Rainy season and headaches

The rainy season is coming soon this year. It’s also a bad time for people with migraines and other types of headaches. It has been more than 10 years since Botox has been used to treat migraine in the United States. We have been using Botox for many years to treat headaches, but Botox may be the second choice in cases where other methods are not effective enough or side effects prevent us from taking existing medicines.

As we’ve mentioned several times before, why Botox is effective for headaches and why changes in barometric pressure, such as the rainy season, are discovered in 2021, Looking back at the Nobel Prize in Physiology or Medicine, you can understand to some extent. Dr. Davis and colleagues at the University of California have discovered that blood vessels on the surface of the brain have receptors for spicy sensation and pain (called TRPV1). It is now also known that this receptor is antagonized by Clostridium botulinum toxin (Botox).

There are also receptors in the brain that are sensitive to changes in barometric pressure. It can be said that the involvement of these factors in the development of headache has expanded the treatment options for headache by adding to the previous theories such as contraction and dilation of blood vessels and serotonin levels in the brain.

Our clinic has been treating headaches with Botox for over 10 years in line with US FDA protocols and guidelines.

What is the relationship between the 2021 Nobel Prize (medicine) and migraine, and what is Botox?

You may not know the story of the Nobel Prize because it does not appear in the media so much, but the 2021 Nobel Prize in Physiology or Medicine discovered an ion channel receptor that feels spicy (capsaicin). It was given to Professor Julius David of the University of California, San Francisco.

The previously unknown receptor for spiciness (capsaicin) is called TRPV1, and it was also found that if it is too irritating, it feels “painful”. This TRPV1 is also present in the trigeminal neuralgia model for pain, and it is thought that botulinum toxin preparations such as Botox suppress the reaction on the blood vessels and the surface membranes of the brain.

Furthermore, TRPV1 may be involved in the transmission of signals to the ganglia of the brain (thalamus) and spinal cord via receptors that detect changes in pressure, which are also suppressed by Clostridium botulinum toxin preparations. It has been suggested that it can be blocked by Botox.

We feel that the mechanism of Botox for migraine, which was not well understood until now, is being elucidated.

Botox at Plaza Plastic Surgery: 1 week warranty with a highly experienced US specialist.

Our doctor is an US board-certified plastic surgeons who has treated many people of all races for over 20 years. In addition, our clinic offers a one-week warranty, and for the treatment of wrinkles on the forehead, glabellar (frown lines), and crow’s feet (outer corners of the eyes), additional treatment after one week is free.

In addition, for Botox treatment of parts other than the above, it is also applied to jaw like muscles (thinning, improvement of clenching), stiff shoulders, migraine, hyperhidrosis (armpit, limbs).

Botox and wrinkles (No. 2)

“the treatment to erase wrinkles with Botox”

Our clinic is in a small town in Tokyo but with many foreigners here in the town of Hiroo. As mentioned in this homepage, Botox is currently widely used for treatment other than wrinkle, such as slimmer of muscle of jawline, hyperhidrosis of armpits and limbs, migraine, and the like. In our clinic, in particular, there are many patients who use Botox for treating headaches.

Today we will talk about Botox treatment example for wrinkles. The unit used here is discussed based on Botox of Allergan Inc.

Frown lines: wrinkles between the eyebrows are types of vertical wrinkles (also called 11 o’clock signs) that can only be made when expressing difficult expressions, or types that always exist irrespective of facial expressions. In the former case, Botox often works, the effect usually appears within one week after treatment and the effect lasts for 4-5 months. Botox works at the site of the nerve endings, making the muscles paralyzed by not transmitting mediators between the muscle junction and making it less likely to wrinkle.

The target muscle is the muscles running parallel to the eyebrows called the corrugator muscle and the muscles running up and down at the base of the nose called the procerus muscle. Normally 4-6 places slightly above the eyebrows, 1 injection at the root of the nose (to the procerus muscle). The dose is 15 – 20 units. Furthermore, when injecting, the outside of the eyebrow shall be shallow and the inside will be treated deeply. Even if you do not make a difficult expression, if there is always vertical wrinkles between the eyebrows, injected materials such as hyaluronic acid may be better (though extreme caution is required for hyaluronic acid injection at this site). Avoid lying down for about 4 hours after injection, avoiding swimming and other exercise, the effect will appear after 4-5 days. It is said that the peak of the effect appears after two weeks, but we check the result after one week and if necessary, carries out additional touch-up injections for free (the guarantee system one week later ). The cost will be 30,000 yen plus tax when only eyebrows wrinkles.

Wrinkle of the forehead: The transverse wrinkle of the forehead can be made when looking upward, and this is due to the frontalis muscle which is one of the expression muscles, the muscles running above and below the forehead, 90 degrees to the wrinkle lines. Wrinkling of the forehead may also always exist regardless of facial expressions, or it can only be seen when making facial expressions. Botox will be a good application in the latter case, and we will inject a total of 15-20 units to the eight forelocks of the forehead.

The point to pay particular attention to in terms of the procedure is that it is often better not to treat the sideways of the forehead at the part near the outside of the eyebrows. If Botox is effective in this part, the eyebrows will drop. Another problem is that when you open the eyes, sometimes you use forehead muscles (forehead muscles) for some people. If Botox treatment is given to the forehead of this type, eyelids become difficult to open. In order to prevent such problems, block the action of the frontal muscle by putting your fingers above the eyebrows in advance and check how much the patient uses the frontalis muscle to open the eyelids. When the frontalis muscle is heavily involved, avoid botox injection in the lower part of the forehead.

By the way, even with the same botulinum toxin preparation, products made in Europe are more likely to diffuse and seem to be prone to the problems described above. Treatment expenses are 30,000 yen plus tax in case of forehead only, but if you join the frown lines or the crows feet, somewhat cheaper on 50,000 yen in two of these parts. The effect is longer than the eyebrows and often lasts more than 5 months. Like the eyebrows, there is a guarantee system one week later. Another thing to note when injecting Botox on your forehead is that you can change the shape of the eyebrows in the way of injection. This method is also used when you want to fist up the crawl outside the eyebrows. This method is also suitable for patients whose eyelid slack is progressing.

Wrinkles in the corner of the eyes (crows feet) can be made fan-shaped from the outer corner of the eyes when laughing with eyes, there are types that can be upward from the outer corner of the eye, downwards, and upwards and downwards. Also, like wrinkles in other parts, there are deep wrinkles that are made even when you are not smiling with your eyes, and not so obvious types of wrinkles when not laughing. The type that Botox shows effective is the latter type. If you have deep wrinkles even when you are not laughing, hyaluronic acid may be injected into that wrinkle.

The treatment amount depends on the number of wrinkles, but it is about 18-25 units on the left and right. The addition of one more thing in the treatment of Botox to the wrinkle part of the corner of the eye can change the shape of the eyebrows. Sometimes it is possible to lift the outside of the eyebrows slightly upwards by Botox injection to the oculi anterior muscle beneath the outside of the eyebrows (it is not a method that everyone can do).

Wrinkles in the upper lip: Longitudinal wrinkles occurring in the upper lip are common in women over the age of 60, but this is caused by the action of the orbicularis muscles surrounding the mouth. This phenomenon is not seen much in men because there is a beard in this part.

When treating, have the patient pucker the mouth, especially marking the vertical wrinkle which occurs strongly with a pen, then inject 10 to 15 units into 4-5 places. Being careful with Botox’s injection to the lips, when the balance between the left and right collapses, the shape of the lips may change or it may be difficult to pronounce correctly.

Injection to other facial sites: Botox is also used for treating temporomandibular disorder by thinning the face line by injection into the muscle of jawline on the face. In addition, Botox’s injection may show a remarkable effect in the uneven surface like the oranges that can be made to the chin. On the other hand, Botox has no effect on the nasolabial lines or Marionette lines (wrinkles extending obliquely downward from the outside of the mouth). Hyaluronic acid injection is recommended for these sites.

“Side effects and failure cases in Botox wrinkle treatment”
Side effects: Although side effects related to Botox treatment are extremely rare, as a example, the eyelid becomes difficult to open (eyelid ptosis is seen less frequently than 1%. It is a complication especially seen in treatment to the frown lines. Even if this condition happens, it will return to its original state naturally in about 3-6 weeks. However, once this condition has occurred, there is a tendency for the situation to become the same again. The next time to be seen is in the treatment section, but the shape of the eyebrows may change or drop down when treating the forehead.

Those who are taking fish oil, DHA, EPA, aspirin or a pain killer tend to have a bruising tendency. In addition to the above, it is not recommended to egg allergy, those who have suffered facial paralysis in the past, those who are pregnant, breastfeeding, those who are planning to become pregnant within the next 3 months. Botox is also used for the treatment of migraine, but as a very rare complication, it may cause a headache to a healthy person. Also, when you have a cold, you may not be able to treat because your condition may get worse when you do not have physical fitness. Even those who are taking some antibiotics are considered to be cautioned.

Failure cases: Extreme failure example does not occur easily, but as we have mentioned, treatment of facial wrinkles using Botox has been used to paralyze muscle groups called facial muscles to make it more attractive. It is a treatment that expects a good effect, so it would be difficult to produce results that you expect to not understand facial muscles and nerve anatomy well. In the United States, Botox’s treatment is usually performed only by a doctor who has received proper training from a plastic surgeon or a dermatologist.

Wrinkles and Botox

Many people know that botulinum toxin preparations (such as Botox injection) are used to treat wrinkles. In the United States, it is widely used for treatments other than wrinkles, but I think that it is mainly used in the eyebrows, foreheads, crow’s feet, and hyperhidrosis of armpits in Japan.

Botox had been used in Japan and the US against the state where the eyebands are twitching more than before but in the United States it gets used for various facial expression wrinkles in the upper half of the face and then jaw muscle (slendering the face), temporomandibular disorder, hyperhidrosis (side arm and limb), and so on.

Details of Botox’s side effects and mechanism of action are described in detail on our website, but serious side effects are rare and representative ones include injection in wrinkles between the brows, it is found below 0.5% that eyelids are difficult to open (ptosis of the eyelids). Also, we can not treat pregnant, nursing or those planning to get pregnant.

Many patients are receiving this treatment because the treatment of wrinkles that can be easily done with a clinic easily and the price is relatively affordable (from 30,000 yen). In our clinic, patients with migraine also receive Botox treatment well (from 20,000 yen).

Botox for treatment of headaches

For treatment of migraine using botulinum toxin (Botox etc.), it is a subject of insurance treatment in Europe and the United States. If a patient is not abnormal by MRI or CT and a headache expert such as neurological department confirms diagnosis. Then, those people are being treated with peace of mind at almost all specialized medical institutions.

In Japan, it is unauthorized as an insurance treatment, so the doctor’s decision is left to the discretion, but our clinic’s guidelines are similar to those in the West. However, if local treatment is desired with mild migraine, we will also conduct partial treatment on a trial basis, so please consult us. In that case, the treatment cost is from 20,000 yen.

Botox treatment popular among men (US news)

According to Huffington news in the USA, in the United States in recent years the number of men who receive Botox treatment has increased considerably. Most patients in our hospital are English speaking patients, but many foreign men are receiving Botox treatment each year. The treatment area is forehead (forehead), eyebrows are central. Unlike women, Botox treatment for wrinkles in the outer corner of the eye may be better for men, if you think carefully.

For details, please see the following:


Migraine headaches and Botox treatment

In our clinic, treatment of migraine is done with botulinum toxin (Botox). This treatment is a treatment method approved by government agencies in Western countries such as the United States, Canada, UK, Australia. Prior to treatment we will check to see if it meets some standards.

First of all, doctors such as neurological department and neurosurgery undergo diagnosis of headaches such as migraine. Then, if possible, receiving image diagnosis such as CT or MRI in the past, it is possible to confirm that there is no abnormality, and so on. At the time of the first visit, if you bring a thing with a history list of medications and a history of treatment up to now, the procedure will be smooth.

Nasal allergy and Botox

For those who are in a season of hay fever or other pollen allergy, although it is unapproved treatment, when improvement is not seen with otolaryngology, taking allergy medicine in ophthalmology, in certain countries a small amount of botulinum toxin is sprayed into the nasal cavity. It has been reported that treatment is effective only by applying to the mucosa.

Use of supplements and filler/Botox

Hyaluronic acid and Botox are rejuvenation methods that can be treated easily without reservation, but there are some conditions.

Those who are regularly using vitamin E, fish oil (EPA, DHA, omega 3, etc.), aspirin and other pain medication called NSAIDs have thin blood, so it is easy to get bruised by stabbing the needle, especially hyaluron near the lower eyelid. It is safer to treat it without taking medication for more than a week when considering such an injection.

Regarding Botox, it is said that it is not recommended if you are currently pregnant, or breastfeeding, but it is also said that it is better not to use it even if there is a possibility of pregnancy within the next 3 months from now. In addition, this is for both sexes.

I heard that injection of Botox to jaw muscles may cause facial paralysis. really?

There is little chance of facial nerve paralysis when injecting Botox into the jaw muscle, but it can occur rarely.

This is because branches of facial nerve are traveling the area near the jaw muscle injection.

If it happens, the left and right difference of facial expressions will appear. Even if paralysis occurs, it will fully recover in the future.

For more details, please visit this page. Thank you.

Please tell me about possible side effects after Botox injection.

Botox itself is a safe formulation and rarely has side effects, but the side effects caused by the relationship of the injection site include eyelid ptosis (eyelid lowering) and eyebrow ptosis.

It occurs with a probability of 1% or less in the treatment of the frown lines and forehead, but it surely recovers.

Next, symptoms such as headaches, fatigue, and a common cold are rare as those occurring regardless of the injection site. In rare cases, facial nerve paralysis may occur due to injection into the jaw muscles.

For more details, please visit this page. Thank you.

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Dr. Kure

Plastic Surgeon in Tokyo Japan