Features of the multi-mini-botulinum therapy technique: natural and lasting results

Botulinum toxin injections have been one of the most effective methods of combating mimic wrinkles for many years. The improvement of drug production technologies, as well as the development of the safest techniques for their administration, have significantly improved the safety profile and reduced the risk of complications after botulinum therapy. But, despite the use of high-quality products and standardized insertion techniques, in practice it is not always possible to achieve the optimal correction effect. In an interview for estet-portal.com, Dr. Christopher Roland Payne spoke about the features of the multi-mini-botulinum therapy technique, which allows you to get the most natural and lasting results when using minimal doses of botulinum toxin.

Dr. Christopher Roland Payne ( United Kingdom) – inthe leading dermatologist of the Great Kingdomobritand. President of the Council of the Faculty of Aesthetics of the Royal Society of Medicine. He headed the European Society of Cosmetology and Aesthetic Dermatology. Editor-in-Chief of Cosmetic Dermatology (a leading journal in the field of dermatology and cosmetology)

What is multimini-botulinum therapy, what are its features?

Multimini Botulinum Therapy is multiple injections of botulinum toxin at very low doses. The main goal of this procedure – reduce the appearance of wrinkles at rest, but not at the expense of facial mobility or natural expression. Therefore, we do not try to completely smooth the skin, instead, the multi-mini botulinum therapy technique allows you to distribute a small amount of botulinum toxin exactly in those areas where it is needed.

The peculiarity of the procedure is that the doctor does not follow any specific scheme described in the manual, and does not inject botulinum toxin into clearly marked points. Instead, the practitioner conducts an examination of the patient, during which he can see and palpate a particular muscle, thus choosing the point of injection of the drug.

Mimic muscles originate from the bones and connect to the skin at certain points. For example, "entry points" the muscle that wrinkles the eyebrow when a person frowns looks like small dimples above the eyebrow. By injecting the drug at such points, the doctor can be sure that he will hit the target muscle.

The main goal of multi-mini-botulinum therapy – reduce the appearance of wrinkles at rest, but without compromising facial mobility or natural expression.

By injecting botulinum toxin in accordance with the standard scheme, the specialist works blindly. And the technique of multi-mini-botulinum therapy allows you to accurately administer the drug and, accordingly, use a smaller amount.

Which patients are best suited for the Multi-Mini Botulinum Therapy technique?

I would say that this technique has advantages for all patients. Therefore, in almost all cases, I would prefer to use multi-mini rather than standard botulinum therapy. This procedure provides more natural results, is more logical and is based on what the doctor sees when determining the optimal injection sites.

This approach is not only more logical, but also more economical, as it allows the use of less drug. In addition, multi-mini-botulinum therapy provides longer-lasting results. As a rule, I repeat the procedure for my patients after 5.5 months, and not after 4 months. It also saves time for patients – they only come 2 times a year instead of 3.

What are the most common complications of botulinum toxin injections?

Fortunately, serious complications after botulinum toxin therapy – an extremely rare occurrence. Mild complications are quite common and are explained by the very low therapeutic index of botulinum toxin. This means that there is an exact dosage necessary to achieve the desired effect, and even if it is slightly exceeded or reduced, the drug will be too much or too little, respectively.

That is why it is important to accurately calculate the amount of drug needed to obtain the desired result. It is very easy to go beyond this narrow range of correct dosage and get minor complications, for which the word imperfections is more appropriate. As a rule, they are easily corrected with additional injections.

As for serious complications such as dysphagia and dysphonia, they occur very rarely. This occurs after the injection of a large amount of botulinum toxin and / or its injection into the wrong points. In practice, we almost never encounter such complications, they occur in people who have not received special training or made a huge mistake in calculating the dose of the drug.

Serious complications such as dysphagia and dysphonia are very rare. This occurs after the injection of a large amount of botulinum toxin and / or its injection into the wrong points

What should I do in case of complications after botulinum toxin injections?

It all depends on their character. If the issue is insufficient muscle relaxation, after 10-20 days, an additional dose of botulinum toxin can be administered. If we are talking about excessive relaxation, the patient needs to perform special exercises. For example, if as a result of the correction the eyebrow fell a little lower than we would like, we recommend performing the following exercise. Let's say the left eyebrow is lowered. It is necessary to stand in front of the mirror, immobilize the right eyebrow and, using the fibers of the frontal muscle, raise the left eyebrow, count to 3 and lower it. This movement must be repeated 10 times. It is recommended to perform the exercise during every trip to the toilet, which is why we call it "toilet training".

What should a doctor pay attention to before giving botulinum toxin injections to new patients?

When working with any patient and before performing any procedures, it is very important to conduct a preliminary consultation. During the consultation, the patient can ask all his questions, and the doctor – get the necessary information about the patient.

It is at this stage that effective interaction between the doctor and the patient takes place. After agreeing on the end result, the methods by which it will be possible to achieve it are determined.

Sometimes patients turn to an esthetician with a specific request to perform a correction with fillers or botulinum toxin. But still it is better to ask the patient what result he wants to get. And only when the patient specifies that he wants to get rid of wrinkles, correct facial contours, etc., the doctor will be able to advise the most suitable procedures for this.

The second aspect of the consultation – the doctor must learn not only about the specific problem that worries the patient, but also about the general state of his health: what procedures (and not only aesthetic ones) were performed earlier. It is important to learn about any diseases, since the condition of the skin is often a reflection of the state of the body inside. During the examination, the doctor may detect skin cancer or a mole that is in the process of regenerating, or any other skin lesions, or perhaps even endocrine disorders such as thyroid disease. The doctor can find out all these nuances during the consultation. Thus, the value of communication with the patient before any procedures can be overestimated.