It seems like centuries have passed since those famous speculations that Victoria Beckham rarely smiled so that the lines of expression wouldn’t show. Also from the statements of photographers, makeup artists, and acting coaches about how Marilyn Monroe practiced her smile in front of the mirror. Apparently, at the start of her career the actress showed a lot of gum and she learned to smile with lips slightly more closed and relaxed, controlling the opening of the mouth. In this way, the overall appearance became more photogenic.
We do not know if Monroe later, in private, laughed heartily, without filters, without measuring anything, but in public, that learned gesture accompanied her until the end of her career. The universe of beauty has evolved in recent times toward a recovery of naturalness. It is no longer about transforming, but about improving our potential. The industry changes constantly and cosmetics coexist with different treatments for facial harmonization. And thus we reach botulinum toxin, popularly known by one of its commercial names, Botox.
Everything starts by paralyzing the muscle
Dynamic wrinkles form as a consequence of involuntary but constant movement. They can be crow’s feet from laughing or between the brows when gesturing. The toxin acts by blocking communication between the nerve and the muscle. To be precise, it prevents the release of acetylcholine, a substance necessary for the muscle to contract. “What it does is ‘block’ the muscular receptor to which the signal emitted by the nerve arrives. The result is temporary relaxation or weakness of the treated muscle,” respond Sara Dominguez Bengoa and Ángela Ojeda, plastic surgeons at STEM Beauty.
During the time the toxin is active (about 4-6 months), the muscle responds less and this changes the sensory information that the brain receives: “As a consequence, motor circuits partially adapt to that new pattern of activity”.
The Forgetful Muscle
Then, can we speak of some learning, of a gestural reeducation? In other words: does the brain ‘learn’ to stop gesturing and does that make us gesture less once the effects of the treatment have passed? “Actually, the term ‘muscle memory’ is a bit misleading. Muscles do not ‘remember’ anything by themselves. In medicine we refer to learned motor patterns that are generated in the brain and executed through the nerves and the muscles,” they explain. That is, it is the result of the interaction between:
- The brain (which plans and automates the gesture).
- The nervous system (which transmits it).
- The muscle (which executes it).
Stop Frowning the Brow
All this triggers sensory feedback from the skin and tissues. “In clinical practice, what we frequently observe is that patients who had a very internalized gesture (such as frowning the brow or repeatedly raising the eyebrows), after several treatment cycles, tend to perform it with less automatism, even when the toxin’s effect has disappeared,” the doctors add.
This does not mean that the patient loses the ability to express themselves normally: if they want to frown or raise their eyebrows, they can do so perfectly. What changes is that the gesture stops appearing so automatically or repetitively as before. In other words, “it’s not about forgetting the facial expression, but that some highly automated patterns can become less frequent over time”.
How Our Brain Doesn’t Forget
There are motor and emotional circuits involved that make some gestures voluntary, others reflexes and others completely automatic. In addition, there is a third element: sensory feedback, that is, the information that the skin and the muscles send to the brain when we express ourselves.
In the case of the face, these patterns consolidate with the repetition of gestures such as frowning the brow or raising the eyebrows. If we talk about expression lines, what part of the process is muscular and what part is cerebral (motor control, habits, automation) when gesturing? Expression lines have two components:
- Muscular: the repeated contraction of the facial muscles mechanically folds the skin. Over time and with repetition, these folds lose collagen and elastin in the weakest area, and the wrinkle that initially appeared only during contraction ends up staying static (when we are not performing the gesture).
- Cerebral: the brain is the one that decides, or, at times, automates those expressions.
When the muscle does not respond with the same intensity due to the toxin, the brain continues sending the same motor commands, but the result changes because the contraction is weaker. “A change in sensory feedback is generated: the brain receives less information from the movement it usually processes and different from the expected,” they note. From there, the nervous system partially adjusts to that new situation.
Put simply: the brain does not stop ‘ordering’ the gesture, but it does receive a different response from the muscle, and that slightly changes the way that motor circuit functions while the effect lasts.
Learning to Gesture Less
Over the course of months, a kind of gestural reeducation occurs: these movements stop repeating with the same intensity and frequency. “When the effect of the neuromodulator disappears, the musculature progressively regains its normal mobility. However, many patients maintain that lower tendency to gesture excessively, simply because several months have passed without performing those gestures continuously,” says Dr. Mar Mira, aesthetic physician.
That gestural memory learned contributes to wrinkles reappearing more gradually, but in many cases, “less pronounced than before starting treatment”.
‘Unlearning’ to gesture excessively is possible, but not always easy, since most of these movements are completely unconscious. “Gestures such as frowning when concentrating, raising the eyebrows when speaking, or tensing the forehead in front of a screen are part of highly automated expressive patterns. With greater body awareness and relaxation techniques or gestural reeducation, some people can learn to better control those gestures and express themselves in a softer way,” she adds.
The ‘Botox-Like’ Label
In recent times, we have found in the market some products under the label ‘botox-like peptides’ or ‘botox-like peptides’, which are ingredients present in some anti-aging creams and that try to indirectly imitate part of the effect of botulinum toxin. Among the most well-known are compounds such as Acetyl hexapeptide-8 (Argireline), as well as other related peptides such as Pentapeptides or Biomimetic Tripeptides, included in various cosmetic formulations.
“The theory behind these ingredients is that they could very slightly modulate the release of neurotransmitters or interfere partially with the superficial muscle contraction, attempting to reproduce in a simplified way the mechanism of the toxin, which acts by blocking the release of acetylcholine at the neuromuscular junction,” say the STEM Beauty doctors.
But there are differences. The toxin’s mechanism is a very specific, potent and localized pharmacological action at the level of the neuromuscular synapse, while these topically applied peptides have limited skin penetration ability and a more superficial action.
The Topical Combo
“Over the years, different topical formulations have been investigated, including using delivery systems such as nanosomes or nanovesicles to favor the penetration of certain actives, but to date they have not demonstrated comparable efficacy,” adds Dr. Mira. What can be done through cosmetic care is to keep the skin in the best possible conditions:
- Good hydration.
- Protection of the skin barrier.
- Structured use of retinoids.
- Antioxidants.
- Daily photoprotection.
Therefore, the current trend is to combine treatments with topical products that help extend results. “All of this helps the skin tolerate movement better and to preserve its quality over time,” she concludes.
