In Morphodynamic Cosmetic Surgery, botulinum toxin is considered an indispensable tool, as it is one of the main agents for myomodulation.
Botox works by temporarily deactivating certain muscle bundles. With repeated applications, a progressive and definitive weakening of the treated muscles can be achieved.
Its applications and indications are numerous, including:
- Treatment of harmful habits
- Correction of negative facial expressions
- Management of tension headaches
- Localized muscle hypertrophy
- Fibromyalgia
- Neuromuscular pain
- Trigger points
- Volumetric reduction of certain regions
- Postural defects
- Muscle spasms
- Scar treatment
- Reduction of excessive sweating
- Supportive therapy against hair loss, etc.
If a patient comes to my practice and declares themselves opposed to the use of botulinum toxin, I often consider it appropriate to refer them elsewhere.
Botox Against Male Impotence
Erectile dysfunction affects around 150 million men worldwide.
Very recently, the use of botulinum toxin (Botox) has begun to spread in cases of erectile dysfunction that are resistant to conventional therapies.
There are several approaches to the treatment of male impotence:
- PDE-5 inhibitors (phosphodiesterase type 5)
- Vacuum devices to create negative pressure
- Low-intensity electrostimulation
- Intraurethral and intracavernous injections
- Stem cell therapy
- Prostheses
Of course, it is essential to consult a specialist to assess the problem and its possible underlying causes (psychological, metabolic, cardiovascular, etc.). However, it is interesting to understand the mechanism of action of botulinum toxin in improving erection.
PDE-5 inhibitors, taken orally, increase blood flow into the corpora cavernosa by both enhancing the effect of nitric oxide and inhibiting the breakdown of cGMP (cyclic guanosine monophosphate). They include:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
- Avanafil (Spedra)
Prostadil can be administered topically or intraurethrally:
- Transdermal patch (Muse)
- Urethral application using a dedicated applicator
It works by releasing nitric oxide.
Prostadil can also be delivered via intracavernous injection, sometimes in combination with vasodilator drugs such as Papaverine.
Recent studies have shown that intracavernous injections of Botox are effective in cases where other therapies have failed. Moreover, they significantly enhance the effects of PDE-5 inhibitors, with improvements observed regardless of the underlying cause of erectile dysfunction.
The mechanism of action of botulinum toxin in facilitating erection lies in the relaxation of smooth muscle within the corpora cavernosa, which results in increased blood inflow.
Botulinum toxin has also proven effective in the treatment of premature ejaculation and in cases of penile retraction.
