Botox Stuttgart

Botulinum toxin is a natural protein produced by bacterial strains that has been used in medicine for over 30 years with a very high level of therapeutic safety. Strictly speaking, the well-known term Botox® is the brand name of a single preparation from the company Allergan, but colloquially it has long since become the general term for all botulinum toxin treatments. In addition to this preparation, other botulinum toxin products are approved on the German market, including Bocouture® and Xeomin® (Merz), Azzalure® (Galderma), Dysport® (Ipsen) and Vistabel® (Allergan). When I speak of Botox® on this page, I mean wrinkle treatment with botulinum toxin in general and am not referring exclusively to a specific preparation from a single manufacturer.

The effect is based on a targeted and dose-dependent principle. In aesthetic medicine, mainly botulinum toxin type A is used, which temporarily inhibits signal transmission between nerve and muscle by blocking the release of the messenger substance acetylcholine. If the treated muscle no longer receives a signal to contract, it relaxes. The expression lines resulting from its constant tension smooth out. It is important to know that botulinum toxin does not destroy any biological structures and leaves the sensation in the treated region unaffected. The effect is also completely reversible, as the body breaks down the active ingredient on its own over the following months, so that the original muscle activity gradually returns.

Every person has individual facial expressions which, depending on predisposition, lifestyle and skin condition, sooner or later lead to characteristic wrinkles. Whether a wrinkle is perceived as bothersome is very personal. Fine laughter lines (crow's feet) may bother one person, while for another they underline a likeable smile. The vertical frown lines between the eyebrows (glabella region) and the horizontal forehead lines, on the other hand, are perceived as bothersome by most people because they suggest a grumpy or stressed expression. Accordingly, the forehead, the glabella region and the outer eye area are among the most frequently requested regions for wrinkle treatment with Botox.

Beyond these classic zones, botulinum toxin can also be used to specifically lift the outer eyebrows and the corners of the mouth. Vertical lines around the mouth (lip lines) can also be reduced, a dimpled chin smoothed and, in suitable cases, a slightly drooping nasal tip subtly lifted. On the front of the neck, bothersome muscle bands, the so-called platysma bands, can also be weakened, contributing to a more harmonious neck contour.

The face has over twenty paired facial muscles that are normally in balance. If individual muscles gain the upper hand, their constant overactivity leads to wrinkles over time. This is encouraged by facial patterns practiced over years and by external influences such as UV radiation, nicotine consumption and natural skin aging. Targeted treatment can therefore not only soften wrinkles but also even out unfavorable muscular imbalances and asymmetries. This has a visibly positive effect on the overall facial expression.

In addition to pure wrinkle treatment, botulinum toxin can also be used for targeted contouring of the lower half of the face. In some people, the chewing muscle (masseter) is very pronounced, either by nature or as a result of nighttime teeth grinding, which can lead to a wider, rather angular-looking jaw area. If the active ingredient is injected specifically into the enlarged chewing muscle, its volume can be reduced over time, making the lower half of the face appear narrower and more softly contoured. This application, known as facial slimming, is very popular internationally, especially in Asia.

When performed professionally, there is no need to fear a loss of chewing strength, as the aesthetic optimization does not result in any functional restriction in the jaw area. The same targeted relaxation of the chewing muscle is also used to relieve muscular overactivity in teeth grinding (bruxism) and associated complaints such as headaches or jaw pain

As effective as the relaxing effect of botulinum toxin is in wrinkle treatment, the active ingredient is just as versatile in medicine. There it has been used for many years to treat various complaints based on muscular overactivity or misregulation. The best-known of these applications include:

• Migraine: In chronic migraine, botulinum toxin can help reduce the frequency and intensity of headache attacks.
• Excessive sweating (hyperhidrosis): If the active ingredient is injected into the affected areas, such as the armpits, excessive sweat production can be significantly reduced for several months.
• Teeth grinding (bruxism): By specifically relaxing the chewing muscle, the consequences of nighttime grinding and the associated headaches and jaw pain can be relieved.
• Muscular tension and spasms: Botulinum toxin is also used therapeutically for certain muscle tensions and for eyelid spasms.

Whether and to what extent such a medical application is an option for you always depends on careful individual assessment of the indication and should be clarified in a personal consultation. I will be happy to advise you and show you which options make sense and are medically justifiable in your specific case.

Treatment with Botox is one of the gentlest and at the same time most effective methods of modern wrinkle treatment, which is what makes it so attractive for many patients. The most important advantages at a glance:

• No surgery and no skin incisions: It is a minimally invasive injection treatment without any surgical procedure.
• No anesthesia required: As a rule, no anesthesia is necessary, as very fine cannulas are used.
• Short treatment time: The actual treatment usually takes only around 20 to 30 minutes.
• Hardly any downtime: You can go out in public immediately after the treatment and continue your normal everyday life.
• Well-tolerated active ingredient: Botulinum toxin has been researched for decades and is used in low, highly diluted doses.
• Quickly visible results: The first effects appear after just a few days.
• Reversible: As the body breaks down the active ingredient again, the result is not permanent and can be adjusted if required.

This combination of low strain, short treatment time and a natural result that can be adjusted at any time makes wrinkle treatment with Botox particularly attractive. It is of particular interest to people who want visible rejuvenation without having to undergo surgery.

My top priority is that you are lastingly satisfied with your result while preserving your natural look. A good Botox result is recognized not by the fact that it stands out, but by the fact that you look fresher and more relaxed without your face losing its expressiveness. That is why the first consultation and the precise analysis of the region to be treated are of particular importance. A treatment concept tailored individually to you best meets your wishes and at the same time ensures maximum reproducibility, so that a result that suits you can be reliably repeated in future treatments. This requires a precise treatment technique and the highest product quality.

Another point is close to my heart. For good reason, botulinum toxin may only be administered by a doctor. Only those who know the anatomical structures of the face in detail can place the active ingredient in such a way that a harmonious result is achieved and undesirable effects are avoided. As a specialist in plastic and aesthetic surgery, I am thoroughly familiar with these structures. Before every treatment, I inform you comprehensively about how it works, alternatives and possible risks, as treatment is not possible without your written consent. I can only advise you to always place yourself in the hands of a specialist with many years of experience.

In some practices, you are treated on a “price per amount” or “price per syringe” basis. The botulinum toxin is often stored pre-drawn and deep-frozen in the freezer and thawed shortly before the treatment, known in the trade as “frozen Botox”. At first glance, it may seem fair to pay for a fixed dose. However, if the effect is not sufficient and a follow-up treatment is needed, you usually pay again in this model, because you paid for a certain dose and not for an optimal result.

I have deliberately chosen a different approach and prepare the botulinum toxin freshly for every treatment. There are sometimes significant differences in quality, purity and duration of effect between a freshly prepared product and one that has been frozen for days or weeks. If a dose increase makes sense after a treatment or a small correction is needed, for example in the unlikely event of a subtle asymmetry, I generally do not charge any additional costs. As the final result can only be assessed once the full effect has set in after about two weeks, such a correction is sensibly only advisable then. In your own interest, feel free to ask which product and which concept your treating doctor works with.

To achieve results that are as natural and at the same time as stable as possible, a thorough analysis of your face at rest and in motion is indispensable before every wrinkle treatment with Botox. I carefully examine the region to be treated, your skin, the course of the wrinkles themselves and the activity of the facial muscles responsible for forming the wrinkles. This most often concerns the forehead, the zone between the eyebrows and the outer eye region, but depending on your wishes I also include other areas such as the mouth region or the front of the neck in the assessment.

In a detailed consultation, I take your wishes into account and make clear recommendations as to which areas can be treated particularly sensibly in your case. I always make sure that your individual facial expressions and expressiveness are preserved. I inform you about how it works, the procedure, possible risks and useful complementary treatment options. By combining different aesthetic procedures, highly effective, mutually reinforcing effects for improving the skin can sometimes be achieved. You will receive open and transparent information from me and enough time for all your questions before you decide at your leisure.

Extensive preparation is not necessary for Botox treatment, but there are a few points whose observance contributes to a smooth process and an optimal result. If possible, no blood-thinning medications or agents should be taken for around a week before the planned treatment. These include painkillers containing acetylsalicylic acid such as Aspirin® and certain ginkgo preparations, as they can increase the tendency to small bruises at the injection sites. If you are permanently dependent on such medications, please tell me in the personal consultation so that we can agree on how to proceed.

Before the actual treatment, I ask you to cleanse your face of cosmetic products if possible; I will of course also provide suitable cleansing products in my practice. If you are approaching Botox treatment for the first time, it may make sense to schedule the appointment towards the end of the week or on a weekend. That way, in the unlikely event of a small bruise, you can stay at home without social obligations. If, on the other hand, you have already had good experiences and know how your skin reacts, there is nothing to stop you from having the treatment promptly. On this point, I am happy to follow your wishes.

After the detailed consultation, the analysis of your face and information about how it works and possible risks, the Botox treatment can take place immediately if you wish. Alternatively, you can make a new appointment for it. First, I prepare the injection solution required for your planned treatment from fresh botulinum toxin type A. The region to be treated is then carefully cleansed. I document your current findings and your individual facial expressions photographically to record the initial state.

I then mark the planned injection points on your skin. During this process, I will ask you to activate your facial expressions in a targeted and maximal way so that I can precisely determine the most favorable injection sites for your result. The actual treatment then consists of injecting the active ingredient through an extremely thin, low-pain cannula, which the vast majority of patients find barely unpleasant. Afterwards, you can cool the treated region for a few minutes in a comfortable sitting position. Depending on individual tendency, minor swelling and slight redness may persist afterwards, but these usually resolve within a very short time, so you can leave the practice without any significant restrictions.

The effect of a Botox treatment does not set in immediately but builds up gradually over several days. The first effects appear, varying from person to person, after about three to six days, while the full effect is only reached after about fourteen days. For exactly this reason, a treatment result can only be meaningfully assessed after these two weeks have passed. Any fine correction that may be desired is therefore only advisable after this period.

As a rule, an effect lasting between four and six months can be expected, although the exact period varies from person to person. Pronounced muscular or facial activity, a high metabolic rate and especially nicotine consumption can noticeably shorten the duration of the effect. In very rare cases, the formation of antibodies even leads to a loss of effect, so a definitive statement about the individual duration of effect is fundamentally not possible. For a long-lasting result, the treatment can be repeated after four to six months to refresh the effect. About two weeks after each treatment, I also offer you a follow-up of the result, at which I make a free adjustment or dose increase if this should ever be necessary.

So that the freshly injected active ingredient can unfold optimally at the desired location, you should observe a few simple rules in the first hours and days after the treatment. First of all, I recommend cooling the treated area for a while. For about 24 hours, you should avoid major physical exertion such as heavy lifting, jogging, fitness training, saunas or thermal baths. Such exertion can encourage swelling of the treated region. In the worst case, it can also cause the active ingredient to shift (diffuse) into neighboring areas where no effect is desired.

Keep your head as upright as possible in the first few days, avoid bending down deeply and refrain from massaging the freshly treated region. Special exercises in the sense of consciously activating the treated muscles are not necessary. For about twelve hours, you should also not cover the treated areas with cosmetic products, as there is otherwise a certain risk of contamination and inflammation at the injection sites. You should also avoid strong heat from the sun, a solarium or a sauna for one to two days. If you follow these few instructions, you actively help your result develop evenly and as desired.

In experienced hands, the risks of Botox treatment are very manageable and largely predictable, which is why wrinkle injections are rightly considered a gentle and low-risk method. However, it is crucial that you follow the rules of conduct mentioned above, as these, in addition to the treatment itself, also help determine success and the risk of possible complications. As with any injection treatment, temporary swelling, redness and, rarely, small bruises can occur at the injection site, but these resolve quickly and can easily be covered with make-up if necessary. A temporary feeling of tightness, slight itching or brief sensitivity to touch are also possible.

In rare cases, visible asymmetries or undesirable muscular impairments can occur. These include, for example, excessive lowering of the eyebrows when treating low-lying horizontal forehead lines or a temporary weakness of the eyelid lifter. As the activity of the individual muscles is very individual and the face is not always tensed completely symmetrically, subtle inconsistencies are possible in principle, but can usually be evened out or corrected without any problems. During pregnancy and breastfeeding, treatment with botulinum toxin or hyaluronic acid is not possible due to incomplete data and is therefore not offered by me.

As well tolerated as botulinum toxin usually is, there are nevertheless situations in which I refrain from treatment. Your safety always takes priority over any aesthetic wish. In the consultation, I therefore ask about existing conditions and regularly taken medications, as individual preparations can influence the effect of botulinum toxin. The most important contraindications include:

• Pregnancy and breastfeeding: Due to insufficient data, neither botulinum toxin nor hyaluronic acid treatment is performed during this time.
• Certain neuromuscular diseases: Conditions affecting signal transmission between nerve and muscle speak against treatment.
• Allergies and intolerances: A known hypersensitivity to components of the injection solution rules out treatment.
• Acute inflammation or injuries in the treatment area: Unhealed skin changes in the planned area must heal first.
• Taking certain medications: These include certain antibiotics as well as blood-thinning preparations and those containing acetylsalicylic acid.

If there is a contraindication in your case or a goal you want cannot sensibly be achieved with Botox, I will openly discuss suitable alternatives with you, provided they are an option for you.

Wrinkle treatment with Botox can be combined excellently with other aesthetic procedures, which improves the skin as a whole and achieves a particularly fresh, youthful appearance. First of all, there is medical microneedling with the state-of-the-art Dermapen, which can be combined very well with peels or treatment with platelet-rich plasma (PRP) to stimulate skin regeneration.

In addition, targeted contouring or volume restoration with hyaluronic acid or other natural fillers may be useful, as may stimulating the body's own collagen synthesis through natural biostimulation with polylactic acid (Sculptra®). While Botox specifically relaxes dynamic wrinkles caused by facial expressions, fillers such as hyaluronic acid fill static wrinkles from within, so the two procedures ideally complement each other in many cases. I decide individually with you in the consultation which combination brings the greatest benefit in your case.

In addition to treatment with Botox, numerous other methods are available for treating wrinkles. Which procedure is best suited always depends on individual skin type, age, the type of wrinkles and your personal wishes. Botulinum toxin is primarily used to treat expression lines, i.e. dynamic wrinkles caused by muscle movement. For static or gravity-related wrinkles that remain visible even when completely relaxed, on the other hand, the choice usually falls on fillers such as hyaluronic acid or the body's own fat, which can fill deeper wrinkles from within.

Other options for wrinkle treatment include thermal, mechanical or chemical peels, which refine the skin by removing dead skin cells and stimulating regeneration. Laser treatments also promote skin renewal. With very pronounced tissue laxity, surgical procedures may be the more sensible option, such as a facelift or a forehead lift, which allow comprehensive tightening where wrinkle injections alone reach their limits. In some cases, only a well-thought-out combination of several procedures leads to the optimal result. That is why, in the consultation, I inform you in detail about all options that make sense for you, even if Botox treatment should not be the best choice for your concern.

In my practice, the costs of Botox treatment depend on the number of regions to be treated and also take into account the size of each area and the dose required. For the first area, you can expect a price from around €250. The exact total costs can only be reliably quoted after an individual analysis of your face and a clear agreement on the desired treatment areas.

Unlike a model that charges for a fixed amount, I focus on a result that suits you. About two weeks after the treatment, I therefore offer you a follow-up of the result, at which a free adjustment or dose increase can be made if this should ever be necessary. This gives you full transparency and the certainty of paying for a result you feel comfortable with.

The wish to get an idea of possible results in advance from before-and-after pictures is understandable and one I hear often. However, due to the requirements of the German Therapeutic Products Advertising Act (HWG), it is not permitted to publish comparative before-and-after images of Botox treatments on the internet or in other media, which is why I unfortunately cannot provide such pictures on this website. This regulation serves to protect patients and applies equally to all reputable practices.

In a personal consultation in my practice, however, it is possible to show you anonymized examples of satisfied patients that illustrate a wrinkle treatment and give you a realistic impression of the result. Feel free to ask me about it; I will take the time to discuss with you what can be achieved in your individual case.

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