The first breakthrough came from Dr. Alastair Carruthers, a Canadian ophthalmologist by training, who discovered the action of Botox® and its paralyzing effect on muscle. His wife, a dermatologist, then tried the product as part of her treatments to improve skin quality. She realized that the product, injected into the eyelid of a blepharospasm patient, had made his crow’s feet wrinkles disappear. Both concluded that botulinum toxin injections significantly reduced wrinkles.

In the hope of furthering my research into the qualities attributable to this product, which was little known to the profession at the time, I set off for Canada to learn from the few pioneers of the time.

A few months later, back in France, I had gathered enough knowledge about Botox® to start using it in aesthetic medicine, and realized that I wanted to make it my profession and my specialty.

I soon became a training physician for my colleagues and began working as a Botox® referral physician for Allergan® Laboratories. Over time, this major laboratory, which initially specialized in the treatment of ophthalmological pathologies, expanded into several medical fields, including dermatology and medical aesthetic surgery.

Getting started with Botox® injections in aesthetic medicine is not easy. The product is often incorrectly dosed or injected, resulting in frozen foreheads. The first Botox® supplied by laboratories had the advantage of making wrinkles disappear completely, but made faces look inexpressive: eyebrows were raised too much, and patients had a look of astonishment on their faces.

As the months and years went by, I learned to handle the product and inject it with greater precision. I realized that Botox® not only neutralized muscle hyperactivity. By treating the cause of the wrinkle, it also made the break in the skin disappear. As I treated more and more patients, I realized that the skin had no memory of this break, and the wrinkle disappeared completely. This product seemed to me to be the revolutionary anti-aging treatment.

Gone are the forehead lifts, the scalped, drawn, bruised foreheads. Gone were the heavy cosmetic surgeries that denatured the face and betrayed a recent operation. Botox® quickly became the go-to solution for rejuvenation that doesn’t show. A less risky, safer, lighter and non-definitive solution, in line with contemporary demands.

Today, product dosages and concentrations have been refined. I inject superficially so as never to render a face static, and succeed in obtaining the effect of a genuine facelift without surgery.

After 25 years’ experience, we finally have enough hindsight to say that botulinum toxin has no known side effects or allergies. These years of use are a guarantee of proven effectiveness, which is why its use has become so widespread.

However, some complications may occur:

• Exceptional complication: worsening of the malar pouch.
  Relaxing the orbicularis muscle at crow’s feet aggravates lymphatic stasis and amplifies the malar pouch.
• Light complication :
  • Eyebrow drooping: if the practitioner fails to recognize the wrinkle to be treated and injects a compensatory wrinkle instead of an expression wrinkle, the eyebrow droops and closes the gaze.
  • Mephisto syndrome: the head of the eyebrow is lowered and the tail of the eyebrow is raised too high. Mephisto syndrome is easily corrected with a touch-up a week later. My expertise guarantees a natural result for my patients in all circumstances.

Dr Bernard Hayot