Question 1

How does Botulinum toxin work?

Accepted Answer

Botox acts by blocking acetylcholine at the neuromuscular junctions between the nerves and the muscles. Acetylcholine is a chemical that is responsible for causing muscle contraction, therefore, blocking it leads to temporary muscle paralysis.
Botulinum toxin is not only used for treating unwanted wrinkles, i
t is also used for:
- Treating facial asymmetry
- Unwanted facial muscle activity, blepharospasm and hemifacial spasm
- Migraine
- Spasticity
- Cerebral Palsy
- Hyperhydrosis (sweaty armpits).

Question 2

What can you expect at the time of your procedure and follow up?

Accepted Answer

For maximum benefit, there needs to be careful assessment of the face and therefore no makeup should be worn. 
Careful assessment and planning by a GMC registered Doctor 
The injectable is carefully injected, using a very small needle, directly into the muscles that cause wrinkles. Several injections are usually needed at specific sites, depending on the area treated. (see diagram on treatment page).   
Combination treatment may be required eg Cosmetic Fillers 
Gentle pressure may be required and the application of arnica cream.
A complimentary 2 week follow up with the Doctor is then booked.

Question 3

What are the results?

Accepted Answer

The injectable starts to work 6-36 hours after injection and maximum effect will be achieved after 7-14 days 
The effect will last between 2 to 4 months before you will start to notice the muscles working and the wrinkles reappearing.  
If the patient wants the effect to last longer, they will require injections around 4 times a year.   
If the patient does not like the effect it will wear off between 2 to 4 months 
We aim to achieve the desired effect after the first treatment but it may require one or two treatments to decide exactly what the patient prefers in order to gain the optimal effect 
Repeated treatments may give a quicker result that lasts longer and therefore increases the time interval between appointments.

Question 4

Advice for before and after the procedure

Accepted Answer

Patients encouraged to move the muscles that are injected 
Avoid lifting bending or staining for 3-4 hours 
Unrestricted activities after 4 hours 
Flying and heat is not thought to have an adverse impact 
The first effect may be as early as 6 hours and maximal effect is at 14 days

Question 5

What are the risks?

Accepted Answer

No severe complications after cosmetic use of Botox have been reported in literature. However, despite the risk being very low, it must be discussed and understood 
 
Local (Normally these are temporary) 
- Pain 
- Tenderness 
- Swelling/oedema 
- Erythema (redness) 
- Bruising (this can usually be covered up by makeup) 
- Headache (do not take aspirin) 
 
Regional complications due to the unwanted effect of Botulinum toxin on adjacent muscles. These are self-limiting and wear off in 2-4 months 
Systemic effects are rare in cosmetic usage 
Anaphylaxis to Botulinum toxin, albumin or normal saline is very rare. 
Therapeutic failure or non response can only be truly assessed after 14 days and before 4-6 weeks and may be due to 
- Persistent muscle activity 
- Surrounding muscle action 
- Static lines will not be affected 
- Persistent wrinkle due to dermal atrophy (thinning of the deep layers of the skin)

Question 6

What are the contraindications for treatment?

Accepted Answer

Conditions or factors that serves as a reason to withhold a certain medical treatment 
 
Pregnancy 
Breast Feeding 
Patients trying to get pregnant 
Previous anaphylaxis (allergic reaction) to Botulinum toxin and other ingredients (albumin, sodium chloride) 
Neuromuscular disease (myasthenia gravis, Eaton-Lambert syndrome, motor neurone disease) 
Tendency to excessive bleeding 
Thrombocytopaenia (low platelets) 
Haemophilia 
Anticoagulation therapy 
Aspirin

Często zadawane pytania dotyczące przeciwdziałania zmarszczkom