Wrinkle Relaxing Treatments

With time, there is loss of the subcutaneous fat pads. In addition, the skin itself becomes less elastic and flexible. These factors cause the skin to sag. Dynamic lines associated with facial expression also become more exaggerated. Botulinum toxin (also known as botox) is a natural protein derived from the bacterium Clostridium botulinum. It rejuvenates the face by reducing these unwanted facial lines.

How Botox works

The toxin binds to the nerve and prevents the release of acetylcholine, which is a chemical required to cause muscle contraction. As the muscle relaxes, wrinkles caused by muscle contractions soften and sometimes disappear.

What to expect during treatment

The treatment is most commonly used for lines on the forehead, between the eyebrows and around the eyes (‘crow’s feet’). Small amounts of Botulinum toxin are injected with a very fine needle into the muscles responsible for the facial lines. Several small injections are usually needed. The injections may be slightly painful but an anaesthetic is not required. You may also experience some redness and swelling at the injection sites, which will settle within a few hours. Occasionally, slight bruising may occur. Otherwise there will be no visible signs of your treatment. It is not unusual to have a mild headache for up to 48 hours after treatment. Simple painkillers, such as paracetamol, can be taken if required. These headaches are less likely to occur with subsequent treatments. In around 1 in 100 patients, temporary weakness of the muscles around the eyes can occur. This may cause drooping of the eyelid (ptosis). These problems are not permanent but may take a few weeks (1-6 weeks) to resolve. Special eye drops may also be used to help correct the problem.

Potential contraindications to treatment

Whilst botulinum toxin is not associated with any serious complications, treatment is best avoided if you fall into one of the categories listed below:

• Pregnant and / or breastfeeding
• Patients with generalised neurological or muscular disease e.g. multiple sclerosis, myasthenia gravis, Bell’s palsy, Eaton Lambert syndrome
• Patients taking aminoglycoside antibiotics e.g. erythromycin;
• Patients taking other drugs including penicillamine; quinine; calcium channel blockers; non-steroidal anti-inflammatory drugs (NSAIDS). Ideally, these drugs should be discontinued one week before treatment
• Patients with bleeding disorders e.g. haemophilia or taking warfarin

In addition, patients taking supplements such as Vitamin E, ginkgo biloba and St. John’s Wort are more likely to experience bruising. These supplements should therefore also be discontinued one week prior to treatment.

Aftercare advice

You will be provided with a detailed aftercare information sheet. However, some of the important things you should avoid are listed below:

• Avoid lying down for 4 hours
• Avoid applying make-up for 4 hours
• Avoid exercising / gym for 24 hours
• Avoid massaging the areas for 48 hours
• Avoid facials for 2 weeks

How long does it last?

The effects of Botulinum toxin take around 3 days to establish, although this may vary. The peak effect of the toxin occurs 1 to 2 weeks after injection. Sometimes, further treatment within a period of 2 – 3 weeks is required to achieve optimum correction. The effects of the toxin are however temporary, lasting for between 3 to 4 months.