Botox: What You Need To Know

3rd September 2020

Anti-wrinkle treatments are commonly referred to as Botox® and are used to smooth lines and wrinkles for a younger, more rejuvenated look.

They are most often used to treat:

• Frown lines
• Worry lines
• Crows feet
• Lip lines
• Lower face treatment to improve jawline and appearance of the neck, known as ‘Nefertiti Lift.’

How does it work?

Botox® is a naturally occurring protein produced by Clostridium Botulinum. The product blocks the transition of chemical messages sent from the nerve to cause the muscle to contract, which normally creates these lines. Without these messages, the muscle stays in a resting state until the ‘messengers’ recover. This recovery varies but takes approximately 3-6 months on average.

Licensed brands of botulinum toxin A include; Botox®, Azzalure®, Bocouture®, Xeomin®, and Dysport®. All botulinum toxins are prescription-only medicines (POM) and can only be prescribed by doctors, dentists and nurses with the prescribing qualification, following a face-to-face assessment and consultation with the qualified prescriber.

What to expect before & after treatment

Before your treatment, your practitioner should make a treatment plan with you regarding the areas that you wish to have treated. You will be informed of the indications and contraindications of treatment and will be asked to sign a consent form which you should read thoroughly.

After treatment, it is expected that you will start to see an improvement within 4 or 5 days. The full result may be judged at 2-3 weeks. You may be invited to attend a review appointment after 2-3 weeks where the success of the treatment may be assessed and adjustments to your personal treatment plan can be made, if necessary.

You will be advised to keep the target muscles active for a few hours and to avoid extremes of heat or cold, vigorous exercise, lying down or leaning over for 4-6 hours.

It may not ‘completely freeze’ the expression, particularly if extreme effort is exerted to make an expression. You should also avoid alcohol for 24 hours after treatment.

There may be only a partial reduction in movement of the muscles and this very much depends on the amount of product administered and location of product placement. Treatment is not a ‘one size fits all treatment’ and will require a tailored approach to suit your individual requirements and expected treatment outcomes – you should discuss this with your clinician at the time of consultation.

Are you suited to treatment?

Your practitioner will take a detailed medical history and an assessment of your needs and expectations to ensure this is an appropriate treatment for you. This must be a nurse, doctor or dentist with specialised training, qualified to prescribe.

• Except in exceptional circumstances this is not a treatment recommended for those under 18 or over 65.
• For best results, the skin should be in good condition and the target lines not too furrowed. Your practitioner will assess your suitability and advise.
• Botulinum toxin cannot be given to pregnant or breastfeeding women.
• Not suitable for patients with certain neurological disorders.
• Not suitable if you are currently taking certain medicines.
• Not suitable if you have previously experienced adverse reactions to any botulinum toxin treatment.

As with any injectable procedure;

Treatment may not be undertaken if:

• You are suffering from any skin infection in or near the treatment area or are unwell in any way (even a cold).
• You are taking any medicines which affect bleeding, such as aspirin or warfarin.
• You are currently or have recently completed a course of Roacutane (acne treatment) in the last 18 months.

Caution should be taken if:

• You are planning to attend a special event when a bruise, should it occur, would be unacceptable to you.
• If you are planning to attend an important event and any adverse event described would be unacceptable to you, discuss it with your clinician in advance of having treatment.
• Some over-the-counter medicines and supplements can also affect bleeding (make you more prone to bruising) as can alcohol- which should be avoided the day before and after treatment.
• Vigorous exercise, sun exposure, sun beds, and sauna should be avoided for 48 hours, or as advised by your clinician, after treatment.

If you are at all concerned about symptoms you were not expecting or not happy with, please contact the practitioner for advice. If necessary, an appointment will be made for you to be seen.

Is it safe?

All treatments carry a degree of risk. Risks and complications will be discussed with you at consultation and prior to any treatment being agreed. Botulinum Toxin should be administered by a healthcare professional with specialist training. Side effects include, but are not limited to;

• Bruising
• Swelling and redness at injection sites
• Asymmetry of expression
• Drooping of the brow, or eyelid
• Headache or a sensation of ‘tightness’ or ‘heaviness’

Adverse events are uncommon, usually occur within a few days of treatment and are expected to be temporary, usually resolving spontaneously within hours, days or weeks. Your practitioner will provide aftercare advice designed to minimise risk and promote speedy recovery from any expected side effects.

Does it hurt?

A very fine needle is used during your treatment and generally, this treatment is not painful and can be well tolerated with no anaesthesia. Ice may be helpful in numbing the skin for nervous patients as well as reducing the risk of a bruise.

How long will it last?

Results tend to take full effect within 2 weeks after treatment and last 3-6 months. Movement will begin recovering from 8- 10 weeks and frequent treatment at intervals of less than 3 months is NOT recommended.

Further help or information needed?

If you develop problems or complications following treatment that you are concerned about, please attend A+E or consult your GP in case of a medical emergency. Otherwise, contact us.