As we age, lines and wrinkles start to appear on the face from repeated facial expressions such as frowning, smiling and squinting. These lines start by being visible during movement and over time become ‘etched in’ to the skin. They often can make us look older than we are and are one of the first signs of ageing that we see.
A very safe and effective way to treat and reduce these lines is to use anti-wrinkle injections, commonly known as ‘Botox’ (botulinum toxin). They work by temporarily reducing the strength of the facial muscles and therefore the contraction of the overlying skin to create a smoother more youthful, appearance for your face and neck.
When done properly, with thorough understanding of the intimate interplay between the facial musculature, anti-wrinkle treatments provide a relaxed, refreshed and natural result. They should not make you look fake nor frozen.
Anti-wrinkle injections are a prescription only medicine (POM) and can only be administered after a face-face consultation with a qualified medical practitioner, such as a doctor, dentist, nurse prescriber or pharmacist prescriber.
What are the benefits?
Reduce existing lines and wrinkles and prevent them worsening
Gives skin a radiant glow
Can provide a brow lift
Quick procedure with minimal down time
Anti- wrinkle treatments are done by using a small needle to inject Botulinum Toxin into the chosen treatment area. Botulinum Toxin is a naturally occurring protein produced by the bacterium Clostridium Botulinum. It temporarily stops the transmission of nerve impulses to the muscles, reducing the ability of the muscle to contract and therefore allowing facial expression to remain in a relaxed state. The overlying skin is therefore smoothed and softened. Repeated treatments at the correct interval will further soften the appearance of lines which may have become ‘etched in’
It is not always possible or desirable to completely eliminate all movement as this may look unnatural or frozen, rather than refreshed and relaxed which is what we aim to achieve.
Azzalure, Botox & Bocouture are the the main brands which are used in the UK.
Botulinum toxin has an excellent safety profile. It has been licensed in medicine for over 30 years to treat various medical conditions of adults and children such as muscular spasms, dystonia, headaches, migraines and hyperhidrosis (excess sweating).
It has been used in aesthetic medicine for over 18 years (approved in 2002) and is the most common non-surgical procedure.
There are no known long term side effects of having repeated treatment for cosmetic purposes.
- The horizontal forehead lines or ‘worry lines’
- The frown lines between eyebrows (or the ’11s’)
- The lines around the eyes (‘crows feet’)
- Brow lifting
- Too much gum show on smiling (‘gummy smile)
- ‘Bunny Lines’ (the crinkles at either side of your nose, towards the eye when you scrunch your face)
- Vertical lines on the upper lip (‘Smokers Lines’)
- Platysmal vertical bands on the neck
- Jawline (‘Nefertiti lift’)
- Chin dimpling (‘orange peel chin’)
- Hyperhidrosis (excess sweating under the arms, hands, feet)
The procedure itself takes around 10-15 minutes.
If you are a new patient, a consultation will always be provided prior to treatment to ensure we have fully discussed your concerns and treatment options and ensure you are suitable for treatment. In this instance the appointment time will be around 30 minutes.
If it is your first time having anti-wrinkle injections, we will review you at 2 weeks to ensure you are happy with the results. If additional anti-wrinkle agent is required to achieve, it can be done at this appointment.
The procedure is done with very small fine needles and is done without anaesthetic. Most people experience very little discomfort. If you are very nervous, topical anaesthetic can be applied beforehand.
It can take 14 days for full effects to be seen with a peak activity at 8 weeks. It then gradually wears off, typically taking 3-4 months.
Most patients return every 3-4 times a year for treatment. With repeated treatments, lines may reappear less severe as the conscious habit of squinting/frowning is broken.
Botulinum toxin works best in those with milder lines and wrinkles, and those which are present on moving the muscle (dynamic lines). Lines which are present on your face with no movement (static lines) can often be treated by repeated sessions, but may will require other types of procedures (dermal fillers or skin treatments). This will be discussed during consultation.
You may be unsuitable if:
You have an infection at the injection site
You have a musculoskeletal disorder such as Myasthenia Gravis or Eaton-Lambert syndrome.
You are pregnant, breastfeeding or actively trying to conceive.
You are under 25 or over 65, though it can be used off-licence outside of this age range.
You are taking antibiotics, such as clindamycin.
You are unwell on the treatment day
You have unrealistic expectations
You have had a negative reaction to any anti-wrinkle injections in the past
Side effects are uncommon, mostly mild and normally resolve within a few days. These include injection site reactions: pain/ minor bleeding and bruising/ redness/ irritation/ headache.
Side effects will be discussed thoroughly with you at consultation.
Ensure you have informed us of your medical conditions, and medication you are on, including changes to your medical history.
Avoid alcohol for at least 24 hours before your appointment
Avoid medication that thins the blood for 3 days prior, such as: aspirin, fish oils, St John’s Wort, gingko biloba, garlic and vitamin E
If you are unwell on the day, contact us to reschedule.
Ensure you have read the aftercare advice BEFORE your appointment so that you can plan around it. If you are prone to bruising, you may want to avoid scheduling important events in the week following your appointment.
There is rarely any downtime at all and you may resume your daily life straight after treatment, assuming you are following the post operative advice.
There may be some tenderness on the treated sites which may last a few days. Bruising is possible but rare. There may be some red bumps on areas treated, which generally subside within a few hours. A small minority of people experience a headache which can last for a few days.
- Avoid rubbing or massaging your face for 24 hours (and be very gentle with face washing for the first few days)
- Do not wear make up for the rest of the day after treatment. In the rare event of a small bruise, this can be covered with make up the following day.
- Keep upright for 4 hours (no lying down/ bending over)
- Avoid exercise for 24-48 hours
- Avoid extremes of temperature for 2 weeks (hot shower on treated area/ sauna/ sunbed/ extreme cold)
- Avoid professional facial treatments (peels, microdermabrasion) for 2 weeks
- If you are considering eyebrow microblading, microblading should be done before anti-wrinkle treatment, or waiting 4 months until the anti-wrinkle effects have worn off, to ensure you eyebrows are bladed in your baseline brow position.
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