Botox or botulinum toxin is neuromuscular agent that prevents the release of acetylcholine at the neuromuscular connection causing muscle paralysis. Botox is used in ophthalmology for more than 40 years, first in the treatment of strabismus and blepharospasm (involuntary contractions of circular muscle of the lids that can be so pronounced so patients can not open the eye). It is also used for shortening the eyelids and muscles that move the eye whan it is caused by the disease of thyroid gland (Dysthyroid orbitopathy) or by excessive tearing.

In the last ten years the use of Botox was approved for cosmetic purposes as well. Due to its paralytic effects on the muscles, when applied for aesthetic purposes Botox paralys facial muscles and softens mimic wrinkles. Botox is administered into the muscle in order to prevent the formation of wrinkles that arise due to repeated actions of this muscle. Patients feel the effect a few days after the application and the injection effects last for 4-6 months, which means that the treatment should be repeated. It is most commonly administered in the area between the eyebrows, around the outer corner of the eye, under the outer edge of the eyebrows and the forehead.

To correct static wrinkles which are formed during aging dermal fillers should be used. The most common material in ophthalmologic practice is the hyaluronic acid since it is similar to the natural constituents of the skin. Fillers are applied most often deep under the skin, usually in the recessed area underneath the eye. Its action lasts from 6-12 months. For a longer filling effect we perform a transfer of adipose tissue. After the application of Botox or fillers patients can immediately return to their daily routine.