Francois J Duminy



Botulinum Toxin is produced by a micro-organism called Clostridium botulinum.

The organism is anaerobic, meaning that it only thrives when there is no Oxygen available.

The toxin interferes with the transfer of motor impulses from nerves into the muscle fibres that should contract when such an impulse stimulates them.

This makes it a very potent toxin or "poison" as large doses will interfere with vital functions like breathing and cardiac item5function.

The toxin has been purified and produced in such miniscule doses that it can be safely used to weaken small muscles.

It can also be used to modify the functions of glands such as sweat glands, apocrine & salivary glands.

Small muscle-like tissues in the walls of blood vessels can also be controlled, forming the basis for treatment of Migraines.

The best known of the botulinum toxin products is Botox® produced by Allergan.

This product has a proven safety record and it is the one we exclusively use in this practice.

  • item6With careful anatomical and functional judgement, Botox® can be used to modify the functions of small muscles of expression.
  • The balances between depressor muscles and elevator muscles can be changed to "re-position facial structures such as the eyebrows, the corners of the mouth and the tip of the nose.
  • Sweating of underarm, groin and hands can be reduced / controlled.
  • A Large proportion of Migraine sufferers find relief of both the intensity and the frequency of symptoms when Botox® has "hit the spot"
  • Spasms in muscles can be controlled.
  • Bruxism - "grinding of the teeth" especially during sleep, can be controlled.

What used to be a feared poison, has therefore become an extremely useful, widely and safely used product.


After injection of Botox®, it usually takes 2 days to start working and approximately 10 days to reach maximum efficacy.

The affected muscles initially remain weakened for about 3 months.

During the time of weakness, the muscle loses bulk (disuse atrophy), so, each time the Botox® is applied, the effect should last a little longer.

If the effect is not not really what one expected, or if it causes some discomfort (as the inability to raise one's eyebrows might), One can be assured that it will disappear in a few months.

As with any treatment, there can be undesirable side-effects, luckily, in trained hands these are rare.

The undesirable effects include:

  • Droopy eyelids
  • difficulty with whistling
  • difficulty with using a drinking straw
  • difficulty with using plosive sounds such as "P" or "B"
  • Asymmetry of the smile
  • Asymetry of eyebrow movement

Some of these problems can be corrected by experienced doctors by using additional Botox®