How does Botox work?
Botox prevents the release of the  neurotransmitter signal from the nerves that stimulate muscles to move. This can be used to relax the muscles that cause wrinkling of the skin when they contract.

How long does it take to work?
Botox takes three or four days to take effect. The maximum impact will be visible at two weeks.

How long does the effect last?
After three or four months the effect of the Botox treatment wears off.
What areas can Botox be used to treat?
Commonly treated areas are the area between the eyebrow where frown lines form, forehead furrows, and the ‘crow’s feet’ at the sides of the eyes. Other areas that can be treated include nose wrinkles ‘bunny lines’, chin dimpling and neck bands. A ‘gummy’ smile can be reduced using Botox to relax the upper lip slightly. Botox is also used for conditions such as muscle spasms, overactive muscles and excessive sweating.

Who should not have Botox?
Botox should not be used when pregnant or breastfeeding. Those with medical conditions such as muscle weakness problems or nerve function disorders also need to avoid Botox. Some medicines, including some antibiotics, should not be used at the same time at Botox. Apart from any “top up” treatment needed at the two week review after your first treatment, it is best to wait twelve weeks between treatments to reduce the chance of developing resistance.

Does Botox hurt?
The needles used to give Botox are very small so patients often comment that it is much less uncomfortable than they were expecting. It is possible to have a pre-treatment local anaesthetic cream or cold pack but this is not usually needed.

Is there any downtime after the procedure?
Usually there is nothing visible or noticeable and most activities can be resumed directly afterwards.I advise my patients to avoid active exercise and alcohol for 24 hours. They should avoid lying flat or face down and avoid touching or massaging the face on the day of the treatment (including applying make-up).

What are the other potential side effects of Botox?
Sometimes bruising or slight swelling at the injection sites occurs. Some people get a mild headache afterwards. Sterile techniques are used to prevent infection and careful needle placement is important to prevent eye or face droop. This requires an understanding of the underlying facial structure so always make sure you choose an accredited specialist to avoid facial nerve paralysis and droop. Serious adverse effects such as an allergic reaction or swallowing/ breathing problems are very rare. The risk of disease transmission via human albumin (which is used as a stabiliser in Botox) is extremely remote.

Can Botox prevent the wrinkles that form with age?
Wrinkles can be dynamic (forming only on movement) or static (present at rest). Botox can treat the dynamic lines which may, in turn, prevent static lines forming in the area of treatment. Static lines that are already present may soften, especially after a few treatments but may remain. It may be possible to combine Botox and Dermal Filler treatments in a treatment plan for deep static lines. Not all wrinkles can be prevented with Botox as movement in certain areas of the face is needed for function. Furthermore, lines form on the face anyway as we age due to gravity, loss of skin tone and sun damage.

How do you ensure that the effects of Botox appear natural rather than over-done?
An aesthetic consultation before treatment is important to ascertain the individual patient anatomy and the desired outcome. The treatment plan is then tailor made and options are discussed. I offer Botox patients a follow up appointment at two weeks with a top-up if required. This gives the opportunity to keep a natural look whilst maximising results.

I am considering having Botox but how do I make sure that I pick the right practitioner?
Choose a well-trained clinician working in a clinical environment. Check their qualifications and that they have insurance.

NHS guidelines state that: Botulinum toxin is a prescription-only medicine that should only be prescribed and given by an appropriately trained healthcare professional, such as a doctor, dentist, pharmacist prescriber, or nurse prescriber. Legally, the prescriber can delegate the administration of the injections to another person, but they are responsible for ensuring it is given safely. They must have expertise and equipment to appropriately deal with any possible adverse effects such as an allergic reaction. Make sure that they offer a follow up service and that they are able to give any advice you may need after the procedure.