Botulinum Toxin — Wrinkle Smoothing

Botulinum toxin injections at Brandeis Clinic are performed by MUDr. Lucie Kalinová — a certified botulinum toxin trainer in the Czech Republic, which places her at a higher proficiency level than standard practitioner certification. The treatment temporarily relaxes overactive facial muscles that cause dynamic wrinkles: frown lines between the brows, horizontal forehead lines, and crow's feet at the eye corners. It can also slim the lower face by reducing masseter (jaw) muscle bulk, and treat perioral smoker's lines. The session takes only a few minutes per area. Results become visible in 3–5 days and typically last 4–6 months.

Botulinum toxin at Brandeis Clinic carries a meaningful credential distinction: MUDr. Lucie Kalinová is a certified trainer in botulinum toxin administration in the Czech Republic. Trainer certification requires demonstrated mastery of injection technique, facial anatomy, and complication management to a standard that qualifies the practitioner to teach others — the benchmark is higher than standard practitioner credentialling. **How botulinum toxin works:** Botulinum toxin type A (brand names include Botox, Dysport, Xeomin) works by blocking the neuromuscular junction — specifically, it cleaves the SNARE protein complex that allows acetylcholine-containing vesicles to fuse with the motor nerve terminal membrane. Without acetylcholine release, the muscle cannot contract. The result is selective, localised muscle relaxation that smooths the overlying skin in areas where the wrinkle is caused by repeated muscle contraction. The effect is temporary because the blocked nerve terminal eventually regenerates: new sprouts form lateral buds that re-establish neuromuscular contact over approximately 4–6 months, at which point muscle activity and wrinkle formation gradually return. **Areas treated at Brandeis Clinic:** *Forehead lines (from 4,500 Kč):* Horizontal lines caused by frontalis muscle contraction. A balanced approach is used — over-relaxing the frontalis produces a heavy brow that most patients dislike. Injections are carefully dose-titrated and placed to preserve appropriate brow movement while reducing wrinkle depth. *Glabella / frown lines (from 3,000 Kč):* Vertical lines between the eyebrows caused by the corrugator supercilii and procerus muscles. This is the most commonly treated area globally and the one with the most evidence for long-term wrinkle prevention with regular use. *Crow's feet (from 4,500 Kč):* Lateral orbital lines caused by orbicularis oculi contraction during smiling. Injections are placed outside the orbital rim to avoid diffusion into the orbital fat or lower eyelid. *Perioral smoker's lines (from 2,000 Kč):* Vertical lines above the upper lip caused by orbicularis oris contraction. Small doses are used here — over-relaxation impairs lip function (speech, drinking). This area requires experience to treat safely. *Masseter reduction / jaw slimming (from 3,000 Kč):* Botulinum toxin injected into the masseter muscle causes gradual muscle atrophy over 6–8 weeks, reducing lower-face width in patients with hypertrophied masseters. This also treats bruxism (involuntary teeth grinding) by reducing clenching force. Results last longer than cosmetic areas — typically 6–9 months — because the masseter is rarely voluntarily exercised to the same extent as facial expressive muscles. **Practical details:** Patients arrive without makeup. The session itself — for a single area — takes only a few minutes; a full face requires 15–20 minutes total. Very fine needles are used; the experience is described as nearly painless. Visible results appear in 3–5 days; maximum effect at 10–14 days. **After treatment:** Leave immediately after the session. Avoid touching or massaging the treated area for 4 hours. Avoid sun exposure, saunas, and swimming pools temporarily. No makeup for 24 hours after facial injections. **Contraindications:** Pregnant or nursing women; neuromuscular conditions including myasthenia gravis and Lambert-Eaton syndrome; active skin infection over the injection site; blood clotting disorders or anticoagulant therapy.