One way to reduce wrinkles is treatment with botulinum toxin type A. The medical benefit
of this active substance for the treatment of strabismus and neurological muscle diseases has been known for over twenty years.

For several years now, botulinum toxin has also been used for aesthetic treatments. It is a substance that can block the release of a neurotransmitter that triggers muscle contractions. Simultaneously, botulinum toxin can be used to reduce excessive sweating (treatment of hyperhidrosis with botulinum toxin). A comprehensive consultation with your doctor about
risks and side effects is important.


Botulinum toxin A is a naturally occurring bacteria protein and a prescription drug. When it is injected into the muscle, it blocks specific nerve impulses so that the corresponding muscle can no longer be tensed as usual. Other nerve functions such as touch or feeling through the skin are not affected. Botulinum toxin A has been used for many years to treat muscle cramps around the eyes and forehead (blepharospasm).

In Switzerland, the substance has been approved as a wrinkle treatment for the correction of frown lines on the forehead. Other approvals are being sought. The injection of very small amounts of botulinum toxin A inhibits the corresponding facial muscle


Pronounced expression lines can be corrected by surgery, by injection of fillers or medications such as botulinum toxin A or even by a combination of these methods. Which method is most appropriate depends on the location and severity of the wrinkles.

With a very fine needle, the solution containing botulinum toxin A is either injected directly into the corresponding muscle or the direct vicinity of the corresponding muscle. Because the injections are done with a very fine needle, the treatment involves relatively little pain. On rare occasions, a light burning sensation can be felt during injection. 


Improvement of the frown lines (glabellar folds) generally occurs within one week after treatment, with the peak effect generally being seen within four weeks. The effect lasts for three to four months. The safety and efficacy of more frequent application have not yet been researched, so frequent use is not recommended. Should the attending physician consider it appropriate, repeat treatments may be administered when the effect of the previous injection has subsided. Repeat injections should not be made more frequently than every three months.


The botulinum toxin products we use are not tested on animals. In 2013, the manufacturer Allergan received approval for the world's first and only cell-based potency assay (CBPA) test for botulinum toxin type A. This cell-based assay was specially developed and makes animal testing for the batch release of the botulinum toxin we use superfluous in Switzerland.
This makes the botulinum toxin products we use the only ones available in Europe for which
no animal testing is carried out prior to batch release.


  • Please let us know prior to the treatment with botulinum toxin if you are pregnant

  • or breast-feeding (treatment may not be carried out during pregnancy or while

  • breast-feeding)

  • if you occasionally suffer from fever blisters (injection in a corresponding area can

  • trigger a renewed outbreak)

  • if you have taken blood-thinning medications within the last seven days prior to treatment (this causes an increased risk of bruising, or hematoma, after treatment)

  • if you suffer from a nerve or muscle disorder (for a small number of illnesses, treatment with botulinum toxin A is not possible)

  • if you are taking aminoglycoside-containing antibiotics (e.g., gentamicin, neomycin) – in this case, treatment would not take place until after the taking of antibiotics has ceased.


Based on findings from controlled clinical trials, treatment-related adverse effects are to be expected for 24% of customers. Side effects may be related to the treatment, the injection technique or both.

In general, side effects occur within the first few days after injection and are usually temporary. Local muscle weakness is an expected pharmacological effect of botulinum toxin. Blepharoptosis is also related to the pharmacological effect and may be related to the injection technique.

The following adverse reactions have been observed after treatment with Vistabel:

Reactions at the injection site
Common (1% -10%): local pain/burning/stinging, edema and/or bruising

Nervous system
Very common (> 10%): headache (13.3%)
Common (1% -10%): pain in the face, local muscle weakness
Uncommon (0.1% -1%): dizziness, nausea, dry mouth, tingling sensation of the skin, paraesthesia, twitching

Common (1% -10%): blepharoptosis
Uncommon (0.1% -1%): eye pain, edema (face, eyelid, periorbital), inflammation of the eyelids (blepharitis), visual disturbances, sensitivity to light

Common (1% -10%): erythema (redness)
Uncommon (0.1% -1%): itching, dry skin

Immune system
Uncommon (0.1% -1%): flu-like symptoms, general weakness, fever, infection

Uncommon (0.1% -1%): concern


Known hypersensitivity to the active substance or to any of the auxiliary agents according to chemical composition. General disorders that affect muscular activity (e.g., myasthenia gravis or Lambert-Eaton syndrome). Infection at the intended injection site(s).


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