At Blemish clinic we offer full medical consultations to discuss treatment with anti-wrinkle injections, alongside other options for treating lines and wrinkles, to answer any questions that you may have about Botox®, and to determine if this is the best treatment option for you, whereupon she can prescribe it and perform the treatment.
Botox is licensed for the temporary improvement of lines and wrinkles on the face including glabellar or frown lines, crow’s feet, and forehead or worry lines. It can also be used under medical discretion for bruxism (teeth grinding and clenching) that causes both discomfort and a masculinisation of the jaw line in women, for prominent neck lines or turkey neck (platysmal bands), bunny lines around the nose, dimpled chin, and lip or smokers’ lines.
Glabellar lines (frown lines), lateral canthal lines (crow’s feet), forehead lines, bunny lines, platysmal bands on the neck, dimpled chin, smokers’ lines, jawline slimming and teeth grinding (bruxism).
With ageing and our genetics, skin starts to lose its elasticity; collagen production and new skin cell replenishment declines and slows down, hydration is poor, and fat volume reduces. This is intrinsic or chronological ageing. Add in a good dose of sun damage caused by exposure to UV light, lifestyle influences including smoking, diet, and alcohol consumption, and environmental factors such as pollution to the mix - the extrinsic ageing caused by external factors - and fine lines and wrinkles will start to form on your skin from about your 30s onwards.
There are two types of wrinkles – dynamic wrinkles and static wrinkles.
Dynamic wrinkles are caused on the face by repeated movement that creases up the skin as movement is made, the most obvious being when we make facial expressions that can include frowning, smiling, raising eyebrows, squinting, scowling, or otherwise ‘pulling a face’ as an emotional reaction using non-verbal communication. They can also be caused by repeated movements that are not related to expressions, such as lip lines caused by pursing the lips repeatedly when drinking from a straw or smoking a cigarette. These lines are referred to as dynamic as they only become visible when the underlying facial muscles are contracted to create the desired movement.
Similarly, overactive muscles can distort the face and cause discomfort, such as with the action of teeth grinding or clenching (bruxism) that can cause an enlargement of the masseter muscle making the jawline overtly masculine on a female face.
Over time, and repeated action, dynamic wrinkles can deepen to create lines that are visible, even when you are not moving your face, known as ‘at rest’, and this is when most people seek anti-wrinkle treatment for visible frown lines or crow’s feet.
Static wrinkles on the other hand are not caused by movement but are a factor of the ageing process, often starting as small or fine lines, and deepening over time to become permanently visible lines or folds. Examples include nose-to-mouth lines (nasolabial folds), mouth-to-chin lines (marionette lines), sleep lines on the side of the cheek or temple, and necklace lines on the neck. Static lines are often related to volume loss, rather than movement.
Depending on the type of wrinkle, the cause and severity, treatments for lines and wrinkles may include topical options such as skin creams and skin peels, light-based treatments, or injectables including dermal fillers, mesotherapy, collagen stimulators, skin boosters or platelet rich plasma (PRP) therapy. Although these all work to reduce static wrinkles caused by ageing and sun damage, they are less effective at treating dynamic wrinkles.
At Blemish Clinic, we can also discuss an alternative treatment option with you during a consultation with our medical practitioner which uses the prescription medicine botulinum toxin to temporarily reduce muscles movement and wrinkle formation in the face to treat dynamic wrinkles.
In the UK, Botox® (botulinum toxin type A) is a licensed medicine for temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines), moderate to severe lateral canthal lines (crow's feet) seen at maximum smile, and moderate to severe forehead lines seen at maximum eyebrow elevation when the severity of the facial lines has an important psychological impact in adult patients.
Botulinum toxin is a prescription only medicine that is one of the options available for the cosmetic treatment of facial lines and wrinkles. It is available under the brand name Botox® and can be prescribed for you after a medical consultation, to include taking a full medical history, and an assessment of your facial wrinkles, alongside discussing the treatment options you have considered or may wish to consider.
Botox is injected into the area(s) where wrinkles are a concern, usually with multiple injections in a pattern across the area. It works by blocking the chemical signals being sent from the nerves to the muscles, this effectively turns off the muscles and they stop or significantly reduce their action when attempting certain facial movements or expressions such as frowning or raising eyebrows. The effect is temporary, wearing off after several months, so does require repeat treatment; however, for many the improvement in their facial wrinkles and the smoothing of the skin over time and repeat treatment is worth it.
Your suitability for anti-wrinkle treatment options, including botulinum toxin or Botox® injections will be discussed during a consultation with our medical practitioner. If after taking a full medical history, discussing any underlying medical conditions, medications, and allergies, reviewing your facial anatomy and movement during a physical examination, they believe you would be a suitable candidate for treatment, you can be prescribed the medication and have it administered to reduce your wrinkles.
If you have very heavy eyebrows or hooded eyelids, you may not be suitable for all areas of anti-wrinkle treatment due to the risk of causing further drooping of the eyelids or eyebrows (ptosis) that could affect your vision. Alternative options to treat your lines and wrinkles will be discussed.
If you suffer from a neurological condition that causes muscle weakness - myasthenia gravis – you will not be suitable for treatment with botulinum toxin.
If you are pregnant or breast feeding, you will not be suitable for anti-wrinkle treatment using botulinum toxin.
The use of Botox (botulinum toxin type A) to treat facial lines and wrinkles including frown lines, forehead lines, and crow’s feet is well researched with multiple published, independent clinical studies reporting that treatment is safe with minimal side effects. It has been used as a cosmetic treatment for several decades in the UK and USA.
There will be little to no discomfort or downtime following treatment, other than some slight redness, swelling, or bruising at the injection points that will fade within a day.
There is a risk that you will experience something called ptosis, that can affect the upper eyelid or eyebrow, causing a droop downwards. Patients are screened and dosed accordingly to avoid this occurrence.
Rarely you may experience a headache, feel sick, or experience muscle pain or weakness after treatment. All potential and rare side effects will be fully discussed during your consultation.
Treatment with Botox does not cause immediate reduction in lines and wrinkles as the botulinum toxin will start to work after 2-4 days (taking up to 2 weeks to take full effect), reducing the nerves impulses to the targeted muscles used to frown, raise the forehead, squint etc.
Once activated, you will notice a relaxation in the treated muscles, meaning that you will not be able create some of the muscle movements responsible for wrinkle formation quite so easily, if at all, such as frowning. The aim of treatment is not to produce a frozen or unnatural look, with an inability to make facial expressions as that would hamper non-verbal communication, but to reduce movement enough to produce a smoother appearance to the overlying skin, by stopping the formation of the dynamic wrinkles.
Over time and with repeated treatment to maintain the anti-wrinkle effect, your skin will have time to rest and rejuvenate, generating new collagen and further correcting and smoothing out the wrinkles formed before treatment.
Anti-wrinkle injections are often used in combination with other treatments, and we can offer a bespoke skincare regime after discussion with our skincare specialist that will further enhance your skin quality alongside the action of the Botox injections.
According to clinical trial data, the severity of glabellar or frown lines, crow’s feet, or forehead lines can be reduced for between 3- 6 months. Therefore, to maintain the results from anti-wrinkle treatments, repeat treatment is required every 3-6 months, although this does vary between patients.
We believe in being transparent with our prices and want you to be fully aware and comfortable with the cost of your treatment. A full list of our prices can be found here. We will always agree a final price with you though before treatment commences.
A consultation to diagnose and discuss treatment options for dynamic lines and wrinkles which may result in a prescription and treatment with botulinum toxin (Botox®) to relax muscles and reduce facial lines creating a more youthful appearance.
Botulinum toxin (Botox®) is a prescription medicine that is licensed in the UK for temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines), moderate to severe lateral canthal lines (crow's feet) seen at maximum smile, and moderate to severe forehead lines seen at maximum eyebrow elevation when the severity of the facial lines has an important psychological impact in adult patients. It is used to blocks the chemical signals to the nerves that control the muscles being targeted for treatment, thus relaxing their action on the overlying skin to stop wrinkle formation.
Allowing up to 2 weeks for the botulinum toxin to take full effect, the result will include a decrease in muscle activity in the area treated, leading to diminished creasing and wrinkle formation, and a softer, smoother appearance to the face.
Treatment will take approximately 30-45 minutes.
We use an ultra-fine needle to deliver the anti-wrinkle injections, treatment is not regarded as uncomfortable, although you may notice a very slight sting.
There is little recovery time required, in fact most patients are happy and comfortable immediately after treatment and can resume day-to-day activities. There may be some redness at the injection points for a couple of hours. A full aftercare leaflet will be supplied.