Botulinum toxin/Botox®

Botulinum Toxin has been used for a number of years for wrinkles, frown lines and other issues such as excess sweating

What is Botox®?

‘Botox®’ is the most commonly known brand name for Botulinum Toxin A (Botox® is a registered brand, hence the ‘R’ in a circle after the name). Botulinum toxin is also produced and packaged by a number of other different companies under different brand names, such as ‘Dysport’ and ‘Vistabel’.

Botulinum toxin, produced by the bacterium ‘Clostridium botulinum’ used to be best known as the substance that caused the illness ‘botulism’. In 1992 a form of the toxin, known as Botulinum Toxin A, was described as being useful in the cosmetic setting. Since then, Botox® has increased in popularity and it has become the most commonly performed cosmetic procedure in America

How does Botox® work?

Botox® acts on certain nerve endings and blocks their action. Muscles need the nerves to make them work, so if Botox® is injected near a muscle and the nerve gets blocked, then the muscle in turn becomes weaker.

Facial wrinkles develop due to the action of underlying facial muscles. Botox® blocks the nerves, the muscles work less, and the wrinkles become less noticeable

Does Botox® work instantly?

The effects of Botox® may be seen fairly soon after injection, but the full effects will generally not be noticeable for about 3-4 days

How long does Botox® last?

Generally, the effects of Botox® will last for 3-6 months, although some effects may still be visible at 6-7 months. Regular repeat injections of Botox can lead to longer and longer durations of action

What else can Botox® be used for?

Botulinum toxin, as Botox® or other names, is often used by doctors for more than just wrinkles – it can for example also be used to reduce excess sweating, ease muscle spasms, help migraines and overactive bladders, and help patients with cerebral palsy

How is Botox® given?

Tiny amounts of Botox® are carefully injected into required areas, following an assessment of the wrinkles and facial movements. This may involve just a few injections, or can be many depending on how much is needed and the size of the area being treated. The needles used are very fine, and are usually relatively painless.

The areas that have been injected with Botox® may appear slightly red at first, which is quite normal. You should not massage or rub the area straight after injection, as this can cause the Botox to spread to unwanted areas

Will Botox® improve all my wrinkles?

Not necessarily. Botox® can be very good at improving early wrinkles and can produce a more youthful appearance; some wrinkles, though, are not suited to Botox® and may instead require fillers, a brow lift or a face lift to regain a smoother, youthful look.

A quick test is to gently pull on either side of your wrinkle. If it disappears, then Botox may be suitable. If the wrinkle remains, then it may not help

Doesn't Botox® give an expressionless face?

When used carefully and in moderation, Botox® can give a very subtle result, whereby you will look more youthful without it being too obvious that anything has been done.

Large areas of facial muscle being affected, however, can result in a ‘mask-like’, expressionless look. Whilst this is not dangerous and will wear off in a few months, it does make it more obvious that something has been done. The ability for a specialist to produce a natural result with Botox® will often rest on their experience, although can be a difficult judgement even in the best hands

What are the risks of Botox® injection?

• Unwanted effects – as mentioned previously, too much Botox® can result in loss of facial expression. Whilst this is essentially the underlying way that wrinkles are treated, a ‘mask-like’ appearance can result from large areas of muscle being affected. Very rarely, the main facial nerve can be affected, which will give drooping of the eyelid and mouth on the affected side. This will wear off after a few months as the Botox® toxin weakens.

• Recurrence of wrinkles – this is not a risk as such, as much as a natural course. As the Botox® toxin wears off the wrinkles may return and repeated procedures may be necessary.

• Bruising – it is relatively common to experience minor bruising at the injection sites, which should settle after a few days

This information is for general information only. If you have any concerns about your health or are considering any treatments, you should seek advice from a healthcare specialist