Botulinum Toxin type A is commonly abbreviated to Botox. The main brands on the market are Botox / Vistabel, Xeomin / Bocouture, and Dysport / Azzalure.
Boulinum Toxin type A is a prescription medicine and therefore can only be administered after an initial face-to-face consultation.
What is Botulinum Toxin type A and how does it work?
Botox is a naturally occurring protein that works by blocking the nerve signals to muscles and therefore causing them to relax. It can also block nerve signals to sweat glands and therefore reduce sweating.
What can Botulinum Toxin type A be used for?
Botox can be used for a number of medical conditions as well as for cosmetic reasons.
Cosmetically, Botox helps to treat dynamic lines and wrinkles which occur when we use our muscles to form facial expressions, such as smiling or frowning. As it causes these muscles to relax, it helps prevent the dynamic wrinkles from forming. Deeper wrinkles, or those caused by gravity, sleep position, or sun damage, are less effectively treated with Botox. I will assess what type of lines or wrinkles you have and advise on the best treatment for them. The most commonly used sites for Botox treatment are for fine lines are the crow’s feet, frown lines, and forehead lines.
Other cosmetic treatments available with Botox are the treatment of a gummy smile, a non-surgical eyebrow lift, and the treatment of excessive sweating (also known as hyperhidrosis).
Will Botulinum Toxin type A treatment work straight away?
The effect of treatment generally takes 4-14 days to take effect, but sometimes can take up to 21 days. Evidence has shown that if you actively use the muscles treated in the hours following treatment, this helps to bind the toxin faster.
Some patients with very active facial muscles require a follow-up treatment 2-3 weeks after their initial treatment.
How long will the effects last?
The effects of Botox treatment are not permanent. The effects peak at around 2-3 weeks after treatment, after which they will very gradually wear off. The overall effects of treatment should last 3-4 months initially, but after repeated treatments the effect should last longer.
Side effects to treatment
Like all medicines, Botox treatment can produce unwanted effects.
As expected for any injection procedure, pain/burning/stinging, swelling and/or bruising may be associated with the injection, but these should resolve within a few days.
Other possible side effects include headache, itching, tingling or numbness. Occasionally, patients may develop drooping of the eyebrow or eyelid, or puffiness below the eye if receiving treatment to the upper face. This usually lasts for no more than 1-2 weeks.
In very rare circumstances, patients can develop antibodies to the Botox protein. This is more likely to occur if receiving treatment more frequently than every three months, and can result in future treatments being less effective or provoke an allergic reaction.
Contraindications to treatment
Patients with a known hypersensitivity to Botulinum Toxin type A or to the other ingredients of the product (eg albumin, sodium chloride, sucrose, lactose), or who have multiple confirmed allergies.
Women who are pregnant or breastfeeding.
Patients suffering from Myasthenia Gravis or Eaton Lambert Syndrome.
Patients who are 4 weeks prior or 4 weeks post a general anaesthetic.
Patients who are currently or have recently been treated with certain antibiotics (namely Spectinomycin, Neomycin, Streptomycin, Gentamicin)
Cautions to treatment
Patients with other neuromuscular disorders (eg amyotrophic lateral sclerosis).
Patients with infection at the proposed treatment site.
Patients on blood thinning medication (e.g. aspirin, warfarin).
Patients taking over-the-counter medication that can thin the blood or increase bruising (Omega-3, Vitamin E, Cod liver oil, Garlic, St. John’s Wort, Ginkgo Biloba).
Patients who have recently taken quinoline-type antimalarial medication.
Patients with a history of swallowing problems or aspiration.
Advice prior to treatment
For seven days prior to treatment, avoid blood thinning over-the-counter medication such as aspirin, or ibuprofen-based medications, Omega-3, Vitamin E, Garlic, St. John’s Wort, Ginkgo Biloba. If you are prescribed a blood thinning medication such as aspirin or an anticoagulant by your doctor for a cardiovascular condition, then please check with your doctor prior to stopping the medication.
For 24 hours prior to treatment, do not drink alcohol to avoid extra bruising.
On the day of treatment, arrive to the clinic with a clean face.
What to expect on the day
I will go through what your aims are for treatment and will explain to you what is appropriate and achievable. A treatment plan will be agreed upon prior to treatment.
You will fill in a medical assessment questionnaire and complete a written consent form.
Pre-and post-treatment photographs will be taken for your medical records.
Any make-up will be removed from treatment area with a baby wipe.
The area will be cleaned again with chlorhexidine solution.
Botox treatment will be injected into the muscles being treated. This usually involves a series of small injections. You may experience some stinging and tenderness during the injection, which some patients describe as feeling like a bee sting.
Dettol cream and/or Arnica gel will be applied to the treated area following treatment.
You will be given a post-treatment advice sheet.
Lauren will let you know if any follow-up is required.
Appointment time will be approx 30 minutes.
What to expect after treatment
There may be small marks, bumps, and bruising immediately following the procedure but be reassured that these will disappear within a couple of days.
You will begin to notice an improvement in your lines/wrinkles 4-10 days following your treatment.
Any follow-up appointments will be given approximately 2-3 weeks following your initial treatment. This is to assess the effect treatment has had and to administer a follow-up treatment if required.