Botox (botulinum toxin) is a medical treatment that temporarily limits the excessive contraction of a targeted muscle. It is used to soften expression lines, ease the symptoms of teeth grinding, reduce the frequency of chronic migraine attacks, and manage excessive sweating. At my clinic in Nişantaşı, Istanbul, I plan each treatment individually, drawing on the anatomy and comfort management that come from my background in anaesthesiology.
How botox works
Botulinum toxin temporarily limits the signal travelling from the nerve ending to the muscle. When the muscle cannot contract with its usual force, the skin above it stops folding and that area enters a period of rest. The effect is temporary, so the muscle gradually regains its normal movement. The same substance has been used for many years in neurology, ophthalmology and physical medicine, not only in aesthetics.
In my practice, the factor that decides the outcome is rarely the dose — it is the planning. The same number of units produces very different results in two people with different muscle strength and brow structure. This is why I plan every treatment while watching you make your own expressions.
Where and why it is used
Upper face and expression lines
Aimed at preventing dynamic lines, caused by muscle movement, from deepening.
- Forehead botox — softens horizontal lines across the forehead.2
- Frown lines (glabella) — softens the vertical “11” lines and the stern expression they create.1, 3
- Crow’s feet — reduces the fine lines at the outer corners of the eyes.2
- Baby botox — a micro-dose technique that preserves natural movement.
- Male botox (brotox) — planned around male muscle structure and a flat brow line.
Facial contour and lower face
- Masseter botox — relaxes the chewing muscle, easing teeth-grinding symptoms and softening a wide lower face.
- Nefertiti lift (neck botox) — relaxes the neck bands and helps define the jawline.
- Trapezius botox (trap botox) — eases shoulder and neck tension and helps the neck appear longer.
Medical applications
- Migraine botox — reduces the frequency and severity of attacks in patients diagnosed with chronic migraine.
- Underarm botox for excessive sweating — reduces sweat production in the underarm area.
The procedure
We start with an examination. I assess your muscle strength, brow position and facial symmetry, and we agree on what you actually want from the treatment. Injection points are then mapped and the appropriate doses given with very fine needles. Depending on the area, the treatment takes 5 to 20 minutes.
Comfort matters to me as much as the treatment itself. Topical numbing cream or cooling can be used; most people describe nothing more than a brief sting. You can return to your day straight afterwards.
When it works and how long it lasts
- Onset: the effect usually becomes noticeable within 3 to 4 days.
- Full result: it settles by day 10 to 14. Judging the result before then is premature.
- Duration: on average 4 to 6 months, depending on muscle strength, dose and area. With micro-dose techniques and in large muscle groups it can be 3 to 4 months.
- Repeat: I recommend leaving at least 3 months between treatments. In people who continue at regular intervals, the effect often lasts longer over time.
Visiting Istanbul or living here?
A large part of my patients are people living in Istanbul as foreign residents or visiting the city, so the practical questions come up often.
Same-day, no stay required. This is a walk-in treatment. There is no recovery period and you do not need to extend your trip for it.
Flying is not a problem. Cabin pressure does not affect the result. You can travel the same day.
We work in English. I speak English, and so does the clinic nurse who assists during treatments. You can also call the clinic in English before booking, so nothing is lost in translation at the consultation.
Licensed for international patients. The clinic holds an International Health Tourism Authorisation Certificate issued by the Turkish Ministry of Health (No. ST-3245).
The clinic is in Nişantaşı, Şişli — central and easy to reach from most of the city.
Aftercare
For the best result, a few simple points on the first day are enough:
- Stay upright for the first 4 hours. Do not lie face down or keep your head bent forward.
- Do not massage or rub the treated area.
- Avoid very hot showers for 24 hours, and saunas and steam rooms for the first week.
- Avoid heavy exercise and intense cardio for the first week.
- Avoid alcohol on the day of treatment.
Mild redness or a small bruise may appear at the injection points and settles within a few days. Allergic reactions are rare, which is why treatments are carried out under medical supervision.
What we review together at your consultation
- Pregnancy and breastfeeding
- An active skin infection at the treatment site
- Neuromuscular junction disorders
- Known hypersensitivity to botulinum toxin components
- Your current medication and general health
If any of these applies to you, we plan a more suitable alternative rather than proceeding.
Frequently asked questions
Will my face look frozen?
The aim is not an expressionless face but a balanced one. With the right dose and anatomical planning your expressions are preserved; only the excessive contraction that creates lines is limited.
Does it hurt?
Discomfort is minimal because very fine needles are used. Comfort management is familiar territory for me as an anaesthesiologist, and numbing cream or cooling is available if you are sensitive.
Is botox made from snake venom?
No. Botulinum toxin is a protein produced under laboratory conditions and used in medicine for decades. It has no connection to snake venom — this is one of the most common misconceptions I hear at consultations.
What happens when it wears off?
Your muscles regain their movement and the lines gradually return to how they were. They do not become worse. During the treated period the skin has rested without folding, which has a protective effect.
If I have it once and stop, will my face change for the worse?
No. There is no downside to not continuing. The appearance simply returns to its previous state.
Is it addictive? Will I need more over time?
Botulinum toxin is not addictive and does not accumulate in the body. Doses do not increase over time — in people who continue at regular intervals, lower doses are often enough as muscle strength reduces.
Can I build resistance to it?
It does not accumulate; the effect appears temporarily and then fades. In people treated too frequently or at higher doses than necessary, a reduced response has been reported. This is why I work at the lowest effective dose and at least 3 months apart.
How often should I repeat it?
Since the effect lasts 4 to 6 months on average, most people have two or three treatments a year. The interval should be at least 3 months.
What is the difference between botox and filler?
They do different jobs. Botox limits excessive muscle contraction, so it works on lines created by movement. Filler restores lost volume and supports facial structure. If a deep line is visible even when your face is at rest, botox alone is usually not the answer — we decide together at the examination.
Is there a right age to start?
There is no fixed age. What matters is muscle strength and whether the lines have set. If a line only appears when you make an expression, a lower-dose preventative approach can be considered. Once a line has set, expectations need to be framed differently.
Which area should I start with?
We decide at the examination. Starting with the single area that bothers you most usually works better — you see the result and then decide whether to go further.
When can I go back to work and normal life?
Immediately. There is no recovery period. If you have an important event, plan the treatment two or three days ahead, since slight redness can appear at the injection points. Wait 24 hours before applying make-up.
Can you tell me the price?
Under the applicable regulations, price information cannot be published on our website. The cost of a treatment depends on the product used, the technique chosen and the extent of the treatment. You can call the clinic for detailed information.
Sources
- Carruthers JA, Lowe NJ, Menter MA, et al. A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol. 2002;46(6):840-849.
- De Boulle K, Werschler WP, Gold MH, et al. Phase 3 Study of OnabotulinumtoxinA Distributed Between Frontalis, Glabellar Complex, and Lateral Canthal Areas for Treatment of Upper Facial Lines. Dermatol Surg. 2018;44(11):1437-1448.
- Camargo CP, et al. Botulinum toxin type A for facial wrinkles. Cochrane Database of Systematic Reviews. 2021. CD011301.pub2