Botulinum Toxin — Wrinkle Relaxation and Hyperhidrosis

Physician-administered botulinum toxin injections by MUDr. Irena Hejcmanová to temporarily relax the facial muscles responsible for dynamic expression lines — including forehead furrows, glabellar frown lines and crow's feet — and to treat underarm hyperhidrosis (excessive sweating). MUDr. Hejcmanová holds a specialist certification in injectable aesthetics including botulinum toxin, gained through accredited training at European institutions. All assessments and injections are performed by the physician personally.

Botulinum toxin is a neurotoxic protein produced by Clostridium botulinum that, when purified and administered in precisely controlled microscopic doses to target muscles, produces temporary and reversible relaxation of those muscles. At the neuromuscular junction the toxin blocks the release of acetylcholine — the chemical messenger that triggers muscle contraction — preventing the muscle from receiving the signal to contract. When the facial muscles driving repetitive expression movements are selectively relaxed, the overlying skin stops folding with each expression, and existing dynamic wrinkles soften while new ones are prevented from deepening. At Derma-plus Tábor, MUDr. Irena Hejcmanová begins each consultation with a dynamic assessment of the patient's facial muscle action — observing brow lift range, the pattern of glabellar contraction with frowning, and crow's feet distribution with smiling. This functional mapping determines the injection points, depth and dose per muscle needed to achieve the desired softening without over-relaxation that creates an unnatural flat appearance. Ultra-fine needles are used; most patients describe the injections as brief pinpricks. No anaesthetic cream is typically needed. Glabellar frown lines — the vertical creases between the brows caused by the corrugator and procerus muscles — are the most common treatment site at 3,000 Kč. Crow's feet at 2,700 Kč target the orbicularis oculi muscle lateral to the eye. Forehead lines are treated in two area sizes: a smaller zone (1,500 Kč) for patients with minimal forehead activity, and a larger zone (2,500 Kč) for broader forehead involvement. Treating the forehead requires careful dosage to preserve some brow elevation function — over-relaxation produces brow ptosis — and MUDr. Hejcmanová's assessment calibrates the dose accordingly. For hyperhidrosis (excessive sweating of the underarms, palms or forehead), botulinum toxin is injected in a grid pattern across the affected area at 7,000 Kč per underarm treatment. The toxin blocks cholinergic innervation to the sweat glands, dramatically reducing sweating output for six to twelve months. This indication is particularly valued by patients for whom antiperspirants are insufficient and for whom quality of life is significantly impacted by excessive sweating. The full effect of any botulinum toxin treatment develops over five to fourteen days. A follow-up assessment at two weeks allows identification of any small asymmetries or undertreated zones and permits minor adjustment if needed. Results typically last three to five months, after which the treatment can be repeated. Contraindications include pregnancy, breastfeeding, neuromuscular disorders (myasthenia gravis) and known allergy to botulinum toxin products.