Botulinum toxin is a neuromodulator and originates from the bacteria Clostridium Botulinum. There are several types of botulinum toxins, and it is type A that is in Botox® and also the most commonly used. Botulinum Toxin has been used extensively in clinical practice since the 1970’s in medical conditions such as muscle disorders and facial asymmetry. Cosmetic use started a decade later as anti-wrinkle injections became popular. It has been FDA approved.

Botulinum Toxin is used as an anti-wrinkle treatment. Typical areas targeted include the:

• Horizontal forehead lines
• Vertical frown lines between the brows (11’s lines)
• Wrinkles around the eyes (Crow’s feet)
• Prominent vertical neck bands

Botox can be used reliably for excessive sweating (hyperhidrosis), rosacea and migraines. There are many other applications, such as brow positioning, gummy smile and teeth grinding.

Botulinum toxin is a neuromodulator and affects the junction between nerves and muscles. Once inside a nerve cell, it interrupts signals and causes targeted muscle paralysis. Wrinkles are caused by the pull of muscles crinkling the overlying skin. Therefore, when we reduce the muscle’s activity, it will lessen the amount of creasing as well. Without the constant creasing, the wrinkles will shallow over the subsequent weeks. 

Botox is diluted to be very safe. There is well documented evidence for efficacy and safety for the main indications of forehead, frown and crow’s feet lines. With time, the toxin loses its effect and repeat injections are necessary to maintain a rejuvenated look.

On the day of your consultation, we will explore what you have in mind. We will analyse your features and discuss which injectable treatments would most benefit you. We will also go over the risks of the procedure and provide realistic expectations. There is no obligation to undergo treatment from your consultation. 

The injections take no longer than 10-15 minutes and there are usually no marks or bumps on the skin as we use the world’s smallest needle. This also reduces pain and bruising risk. The clinical effect on the underlying muscles occurs within days and lasts approximately 3-4 months, but this can vary from person to person.

There are no aftercare instructions after this type of injection. There are many myths about things to do or avoid after injections but a 2025 retrospective 5,000-patient study found omitting post-care instructions did not worsen outcomes. We suggest that you do not have large events (e.g. weddings) planned within three weeks, just in case of the minimal risk of bruising and any adjustment that might be required.

If this is your first treatment or you have not had treatment in a while, then it is worth knowing that in the first 2 weeks, the effect may appear a little strong. This relaxes in the following week or so and is a common phenomenon of the toxin settling in. In the uncommon case of needing to top-up, this is provided free of charge. We will suggest a reasonable maintenance regimen for you and provide advice on how to prolong your results in between your treatment doses.