Here are a few questions I get asked by Instagram, Facebook, Text, email and in person about Botox or anti wrinkle injections which I wanted to share.
There is nothing new about botox, it’s has been used successfully in the medical profession for well on 20 years now, but probably in the last 10 years has become a mainstream cosmetic procedure for the reduction in dynamic wrinkles.
Most commonly known as botox but to be clear it is actually Botulinum Toxin Type A and when injected into a muscle will relax the muscle contraction for at least 3 months, sometimes more, sometimes less depending on where it has been injected and your physical anatomical makeup.
1. What is Botox and what is the difference between Botox™ and Azzalure™?
Botox is a purified protein that is used to relax muscles. Botox and Azzalure are just different brands. They both work well and can cause the muscles to relax and diminish the appearance of wrinkles.
2. What areas of the face gives the best results when it comes to using muscle relaxing injectables?
By far the most popular in my clinic are crow’s feet and the vertical frown lines of the forehead. The horizontal forehead lines, although popular can be more tricky to resolve as people age. Muscle relaxants such as Botox™ or Azzalure™ can also be used in the masseter muscle of the jaw to slim the lower face, this is a really popular treatment at my clinic.
It can also be used for the Depressor Anguli Oris muscle (the muscle that pulls down the corners of the mouth). Treating this muscle with muscle relaxing injectables makes the mouth less droopy. It can be used in the lip lines to give a slightly fuller appearance and in the brow area for a brow lift. It can also be used in the neck for what is known as a “Nefertiti lift”, where it’s injected into the platysmal bands to soften this area.
3. How long will my results last?
It depends on the dose and also the patient’s metabolism. With a typical dose and patient, the product is injected, with the maximal effect at four weeks. At eight weeks, the movement starts to slowly return and at twelve weeks, there is about 50% of normal movement back and at sixteen weeks there is approximately 80% of normal movement back. Most patients choose to have treatment every 3-4 months to maintain results. See my post on longevity for more info on this?
4. How do I avoid a ‘frozen’ appearance?
This involves the injector choosing the right dose and placement of the product. I believe it’s a far better not to overdo the dose, in particular, the horizontal forehead lines as this will leave the patient with a frozen forehead, not always a good look. When it comes to the crow’s feet it is important for the injector to get this just right so there is still natural cheek movement.
5. Are there any side effects?
Being a medical procedure, there are side effects and risks. The most common ones are red dots at the injection sites, small areas of swelling at the injection sites, bruising and a mild headache. The more significant side effects are eyebrow or eyelid droop, but fortunately, these are uncommon. If you are worried always raise any concerns before commencing your procedure.
6. Is there anything I can do or use at home to prolong the results?
There are many things that patients should be doing at home, such as a great skin care regimen by using cosmeceuticals. However, they are not they are not just improving your skin but will mean overall better skin condition and a more youthful appearance.
7. What is the difference between muscle relaxants and dermal fillers?
One relaxes the muscles (botulinum toxin), and in the case of dermal fillers, these are gels placed under the skin. A dermal filler is used to volumise and fill lines, wrinkles and folds and also to augment certain areas of the face such as the chin, lips and cheeks.
8. I’ve also heard I can get a brow lift with this type of procedure? Do you recommend this?
It is true; please check out the numerous before and after photos I have of my patients on instagram to see the results. I use it regularly. The lift is only minor, usually between 1-2mm at best (which sounds small but is quite noticeable in the eye area).
The relaxant is injected into the orbicularis muscle, which pulls the eyebrow down, especially when the patient is smiling. When this muscle is relaxed, the muscle above the eyebrow, the frontalis, can work unopposed and lifts the eyebrow.
I recommend it to many patients. The only patients I don’t recommend it is patients who have very low brows where the brows are too close to the patient’s orbital rim as I worry about causing an eyelid droop, so I would rather avoid that problem. In these patients, I would just inject the crow’s feet area and hopefully, they get a small lift from those safer injection sites.
9. When it comes to pricing there seems to be a disparity amongst clinics or the various places where you can get these injections? Do you have a view of advice on this?
I think between clinics that are of the same standard or quality, patients will find that pricing is in general quite similar.
Many clinics, would actually lose money with every patient if the dose they claimed to be giving is believed. Patients should be cautious with their trust when this is occurring. The price should be at least £130 if it is genuine and used and diluted correctly.
There are clinics where the patient doesn’t have a consultation with a Prescriber face to face first before the treatment. This practice is illegal, and these clinics tend to be cheaper. Patients should be wary about clinics who are breaking the law in their procedures.
There are chain clinics where there may be a telephone “consultation” with a Prescriber, and then an ‘aesthetician’ who may have learned how to inject yesterday on a 3 hour training course treats the patient. These clinics also tend to be cheaper. They are hanging onto the law by a thread. This practice has been banned in the UK since 2012 .
If a patient wants to see a medical practitioner with years of experience and thousands of injectable procedures under their belt, then patients should expect it to be more expensive, given the superior training requirements and experience.
In my clinic, I always keep my prices competitive and as affordable as possible. Including interest free credit being available.
10. And should we expect to be charged by unit or by area?
I don’t think it matters really. It’s about the service at the end of the day, and patients making the decision about whether the experience and results that they achieved are worth the money they paid.
At my clinic, we do it by area, which makes it easier for the patient and should someone require a different amount of units I can adjust the dose for the best results.
A few final thoughts.
In my own experience, I would always choose to visit a cosmetic clinic where the practitioners are fully medically trained and accredited in cosmetic medicine and someone who injects every day on many faces.
While there is no ideal age to start, the quality of your skin condition will determine your results and if you are going to take the leap as millions of others already have, then ensure you choose your cosmetic practitioner wisely. If you are not given a full consultation to discuss your areas of concern and all the possible side effects prior to your first injection then you really should keep looking for someone who offers you professional and safe experience.
If you feel worried or things do not seem quite right, then always walk away.