Wrinkle reduction (Botox)

Facial lines are often caused by the repeated movements of the facial muscles which can lead to the formation of a permanent wrinkle. These occur particularly on the forehead, at the outside of the eye (“crow’s feet”) and at the top of the nose.

Botox wrinkle and line reduction in London UK

Frequently asked questions about Botox wrinkle and line reduction

What does Botox wrinkle treatment involve ?
What should I expect after Botox treatment ?
Are there any alternatives to Botox ?
Is Botox treatment safe? What are the risks?
How do I arrange a consultation with Mr Hamilton in London, UK

What does Botox wrinkle treatment involve?

In many patients, these lines can be softened or even removed by reducing the degree of muscle contraction. This is achieved using very small doses of botulinum toxin (e.g. Botox). Where Botox is injected, it relaxes the underlying muscle, diminishing the wrinkling effect and results in a more refreshed, smoother look. The use of Botox may help prevent deep wrinkles in the long-term by “re-educating” muscles not to make unwanted wrinkle-inducing movements.

What areas can be treated using Botox?

The most common areas to treat are the forehead, the outer part of the eye (“crow’s feet”) and the upper part of the nose between the eyebrows. Botox can also be used to soften bands on the neck caused by activity of the underlying muscle running from the chin to the lower neck. Some practitioners use Botox to treat lines around the mouth and between the nose and the outer edge of the mouth. However, this carries some risk of weakening important muscles of expression near the mouth and we do not recommend this area be treated. Other methods, such as fillers like Restylane, can improve lines near the mouth.

Is Botox safe?

Botox has been used for more than 30 years, initially to treat unwanted muscle twitching. It has been used for over 15 years for wrinkle treatment and is now the most common cosmetic procedure. It has a very good safety record when used by properly trained practitioners. Botulinum toxin is now licensed for cosmetic use by the Food and Drug Administration (the FDA) in the US. For patients with minor lines and early wrinkles, Botox is an excellent treatment, usually with an immediate return to normal activities.

What should I expect during the Botox treatment? Is it painful?

Botox is administered by injection using a very fine needle as an outpatient. The injections are carefully planned during the consultation and can then be applied quickly. No anaesthetic is required – the injections sting less than the local anaesthetic!

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What should I expect after Botox treatment?

Sometimes there can be little bruising and swelling after treatment, particularly in patients taking aspirin or other blood-thinning medicines. These are best avoided before treatment if possible. There can be a little discomfort or mild headache immediately after treatment, though, interestingly, many migraine sufferers have reported improvement to headaches after Botox. Muscle relaxation is not immediate and the muscle-weakening effect becomes apparent in the first 3 to 8 days after treatment, usually reaching its maximum at about day 7.

Is there anything special I need to do after Botox treatment?

We recommend that you keep in an upright position for 3 to 4 hours after treatment to localise the Botox to the desired area. Avoid rubbing or massaging the treated are. There is no need to avoid movement of the muscles after treatment. It is sensible to avoid aspirin or other blood-thinning medication for a couple of days after treatment to minimise the risk of bruising.

How long does the Botox treatment last?

Most patients find that Botox lasts 3 to 6 months. The muscles gradually recover movement over this period.

Can I have the treatment repeated?

Yes. Most patients are pleased with the results and wish to maintain them. In fact, retreatment is usually recommended 4 to 5 months after the initial treatment to keep the muscles relaxed and prevent lines re-forming. This means treatment perhaps three times in the first year though with repeated treatments, Botox may be required less frequently.

Can Botox be used to treat other conditions?

Botox was initially used to treat troublesome muscle twitching, especially on the face. More recently, it has been used to treat areas of excessive sweating (hyperhidrosis).

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Are there any alternatives to Botox line reduction?

There are alternatives depending on the area treated. The best treatment will be discussed in a friendly and honest fashion at your consultation. Botox often remains the most effective treatment for forehead wrinkes, laughter lines and frown lines. Around the mouth and for finer lines, fillers such as Restylane may give the desired correction. Chemical peels can also be effective for fine lines on the face. In patients with more pronounced aging changes on the skin, surgical correction by lifting the brow, eyelid surgery or face-lifting techniques may be more appropriate.

Click here for information on facial "fillers"

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Safety and potential risks of treatment using Botox

As already mentioned, a minor degree of bruising and swelling can occur after any type of injection. If it does occur it usually settles very rapidly within a few days. In very rare cases, Botox can reach muscles it is not intended to relax and cause unwanted weakness. In cases where it reaches the upper eyelid muscle it can result in temporary, unwanted drooping of the eyelid. This has been reported to occur in about 1 in 1000 injections, though the risk is minimised by careful planning and a meticulous injection technique. If drooping occurs, it usually improves over a few weeks.

Are there any people who shouldn’t have Botox?

  • Pregnant women – there are no reports of problems but it is best to be safe and we will not offer treatment to pregnant women
  • Women who are breastfeeding – similarly, though there are no specific reports of problems, we feel it is safer to avoid Botox when breastfeeding
  • Patients with a history of neuromuscular disease such as myasthenia gravis and multiple sclerosis
  • Patients taking certain medication: Aminoglycoside antibiotics (such as gentamicin), penicillamine and calcium-channel blockers (including verapamil (Cordilox, Securon), diltiazem (Tildiem), nicardipine (Cordene), amlodipine (Istin), felodipine (Plendil) and nifedipine (Adalat))
  • Patients with known allergy to albumin (egg white) or Botox. Currently, no cases of Botox allergy have been reported

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