Botulinum toxin (botox)

• Frown lines (11s) between the eyebrows
• Crow’s feet or smile lines around the eyes
• Horizontal forehead lines

Other areas can be treated, such as an eyebrow lift, wrinkles around the lips, dimples on the chin, neck cords (turkey neck), wrinkling of the nose (bunny nose) and the jaw muscles (to help prevent jaw clenching). These treatments are not commonly included in the grouped areas of facial muscles. 

Side effects are uncommon and temporary – you may experience bruising or tenderness at the injection site, a mild headache and very occasionally the treatment may not work as some people are immune to the effects of Botox.

When injecting close to the eye there is a very small chance (significantly less than 1%) of developing a temporary drooping of the eye lid.  If this occurs, eye drops can be used to lessen the effect until it wears off naturally.

Using a tiny needle, small quantities of the protein are injected into the muscles under the skin where wrinkles are most troublesome.  

The protein temporarily blocks the nerve signal to the muscle, with effects lasting for three months or more.  Without the signal, the muscle cannot contract, and as it is muscle contraction that causes wrinkles, the wrinkles disappear.

Millions of people worldwide have had these injections and the safety of the product is well established and beyond doubt.

There are a few rare medical conditions such as myasthenia gravis which affect muscles, and people with these conditions cannot have treatment.  

Treatment is also not recommended in pregnant or breast-feeding women.

The injections are virtually painless and may cause a minor stinging discomfort.  

As the needles are very small, the risk of bleeding or bruising is minimal.

Avoid:

• Taking anti-inflammatories (such as aspirin, ibuprofen, naproxen) for 3 days prior to treatment (unless this has been prescribed by your doctor) as this increases the risk of bruising.
• Alcohol, fish oils, St. John’s Wort, Gingko Biloba, garlic and Vitamin E should also be avoided for 3 days prior to treatment to lessen the risk of bruising.
• If you are prone to bruising, taking arnica orally for a few days prior to treatment may lessen the risk.
• If you are unwell on the day of your appointment, contact the practitioner to reschedule.
• Ensure your practitioner is informed if there are any changes in your medical history or medication taken before receiving any treatment.
• Do not plan to have treatment within 2 weeks of an important social event or holiday as this may not allow enough time to have some correction if the desired result is not achieved.

Treatment results are often more successful when the skin is in a good condition, with good elasticity, where facial expressions are not excessive and there are no or only minimal static lines in the area to be treated.

You may not be suitable for treatment if any of the following apply:

• Botulinum toxin is generally only recommended to those aged between 25 to 65, although it may be used off-license for people outside this age range.
• Botulinum toxin cannot be given to pregnant or breast-feeding women and is not recommended if you are actively trying to get pregnant.
• Patients with certain neurological disorders (such as myasthenia gravis).
• You are currently taking certain medicines (including antibiotics, such as clindamycin).
• You have previously experienced adverse reactions to any botulinum toxin treatment.
• Treatment is not recommended if you are suffering from any skin infection in or near the treatment area, including cold sores.
• You are unwell, including coughs and colds, on the day of treatment.
• You are taking any medicines which affect bleeding, such as aspirin or warfarin.

There may be some temporary after-effects of the injections.  Most commonly these are bruising, tenderness, swelling and occasionally a headache or mild flu-like symptoms.  The latter two may last two to three days, the others usually resolve within a couple of hours. Paracetamol can be taken if needed. 

Occasionally a mild drooping of the eyelid can occur but this is very rare.  In the unlikely event that it does happen, please contact the clinic so that we can make an assessment.

Following the injections it is important to use the treated muscles as much as possible (i.e. frown, squint or raise the eyebrows depending on the area treated) for the next few hours. This helps to maximise the effect of treatment.

For 6 hours after the injections you should avoid heavy exercise and alcohol as these can increase blood flow and may dilute the effect.  You should also avoid rubbing the area or applying pressure and do not use make-up for the same period of time.

Wrinkles usually begin to disappear after three or four days but may take up to ten days for the full effects to become apparent.

On average the results last three to four months after the first injections but repeat treatments often lead to longer-lasting effects.

We normally ask you to come back for a review with the practitioner following the injections. We tend to use the optimum amount likely to be beneficial the first time you are injected but sometimes a top-up is needed at this review. There are no additional costs if a top-up is required within the first three weeks following treatment.

For six hours after treatment we advise that you avoid exercise, hot baths or alcohol as these can increase blood flow and dilute the effect. 

It is important to avoid touching the area injected, including applying make-up, as this may actually push the product beyond the intended area.  

We do encourage you to actively use the treated muscles (e.g. frown or squint) frequently during this initial period as this may enhance the effect.

Wrinkles normally begin to disappear after two or three days, and full results are usually seen within ten- fourteen days.  

On average the effects last three to four months, but with repeated treatments the results may last longer.We always offer a follow-up appointment two weeks after the treatment and if we haven’t got the perfect result, we will gladly top-up for free!