a movement is generated in the brain and this signal is also transmitted via the nerve pathways, the transmission is interrupted where the signal actually reaches the muscles.

The prices of Botox treatment vary, depending on how many regions are treated and how many units are needed. When treating one region (for example, the frown line or crow’s feet), costs from €200 can be expected. The combined treatment of frown lines and forehead wrinkles costs about €360. The costs will be discussed with you in detail in advance.

First, a detailed consultation takes place in my practice. Then, photos of the areas to be treated are taken. Afterwards, the skin is cleaned and the Botox is injected under the skin with thin needles. Finally, the skin is cooled.

A follow-up appointment after 14 days, during which small touch-ups may be performed if necessary, is included in the price.

For wrinkles that are not caused by movement of the facial muscles, but by sagging skin, such as the nasolabial fold or fine wrinkles on the cheeks, Botox is not the means of choice. Also, mimic wrinkles that are already very deeply ingrained cannot be made to disappear with Botox alone.

The Botox effect is when you repeatedly use Botox in the same area of the face and the muscles in question become weaker and weaker due to the permanent immobilization, so that the result lasts longer.

Of course, you can also combine Botox treatment with other treatment methods such as fillers, PRP, skin boosters, Profhilo, peels or microneedling. This can even achieve particularly beautiful results. You can get more detailed information in a detailed discussion in the Ordinaion. However, it is recommended to divide this into two different appointments in the Ordination if the same area of the face, for example the crow’s feet or the upper lip wrinkles, are treated.

Small bruises may occur during treatment. Improper use can lead to an asymmetrical facial expression. If too much Botox is used, the facial expression can appear too rigid and therefore unnatural.

That is why it is very important to only be treated by experienced doctors.

You should not visit a sauna, steam bath or solarium for a few days. It is best not to do any sports for about three days.

No cosmetic treatments on the face such as cleansing, lymphatic drainage or facial massages may be carried out for seven to ten days. For just as long, facial massage devices for home use such as cleansing brushes, jade rollers or Gua Sha should not be used either. It is best to touch the face only carefully and gently. Creams, washing, make-up and make-up removal are allowed, but carefully and gently. Please also do not wear ski or swimming goggles in the days after the Botox treatment.

In rare cases, patients develop antibodies against Botox and the preparation therefore no longer works or only works weakly. This is more common when Botox is used in neurology (for example, against spastic cramps), because much larger amounts of substance are used here than in aesthetic medicine.

In order to avoid it anyway, there should always be at least three to four months between the individual treatments. This means that it is better to treat all the regions you want to treat at once than to treat the frown line in one month, the crow’s feet in the next, etc. If you still suspect that Botox is no longer working for you, you can try to take a longer break so that the body can break down the antibodies again or you can try to switch to another botulinum toxin preparation.

Diese Behandlungsinformation wurde erstellt und medizinisch geprüft von Dr. Vjara Ilieva, Ärztin mit Schwerpunkt auf ästhetischer Medizin, Longevity- und orthomolekularer Medizin und Fachärztin für Radiologie.

Mehr über Dr. Vjara Ilieva.

Letztes medizinisches Update: Jänner 2026

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