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10 things you need to know about toxin

5th March 2024

I know you’re all curious about wrinkle-relaxing toxin, even if you’re someone who says they are ‘no way, never going try to the stuff’ … (go on, admit it!). If you want the full Tweakments Guide lowdown on toxin, what it is, how it works and what it’s used for, hop over to this page. Here are some other things you might need to know.

All the names

There are several brands of botulinum toxin A – the drug that works to relax muscles — licenced for use in the UK (Botox, Azzalure, BoCouture, Nuceiva, Alluzience and Letybo) and they work in much the same way as each other. Nucieva is reputed to start working sooner than the others, and Alluzience and Letybo to last longer. Which one your practitioner chooses to use is a matter of their personal preference, though I’m told some patients deliberately request brands such as Bocouture (Xeomin) or Azzalure (Dysport),  simply so that they can say – truthfully, if disingenuously, ‘No, I don’t have Botox…’

Drooping brows

This can and does happen – because your practitioner has injected too much toxin or in the wrong muscles (if they inject the muscles that lift the brow, it will weaken, and the brow will drop). How to avoid this? Choose a practitioner with sufficient training to know precisely what they’re doing, and enough experience to know that our muscle-movement-patterns are all individual, and need appropriate treatment. And if it happens? It will wear off, but it may take a couple of months.

Doing it on the cheap

Bad idea. Risky. Newbie practitioners often follow a standard injection pattern and that might do the job for you, but it might, well … look a bit odd. I know lots of you tell me that ‘we can’t all afford Harley Street’ and I hear you, but I bet there is someone highly trained who really knows what they’re doing in your neck of the woods – look at the TTG practitioner guide, for a start.

Toxin immunity

Can you become immune to toxin, so that it no longer works? Yes – a number of you, both practitioners and patients, have told me that they see this – but in the words of Dr Michael Kane, the plastic surgeon commonly known across the global aesthetics community as the ‘King of Tox’, ‘It is a thing, but it’s a small thing’ – you can watch his full explanation here.

It’s all about balance

Our face muscles work in opposing pairs. Some lift, some lower. Getting a nice result from toxin treatment is all about treating/ relaxing the muscles that are working overtime so that your face looks less tired, or cross. None of us has a face where the muscles work in perfect symmetry. A skilled practitioner will see where one muscle group needs a tad more product than another, to help your face look more balanced.

One area? Two areas?

Many clinics price toxin by the area, an area being, say, between the eyebrows, or the crow’s feet wrinkles. Which means you know what you’re spending, but you get a better overall result if your practitioner looks at your face as a whole, and works on balancing areas, as above.

If you’re nervous

Anxious about trying toxin? My two key pieces of advice are, firstly, to find a highly experienced practitioner who you like and feel comfortable with and who is listening to your concerns. And, secondly, to start with a small dose, just to get an idea of what toxin can do. You can always go back for more.

Less is more… usually

Just a bit of toxin can be enough to soften the look of your face and the extent of the wrinkling. But it won’t last long. The older I get, the more toxin I have – to soften the strength of the muscles that pull on my neck, that clench my jaw, that bunch my chin up into a cobblestone and that pull the corners of my mouth down, as well as to relax my crow’s feet and frown lines.

It’s a remarkably safe treatment

In the right hands, that is. Because the substance is so toxic, it has been subjected to an enormous number of research papers and for years before it became known as a wrinkle-relaxer, it has been used to help children with cerebral palsy manage muscle spasticity.


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