What is botulinum toxin?
Botulinum toxin type A is a purified protein produced by the bacterium Clostridium botulinum. Used in aesthetic medicine since the 1990s, it is today one of the most studied, safest and most effective anti-ageing treatments in the world, approved by the main international regulatory authorities (FDA, EMA).
Its mechanism of action is simple but precise: botulinum toxin temporarily blocks the transmission of the nerve signal to the muscle, preventing its involuntary contraction. In this way expression lines — which form precisely because of the repeated contractions of the mimetic muscles over the years — relax gradually and naturally.
The main areas and conditions treatable with botulinum toxin include:
- Forehead lines (the horizontal lines that appear when raising the eyebrows)
- Glabellar (frown) lines (the vertical lines between the eyebrows)
- Crow's feet (the lines at the outer corners of the eyes that form when smiling)
- Bunny lines (the lines on the nasal bridge)
- Non-surgical brow lift
- Gummy smile reduction
- Hyperhidrosis (excessive sweating of armpits, hands and feet)
- Bruxism and jaw pain (treatment of the hypertrophic masseter muscle)
Dr. Marco Galati, with over 20 years of experience in plastic and aesthetic surgery and more than 5,000 certified procedures, performs this treatment with the utmost anatomical precision, guaranteeing results that are harmonious and proportionate to each patient's individual features.
How the treatment is performed
The pathway begins with a personalised medical consultation with Dr. Galati, during which facial features, mimicry, muscle thickness and expectations are analysed. This assessment is essential to plan the most appropriate treatment, choose the optimal injection points and determine the correct dosage.
- 1. Consultation and assessment — the physician analyses the facial anatomy at rest and during expression, identifies the areas to be treated and discusses expectations. The areas of interest are photographed to document the starting condition.
- 2. Preparation and mapping — the skin is carefully cleansed. Dr. Galati identifies and marks the injection points based on the individual muscle map. In some cases a topical anaesthetic cream is applied for extra comfort.
- 3. Injection of the toxin — botulinum toxin is injected into the target muscles using extremely fine needles (30–33 gauge). Each injection takes a few seconds and the complete treatment is finished in 15–20 minutes, with minimal discomfort.
- 4. Follow-up at 2 weeks — a review after 10–14 days allows the result to be assessed and, if necessary, a small touch-up to optimise the effect in areas where the muscle response was less than expected.
What to expect after the treatment
Immediately after the injections, small wheals or localised redness may appear at the injection sites, disappearing spontaneously within 20–30 minutes. No recovery period is needed: patients can resume their normal daily activities immediately. In the first hours after treatment it is advisable to:
- Avoid massaging or rubbing the treated areas
- Not lie down for at least 4 hours
- Avoid intense physical activity for the rest of the day
- Avoid intense heat sources (sauna, steam bath) for 24–48 hours
- Avoid anticoagulant medication and alcohol to reduce the risk of bruising
Recovery and results
One of the main advantages of botulinum toxin is the absence of a true recovery period. As it is not a surgical procedure, there are no incisions, sutures or mandatory rest. Patients can return to work and their usual activities on the same day.
When results appear
The first effects become perceptible 3–5 days after the injections, as the toxin acts on the treated muscles. The complete, definitive result is appreciated within 10–14 days, which is why the post-treatment review is scheduled around the second week.
Duration of the effects
The effects of botulinum toxin are not permanent: the muscles progressively recover their function over 4–6 months. Duration varies with individual factors including metabolism, the treated area, the dosage used and the intensity of facial mimicry. With regular, repeated treatments, many patients notice a progressive lengthening of the duration: the muscles become accustomed to contracting less intensely, and the expression lines soften more and more markedly.
A natural, personalised approach
Dr. Marco Galati firmly believes in an aesthetic approach that respects each patient's naturalness and individuality. The goal of botulinum toxin treatment is not to eliminate every sign of expressiveness, but to soften the most marked expression lines while preserving natural mimicry. A correctly treated face looks rested and fresh — not artificial or expressionless. Precise dose calibration and careful selection of the injection points are the keys to this balance.
Frequently asked questions
The treatment is generally well tolerated. Injections are performed with very fine needles and the discomfort is minimal, comparable to a small pinprick. A topical anaesthetic cream can be applied about 30 minutes beforehand for extra comfort. Small red spots or wheals at the injection sites disappear within a few tens of minutes.
The first effects appear 3–5 days after the injections. The complete result is appreciated at around 10–14 days, which is why Dr. Galati schedules a review at 2 weeks, when a small touch-up can be performed if needed to optimise the result.
The effects last on average 4–6 months, depending on the patient, the treated area and the amount of product used. With repeated treatments over time, many patients notice the duration tends to increase, as the muscles become accustomed to contracting less intensely.
A treatment performed correctly by an experienced physician does not produce the frozen or artificial look sometimes associated with it. Dr. Galati uses calibrated doses and precise injection techniques to relax the wrinkles selectively while preserving natural facial expression. The key is personalising the treatment to each patient's anatomy and needs.
The main aesthetic indications are forehead lines, frown lines and crow's feet, plus bunny lines, non-surgical brow lift and gummy smile reduction. Botulinum toxin is also used for hyperhidrosis (excessive sweating) and for bruxism with hypertrophic masseter muscles.