Why have a Botox® treatment?

What is botulinum toxin?

Botulinum toxin is a chemical produced by the botulinum bacterium. Botox® is a protein derivative of the toxin, which, when injected into the muscle, causes it to become weakened or inactivated. It stops the muscle from functioning by blocking neuromuscular transmission – it stops chemical messages from the nerve to the muscle.

How does Botox® therapy work?

By using facial muscles repeatedly throughout a lifetime, the skin becomes creased in the areas most used. The ageing process causes collagen and elastin production in the skin to slow down so that, as we get older, these areas of over use become damaged and the lines become permanent. By reducing the movement of muscles in these areas, the skin stops being creased and is allowed to recover, causing the lines to soften or even fade away. In the areas treated, the muscles are temporarily (always reversibly) inactivated, during which time the patient can break the subconscious habit of overusing these muscles. Depending on each individual and the dose used, the response to treatment can vary from a relaxation of the muscles to an inability to move them. For the first couple of years, frequent treatments are required to ‘re-educate’ the facial muscles. Thereafter, treatments would be less frequent until a yearly maintenance treatment is normally all that is required.

Botox injections are also a safe method to treat Hyperhydrosis (excessive under arm sweating). When Botox is injected into your skin, it blocks the acetylcholine receptors which activate your sweat glands, disabling your ability to sweat in this specific areas.

How long has Botox® been in use?

As long ago as 1978, Botox® was used as a treatment for patients with eye squints by weakening the over-active eye muscle. Since then, it has been used in a variety of therapeutic areas such as spasmodic neck, writer’s cramp, tics, multiple sclerosis, facial spasm, Parkinson’s Disease and cerebral palsy. Botox® has been increasingly used for cosmetic therapy in the last 15 years.

How safe is Botox®?

In the very small doses used for cosmetic treatments, Botox is a very safe treatment with large safety margins. In high concentrations, botulinum toxin is a potent poison, but this would require a dose hundreds of times larger than that used for cosmetic procedures.

What happens during treatment?

The procedure takes about 5-10 minutes. The practitioner will ask you to use certain muscles of the face to observe how they work. An extremely fine,
to inject the Botox into the appropriate area. This may cause some slight, but brief discomfort. The area may have some slight redness and swelling, which normally resolves in an hour or two.

After treatment, you should not massage the injected area. You should not lie down for four hours after treatment. The treatment normally starts to take effect after 4 to 14 days, but this may vary slightly with some individuals. The effects will normally last between 2 – 3 months, when you will start to notice an ability to move the muscles more freely.

Top ups

Complimentary Botox tops ups are given between 10 days – 3 weeks, if required, following an initial treatment. Clients requesting a top up need to contact us within the first 2 weeks of their treatment. We are not in a position to offer top ups after this time period.

Are there any side effects?

Overall Botox is a very safe and well tolerated treatment. It produces excellent cosmetic results and side effects are mild, temporary and uncommon. However, as with all medical and injectable procedures, there are some potential risks which you need to be aware of listed below.

Potential side effects related to using a needle for the procedure include:

• Temporary discomfort – very brief – can be reduced with Emla cream
• Redness at the site (typically 20 – 40 minutes post procedure)
• Bruising (uncommon, usually small and fades within 1 week – maximum of 2 weeks)
• Swelling (uncommon, up to 48 hours after treatment)
• Infection (very rare, approximately 1 in 100,000 patients)
• Fainting (needle related pain or anxiety)

Potential side effects related to Botulinum toxin include:

• Incomplete removal of deep lines – these may require further treatments at 3 – 4 month intervals or an additional filler treatment
• Brow heaviness or drooping of the upper eyelid (too higher dose in the forehead zone)
• Headaches – when the forehead area is treated (1 – 10%)
• Dryness of the eyes (1 – 10%)
• Reduced facial expressions – inevitable – doses are adjusted according to desired outcome
• Asymmetrical movement e.g. one eyebrow moves more – easily treated with a top up
• For treatments in the mouth area, a risk of difficulty swallowing or speaking
  The results from treatment and any untoward side effects are temporary and will resolve over a 3 – 4 month period. If you have any questions regarding the procedure, please ask your doctor prior to signing this consent form.

After care

• Do not lie down, rub or massage the treated area for 4 hours after treatment
• You can help activate the Botox by gently exercising the muscles that have been treated, i.e. frown and smile as frequently as possible
• Some patients experience slight discomfort around the treatment area for a short time (1 hour) after treatment
• Bruising can be avoided or minimized by avoiding aspirin and alcohol for 24 hours pre and post treatment
• You may experience temporary swelling which will usually settle within a day or two
• Most people don’t have any bruising, but it is always a risk with injectable procedures and we can never guarantee no bruising. If a bruise does occur, it can take up to a week to fully resolve, but they are usually small (5mm diameter) and easily covered with make up
• Some patients experience a headache following treatment (especially when the forehead area is treated) for which you may take paracetamol
• The results are not permanent and the effects duration will differ from patient to patient
• The treatment takes 4 – 10 days to take effect and you will see the full effect within 2 weeks
• If you require a top up treatment, you need to allow at least 1 week for it to take its full effect. Over treatment sooner, can result in undesirable results e.g. excess heaviness of the brow.
• Side effects, if they occur, are temporary and mild