Wrinkle treatment with Botox® FAQ

Botulinum Toxin (Botox®) when injected into a muscle temporarily relaxes the muscle by blocking nerve impulses. As the nerve impulses are blocked the muscle is temporarily unable to contract so that dynamic wrinkles are not formed. This gives the overlying facial skin a softer, smoother and more youthful appearance.

Botulinum Toxin as a muscle relaxant has an excellent safety record and a long record of use in medicine. It has been used successfully in adults and children in a variety of medical conditions over the last 30 plus years. It has been used cosmetically to treat facial wrinkles for almost 20 years and has become one of the most popular and frequently used cosmetic treatments.

Botox® Treatment can be used for treating wrinkles in men and women, however men may need slightly higher doses than women.

It should not be used in

• People with infection at the proposed injection site.
• People who have previously had an allergic reaction to Botulinum toxin type A injections.
• People with muscle problems or chronic diseases affecting the muscles, such as Myasthenia Gravis, Eaton Lambert syndrome.
• Children under the age of 18 years.
• Women who are pregnant or breast feeding.

It should be used cautiously in

(please let the doctor know if the following applies to you)

• People at risk of bleeding as there is an increased risk of bruising post procedure. These include people who have blood clotting disorders such as Haemophilia, those who are taking treatments with anticoagulant medicines such as Warfarin, Heparin, Aspirin and Anti-Inflammatory medicines. 
• People with excessive weakness or wasting of the muscle to be injected, such as those patients with a history of Stroke or Bell’s palsy.

Botox® injections are relatively painless as the injections are performed using a very fine needle. Patients therefore do not require any anaesthesia. The full treatment takes about 15-30 minutes to perform and you are able to drive and go to work the same day.

It can take about 3-14 days to see the full effects after the initial treatment. The cosmetic effects can last up to six months but typically range from three to four months. Eventually most people require re-treatment as the wrinkles begin to reappear. However in some treated areas (such as frown wrinkles), the wrinkles may cumulatively become less severe after repeated treatments as the unconscious muscle contraction habit is broken. We offer all our patients a free two week follow up appointment to assess the effect of treatment and administer any adjustment treatments if necessary.

Most people find that the injections cause only mild local pain and tenderness. Immediately after the injection there may be mild swelling at the injection site which usually subsides within 48 hours. Some bruising is also possible. Side effects of these treatments are extremely rare. Occasionally, the treatment may relax nearby muscle groups causing temporary drooping of the eyebrow or eyelids. This may last for a few weeks but will resolve with time. As with any medicine an allergic reaction may occur, this is however quite rare. Conversely there may be some unintended benefits in some people such as easing of tension type headaches as the muscles in the forehead relax.

When the effect of the Botox® injections wears off the wrinkles will always return to their pre-treatment state. Treatment is not recommended again until the wrinkles have returned, which is generally a minimum of three months. The effects may last longer for some individuals, especially if they have had previous treatments to the same area.

Botox® treatments are always tailored to your personal objectives and expression can be retained, indeed this is usually desired. The final result can be tailored to each patient and can be discussed at the initial consultation.

• Try to contract the treated muscle areas for up to four hours after treatment, for example by frowning and lifting eyebrows to allow the toxin to reach all of the treated muscle.
• Avoid rubbing or touching the injected areas and avoid having facials and massage for 48 hours this is to ensure that the treatment remains at the site of injection.
• Avoid vigorous exercise and alcohol for 48 hours.
• If bruising develops then you can apply Arnica cream.
• Paracetamol can be taken for mild pain post procedure.

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