What is Botox?
Botox – or botulinum toxin A if you want to get technical – is one of the best-known drug names in the world. You’d be forgiven for thinking that Botox is the proper term for all wrinkle-relaxing injections, but it’s actually just one of a number of brands on the market. It is, however, the best-known brand of wrinkle-relaxing injections and the one most commonly used by practitioners. Botox is extremely popular in the aesthetics world due to its relatively cheap cost (compared to a surgical face-lift, for example), reliable results, minimal pain level, and the short time it takes to perform the procedure.
Pain level: Low
Cost from: £200
Recovery time: 1 Day
Is Botox safe?
Let’s address the elephant in the room. As its full name suggests, Botox is a toxin. A nerve toxin, to be precise, that, let’s be honest, someone else is going to inject into your face. However, because of its toxic nature and widespread usage, there have been a lot of studies done to ensure its safety. It is widely accepted that, when administered by a skilled and responsible practitioner, you have nothing to fear.
How does Botox work?
The toxin interferes with the transmission of nerve impulses that tell muscles to contract. It does this by blocking the acetylcholine receptors in the muscle. It is injected into the muscles to soften the appearance of frown lines and other ‘dynamic’ wrinkles which form where we use facial muscles to make expressions. Botox reduces the ability of these muscles to contract, so it can soften frown lines, or lift downturned corners of the mouth. The product is injected into the muscles responsible for making these expressions, to weaken them for three-six months, which in turn will, for example, soften your frown lines, or lift downturned corners of the mouth.
What can Botox be used for?
There are so many ways in which Botox can be used, but some of the more common ones are:
- The ‘eleven’ lines between the eyebrows.
- Crow’s feet wrinkles at the sides of the eyes.
- In the forehead, to soften horizontal lines
- In the ‘bunny lines’, the horizontal wrinkle-lines at the top of the nose.
- In the jaw, to reduce muscle clenching of the masseter, the main chewing muscle
- In the chin, to relax a ‘cobblestone’ chin
- Beneath the corners of the mouth, to reduce a habitual grumpy downturned-mouth expression.
- In the upper lip, to reduce the lip retraction which makes a smile look ‘gummy’
- In the neck, to soften a stringy-looking neck
Where can I get Botox?
Botox is a prescription-only drug, so has to be supplied by a medical professional who is qualified to prescribe — in the UK, that means a doctor, a surgeon, a dentist, or a nurse-prescriber (a qualified nurse who has taken a further course to become a non-medical prescriber). Prescribing pharmacists can also prescribe Botox, and many are taking training courses in injecting the toxin, too. The injections can legally be given by someone working under the supervision of that qualified professional, though the prescriber is the one who takes responsibility for the treatment. The makers of Botox – and the makers of other wrinkle-relaxing toxins such as BoCouture and Dysport (aka Azzalure) – are scrupulous about only supplying their products to medical professionals. Does that mean that the system is watertight? Unfortunately not. Unscrupulous practitioners find ways around the system, which is why it’s so important to make sure you choose a really good Botox practitioner.
How much does Botox cost?
This varies depending on how many areas you have treated, but expect to pay from £150 per area (the lines between the eyebrows is one ‘area’, the crow’s feet are another ‘area’, horizontal lines on the forehead are a third ‘area’) at a reputable clinic and £450 or more for a top practitioner. Bear in mind that prices at prestigious clinics at prestigious addresses, like Harley Street in London, will be higher than elsewhere.
How long does Botox take to work?
You’ll start seeing the effects take hold within a week and the treatment will reach full effect in 10-14 days. The procedure itself takes hardly any time. About 10 minutes if you’re getting one or two areas done. The initial consultation is a longer process (which is a good thing and one of the hallmarks of a good practitioner) so set aside an additional 30-40 minutes for your first time. All said and done, you’ll be in and out within an hour.
I would always recommend booking in for a review two weeks after treatment, by which time the full effects of the treatment will be showing. That way, if you end up with, say, one eyebrow arching higher than the other, your practitioner can make a small adjustment to even things out. Most practitioners will not charge you for this review appointment, and you can always cancel it if you are happy with the way your face is settling down.
How long does Botox last?
Botox lasts from two to six months, depending on how much is used and the level of muscle activity in the area. A very light treatment with Botox, perhaps described as ‘baby Botox’ or a ‘microdose’ of Botox, will be wearing off after two months. An average treatment will last for three months. A stronger treatment of more toxin will give a more obvious result (i.e. it will pretty well stop all movement in the area where it is injected) but will last for five or six months.
What happens if I stop getting Botox?
After two to six months, the effects of Botox will be wearing off as the muscle develops more acetylcholine receptors to pick up signals from the nerves, and the muscles will fully recover their function. Amazingly, this is a reliably observed process that happens time after time, even with serial Botox fanatics. (More seriously, this effect has been studied over many years with patients who have repeated treatment with Botox treatment to control muscle spasticity. With this sort of treatment, much larger doses of Botox are used than in cosmetic treatment.) The upside of this is that if there’s something you don’t like about the result then you can tell your practitioner and they can make sure to adjust your treatment accordingly. The downside, of course, is that this is a repeat cost that adds up over time.
Are there any side effects with Botox?
As with any injections, there can be bruising or bleeding at the injection site, but the main issues with Botox stem from over-treatment. Aesthetically, too much of it results in a frozen-looking face that can’t express emotion. If muscles are poleaxed with Botox for too long or too often and don’t get a chance to regain their full range of motion, they may begin to waste away through lack of use. Inexpert injecting can lead to drooping (ptosis) of the eyelid or brow, which will last until the effects of the toxin start to wear off — another good reason for starting with a low dose.
What are some alternatives to Botox?
Nothing will relax the muscles that create dynamic wrinkles in the way that botulinum toxins can. But if you don’t fancy it, there are many other approaches to try. You could:
- Try other treatments that will reduce the appearance of lines by boosting collagen growth within the skin, such as: microneedling, fractional laser treatment, or Tixel.
- Using stick-on patches that will remind you when you are frowning, such as frownies.co.uk. Relax your forehead and stick on a patch. When you frown, the patch will tweak at your face and remind you to relax your expression.
- Try serums containing Argireline. This is a peptide that has a relaxing effect on dynamic wrinkle lines around the eyes. It will not have as marked an effect as Botox, but studies suggest that it can help, if used at a concentration of 10 per cent.
- Use a night cream containing retinol. This will stimulate the growth of collagen within the skin and this will reduce the appearance of wrinkles.
- Practice feeling serene. I’m not joking. Sit in front of a mirror, frown, and then work out how to actively relax your forehead. Practice that movement, along with an exhale.
Botox can help you with these concerns: