Botulinum Toxin Treatment in Northern Cyprus

Four botulinum toxin type A products are legally used in the EU and Northern Cyprus. All four share the same active ingredient; the differences lie in manufacturing technology, accessory protein content and unit definitions.

• Botox® (Allergan): The reference product in the field, with the longest clinical history. Effect begins within 3–7 days and typically lasts 4–6 months. Its dosing units are considered the industry standard.
• Dysport® (Galderma/Ipsen): Smaller protein molecules mean it spreads slightly further from the injection point. It may be preferred when targeting a broad area such as the forehead or when treating a widespread gland network as in hyperhidrosis. Its unit definition differs from Botox — 1 unit Botox ≠ 1 unit Dysport (approximately a 1:2.5–3 conversion applies).
• Xeomin® (Merz): Known as a "pure neurotoxin" — it is manufactured without accessory proteins. This may reduce the risk of antibody development with long-term or frequent use (particularly relevant for patients who use it for years in medical indications such as migraine or spasticity). Its unit conversion against Botox is approximately 1:1.
• Nuceiva® / Jeuveau® (Evolus): A newer-generation product, approved primarily for cosmetic indications. Its unit dosing is close to Botox.

At Nis Clinic, the product chosen is decided at consultation based on the target area, the patient's botulinum toxin history, expected duration and diffusion requirements. Whichever product is used, it must be CE-marked, supplied via a verified cold chain, with batch number and expiry date clearly visible on the vial. Every patient has the right to see these details.

Botulinum toxin is used to soften dynamic lines caused by overactive facial muscles. Static lines arising from volume loss or gravity are better addressed with dermal fillers or other treatments. Common cosmetic areas include:

• Forehead lines (frontal lines): Horizontal lines caused by raising the eyebrows. The most frequently treated area.
• Frown lines (glabella, "11 lines"): Vertical lines between the brows that deepen during concentration, giving a tired or stern appearance.
• Crow's feet: Fine radiating lines at the outer corners of the eyes when smiling. A precise, low-dose area.
• Bunny lines: Diagonal lines on the upper sides of the nose when smiling.
• Perioral lines (smoker's lines): Vertical lines above the upper lip. Very low doses and high precision are required.
• Chin (mentalis): Orange-peel texture on the chin, or downward pull of the chin tip.
• Neck bands (platysmal bands): Vertical bands on the front of the neck.
• Masseter (jaw angle): For patients with a square jaw appearance, heavy jaw set or teeth grinding — to slim the face and relieve bruxism.

As a patient ages, the number of areas treated, the dose per area and the frequency of sessions all change. There is no single protocol that fits every patient.

Botulinum toxin is an approved medicine for multiple medical indications by the US FDA and the European Medicines Agency (EMA). Many patients associate it solely with cosmetics; in practice, a significant proportion of its use is therapeutic.

• Chronic migraine: An FDA/EMA-approved treatment for patients experiencing headaches on 15 or more days per month, at least eight of which meet migraine criteria. It is injected across 31–39 points in the head, forehead, temples, neck and trapezius, every 12 weeks. A meaningful proportion of patients with chronic migraine experience a significant reduction in attack frequency and severity. The dose used far exceeds cosmetic levels and must be administered under medical supervision.
• Hyperhidrosis (excessive sweating): Used for patients with uncontrolled sweating in the axillae, palms or soles. Botulinum toxin blocks the nerve signal that activates sweat glands. Results typically last 4–9 months and can substantially improve quality of life.
• Bruxism (teeth grinding/clenching): Injected into the masseter muscle in patients who clench or grind at night or under stress. It reduces dental wear and temporomandibular joint (TMJ) pain, with the added cosmetic benefit of slimming the jaw angle.
• Cervical dystonia, blepharospasm, spasticity: An established treatment option for neurological muscle spasm conditions.
• Overactive bladder: Also used within urology practice.

Medical indications must be managed only by the relevant specialist (neurologist, dermatologist, plastic surgeon or urologist) following a formal diagnosis and at appropriate doses. A cosmetic clinic stating it offers "migraine botox" is not sufficient; treatment must be planned in conjunction with neurological assessment.

Your consultation can take place in person at our clinic or online via WhatsApp or Zoom. At the initial assessment we cover:

• Your expression map: We ask you to perform a series of movements — raise your forehead, furrow your brows, give a broad smile, purse your lips. These movements reveal which muscles are dominant, whether asymmetry is present and which points will receive treatment.
• Your expectations: "I want the lines completely gone" requires a very different dosing strategy from "I want to look less tired, but I still want expression." Clear expectations lead to natural results.
• Medical history: Pregnancy or breastfeeding plans, neuromuscular conditions (myasthenia gravis, Lambert-Eaton syndrome, ALS), current medications (particularly aminoglycoside antibiotics and anticoagulants), allergy history, and any previous botulinum toxin or filler treatments.
• Areas we will not treat: If you have a tendency towards brow ptosis, certain forehead points must be avoided. Fully blocking the brow-elevator muscle will lower the brows further, making you look more tired — the clinical judgement here is more critical than the dose itself.

At the end of the consultation, a written summary is provided: which areas will be treated, the planned dose, the preferred product, when results will appear and an indicative price range. There is no obligation to proceed on the same day — taking time to think is your right, and something we encourage.

On the day of treatment, please avoid alcohol and discontinue blood-thinning agents (aspirin, ibuprofen, fish oil, ginkgo biloba) for at least seven days beforehand. This significantly reduces the risk of bruising.

Typical session flow:

• Skin cleansing and antiseptic preparation.
• Optional topical anaesthetic cream (applied for 10–15 minutes). The needles used are 32–33 gauge — extremely fine. Most patients feel no pain, though the cream provides added comfort for sensitive individuals.
• Injections at the pre-marked points, at the planned doses. A typical session involves 15–30 small injections.
• Session duration is 10–15 minutes. You remain awake and seated throughout.
• Mild redness or small wheals may be visible on completion; these resolve within 30 minutes.

You leave our clinic half an hour later and return to your normal day — meetings, meals, shopping. No visible marks remain; no bandages, tape or dressings are needed.

The only practical guidance for the first four hours: do not lie flat, avoid strenuous exercise, do not rub the treated area and avoid very hot environments (sauna, steam room). These precautions minimise the chance of the toxin spreading from the injection site to adjacent muscles.

The effect of botulinum toxin is not immediate. A realistic timeline:

• Days 2–3: A first softening may be perceptible; some patients notice a change, most do not yet.
• Days 5–7: Effect begins to establish; facial movements have eased noticeably.
• Days 10–14: Full effect is settled. This is the correct point at which to assess your result.
• Day-14 review (included): You are invited back to the clinic — or assessed remotely with photographs. If any asymmetry, undertreated point or area requiring adjustment is found, a touch-up dose is administered at no additional charge. This review is our quality standard; assessing the outcome before day 14 is premature.

The effect typically remains at full strength for 3–4 months, then gradually diminishes from months 4–6. A shorter duration after the first session is normal; with regular treatment, as the muscle is progressively retrained, the duration tends to extend. A booster session at months 3–4 is optional; two to three sessions per year is a typical pattern for sustained results.

• Preventive / "baby botox" patients aged 25–30: In younger patients who have no static lines yet but are noticing increasingly expressive dynamic movement, a very low dose can delay the deepening of lines over the years. This is not a gimmick — preventive approaches in aesthetics have become standard practice over the past decade.
• Classic cosmetic candidates aged 30–50: The most common indication — patients with forehead, frown and periocular lines that are prominent during expression.
• Patients over 50 seeking a combined approach: Where static lines have deepened, botulinum toxin alone is often insufficient; a combined plan incorporating dermal fillers, collagen stimulation, mesotherapy or surgery is usually required.
• Patients with a medical indication: Those diagnosed with chronic migraine, hyperhidrosis or bruxism (assessed in conjunction with the relevant specialist).
• Patients with masseter hypertrophy: Both male and female patients with a square jaw who wish to slim the facial contour.
• Male patients: The idea that botulinum toxin is "a women's treatment" is a misconception. Because male muscles are denser, doses are typically 30–50% higher; the goal, however, is generally not to erase lines but simply to soften a heavy, fatigued look.

Botulinum toxin is not administered, or requires careful specialist review, in the following circumstances:

• Pregnancy: Contraindicated. Clinical data are limited; treatment is not performed during pregnancy.
• Breastfeeding: Contraindicated. Safety data regarding transfer to the infant are insufficient; treatment is deferred until breastfeeding has ended.
• Neuromuscular conditions: In patients with myasthenia gravis, Lambert-Eaton syndrome or ALS, the effect of the toxin may be unpredictable and amplified; treatment is not performed.
• Active infection: If there is an active skin infection at the treatment site, the session is postponed until it has resolved.
• Aminoglycoside antibiotic use: Potentiates the effect of botulinum toxin; a suitable interval is observed after completing the course.
• Anticoagulant use: Aspirin, clopidogrel, warfarin and NOACs increase the risk of bruising. Medication is not stopped without the prescribing doctor's approval; the decision is made in the context of the underlying condition.
• Suspected body dysmorphic disorder: Patients who feel persistently dissatisfied or who repeatedly request further treatments are referred for psychological assessment before any procedure is undertaken. A clinic willing to say "no" is a clinic that protects its patients.
• Cancer treatment or immunosuppressive therapy: Oncologist or haematologist approval is required.
• Under 18: Not performed for cosmetic purposes.

Declining a patient is not a loss of business for us — it is a clinical responsibility. Telling you that you are not a suitable candidate is always preferable to performing a procedure that is not right for you.

Botulinum toxin treatment is about placing the injection at the right point — and knowing the right point requires a thorough understanding of the facial muscle map and neurovascular anatomy. In Northern Cyprus, botulinum toxin is administered through many different channels, from beauty salons to pharmacist-led consultations. At Nis Clinic, Op. Dr. İbrahim Meyzin, Specialist in Plastic, Reconstructive and Aesthetic Surgery, personally administers every treatment. Cyprus Turkish Medical Association (CTMA), Registration No. 969.

The practical difference: the needle enters the correct muscle, at the correct depth, at the correct dose. Asymmetry is observed, expression balance is maintained and a "frozen face" outcome is avoided. The model of "aesthetician treats, doctor supervises" is not practised at Nis Clinic.

Full doctor profile: Op. Dr. İbrahim Meyzin

The most common concern about botulinum toxin is this: "Will my face look frozen? Will I lose my expression?" This concern is legitimate — real cases exist in which exactly that outcome has occurred. The cause is not the treatment itself; it is poor technique.

Three classic errors that cause a frozen appearance:

• Excessive dose (particularly blocking the entire frontalis muscle in the forehead)
• Wrong injection points (fully silencing the brow-elevator muscle → brow ptosis, "heavy look")
• Ignoring asymmetry (equal dose to both sides, when almost everyone is naturally asymmetric)

Dr. Meyzin's plastic surgery expertise is decisive here; facial anatomy, muscle groups, expression dynamics and asymmetry management are foundational elements of this specialty. Every patient's face is planned through careful observation, not a formula; even a half-millimetre difference between the two brows is reflected in the dosing. The goal is always to preserve expression whilst softening lines — never to flatten lines at the expense of expression.

The sentence we hear most often after treatment: "My family said I looked refreshed — but they couldn't tell what I'd had done." That is our quality benchmark.

Botulinum toxin prices in Northern Cyprus span a wide range. Unusually low prices typically reflect product dilution, shared vials from partially-used stock or an uncertified practitioner. Nis Clinic's pricing policy is based on per-area packages — we do not negotiate on a per-unit basis, because that approach focuses the patient on dose quantity when the real focus should be on aesthetic outcome.

Indicative price ranges (Nis Clinic — 2026):

Pricing varies with the number of units required, the product used, the size of the target area and any combination treatments. All prices are confirmed after consultation; there are no hidden charges. The day-14 review appointment and any touch-up dose required are included in the package.

Botulinum toxin is a single-session, same-day treatment; a medical tourism package is not required. If you are visiting the area, our Nis Clinic Kyrenia branch is well-positioned for consultation and treatment. You may also wish to combine your visit with a complementary dermal filler treatment or mesotherapy for skin rejuvenation.