Recently many creams and lotions have come into the market. “Botox in a bottle” is quite a common phrase. However, it is inaccurate to compare them to Botulinum Toxin. These creams are cosmetic products; hence, they work only on the most superficial skin layers. There is no penetrating depth to any of the products you can buy over-the-counter. Botox® is a medical substance to be injected by a trained professional past the skin layers deep into the muscle. There are no creams available at all that penetrate that deep or give the same results as Botox® is a prescription only medication and can only be used if deemed appropriate for the patient.

People are sometimes scared off having a frozen look after treatments. My practice techniques make me very confident that I will only place as much Botox® as is required to get the desired effect that you wish. I always focus on making my patients look fresher and more natural and hence I stay clear from the frozen look, which is normally due to inexperienced hands handling muscle treatment. The treatment works by relaxing muscle groups, but it is essential to get the dose required just right. Hence, I would always rather undertreat a patient and then adjust appropriately at a two-week follow-up than give them too much at one go. I find my patient are very thankful that they can still maintain all of their natural facial expressions while looking more hydrated, with fewer lines and wrinkles, and overall a lot fresher.

This is a recognised potential side effect of all the treatments, and international literature quotes the risk of eyebrow droop at approximately 1 in 200 patients. However, in my personal practice, the rate is much lower because of my personal practice techniques and I make sure my patients are fully informed about what to do and what not to do after undergoing the procedure. If after having the procedure, the patient rubs their face, massages or pushes the product manually within the first four days then the risk of the Botulinum Toxin moving to other muscle groups is higher and hence eyebrow droops can occur. In the unlikely event, that such a complication was to occur it is good to be aware that all complications with Botox® are short lived and within three weeks return to near normal. All the effects of the treatment and all of the unlikely complications are temporary and hence there are no long-term complications from undergoing the treatment. I always see my patients at a free-of-charge two-week follow-up appointment to make sure they are happy with the results.

Once injected, the actual active portion of the Botox® molecule is normally only within the body for a period of days, and by day five the active portion has done all of its work and is removed by the body naturally. Once injected, it very quickly finds nerve endings and starts work straightaway. The visible results of this become normally apparent between day three and day five. Improvements normally continue to show until day 14. Therefore, it is not possible for Botox® to build up like other drugs can.

The use of Botulinum Toxin A has built up an excellent track record for safety over the last 30 years in various medical specialties. It has an active food and drug administration (FDA) approval license for use in cosmetic treatments in 13 countries worldwide. This is definitely not an easy feat to accomplish. Apart from its cosmetic use within various fields including ophthalmology, occulo-plastic surgery, gastro-intestinal surgery, plastic surgery and even in severe conditions like cerebral palsy where very high doses of Botox® are injected into the large muscles of the arms and legs in order to reduce spasticity, improve mobilisation and aid with physiotherapy. All of the research over the 30 years has shown Botox® to have no long-term side-effects, making it a very safe and effective treatment.

At Skin Radiance Clinics we strongly believe that patients should not look like they have had any “work” done at all. We aim to make results look as natural as possible. Unless you specifically request it, we only administer enough treatment to soften fine lines and wrinkles, and freshen your look. This means you can continue to frown and smile and these expressions are not affected by the treatment whilst there is still noticeable improvement in your overall look. Another important advantage is that the effects wear off over time, so you can be doubly sure. Happy Patients? Tick.

Few specific reasons why patients should not undergo the procedure exist. Patients with a previous history of allergic reaction to Botulinum Toxin A or hypersensitivity reactions should not proceed with the treatment. It is also important that the area injected is infection-free as this can complicate the treatment outcomes. Treatment with Botulinum Toxin A is prohibited in select patient groups. These include patients with neuromuscular disorders including, but not limited to: myasthenia gravis, muscular dystrophy, Lambert Eaton syndrome, multiple sclerosis and other rare neuromuscular conditions. If you suffer from any of the above conditions, all you need to do is discuss your personal circumstances further, we urge you to get in contact for direct consultation. If you are currently pregnant, breastfeeding, trying to get pregnant or envisage yourself getting pregnant in the next nine months, you must strictly not undergo any cosmetic procedures.

Straight after your treatment, you may have small red raised lumps on the injection sites. These are completely normal and will settle within the hour. Patients are asked to remain, wherever possible, upright for the next four hours after treatment. Patients are also urged to be over expressive with the facial muscles for the next hour after treatment for a better absorption of the Botox®. Alcohol is discouraged for the first 48 hours and extreme exercise and extreme heat is discouraged for the first four days at least, as these activities all increase blood flow to the face which can wash away the product.

Most people do not require any form of anaesthesia or pain relief prior to the injections taking place. If so required, a cool icepack can be used prior to injecting to ease any mild discomfort. There is normally no downtime with Botox® and you can continue the rest of your day as normal, apart from in a few specific situations.

In most cases, the results can last for approximately 12 weeks depending on the individual. In some, it may last longer, however in others it may take considerably less time due to many factors including lifestyle, metabolic rate, the amount of physical activity one partakes in, and also the amount of alcohol one consumes.

Botulinum Toxin A is a prescription only medication in the UK. Hence, it is only an option after a formal face-to-face consultation with a prescriber. In the UK, doctors, dentists, nurse prescribers and prescribing pharmacists are the only ones allowed to prescribe the drug. However, there is currently no UK regulation on who can administer these treatments and hence many allied healthcare professionals and non-medical practitioners including beauty therapists are administering patients with this treatment.

Skin Radiance Clinics stands by our view that only medically trained fully insured and aesthetically trained practitioners should administer this treatment. Although they are rare, experiencing the side effects of this treatment is possible and you need the assurance that you are in the safest hands possible if such complications were to arise.

At Skin Radiance Clinics, you only see a General Medical Council registered & experienced cosmetic doctor, who is fully trained and fully insured. Dr Raj Thethi MBChB BSc(Hons) MRCSEd takes you through the full consultation and if deemed appropriate is the only person who consents for and administers the treatment throughout.

Most patients report seeing results within a few days initially, and then continual progress over the next two weeks, which is when they see the maximum effect of the treatment. This is when the muscular activity is affected the most by the treatment. The results normally stay at this level for approximately 12 weeks in total, depending on individual patients.

Fine lines and wrinkles that appear on the face normally result from repeated muscle contractions in the area. As the muscles continue to contract in a certain way, fine grooves form which over time can devolve into deeper lines and wrinkles. It is this repeated muscular activity that we try to reduce. The Botulinum Toxin Type A once injected works at the nerve endings trying to excite the above-mentioned muscles. By blocking these nerve channels, muscular activity is significantly reduced and overtime the skin overlying the muscle can relax and naturally reduce the apparent final lines. The Botulinum Toxin Type A also tightens your skin and can lead to better skin quality overtime. Another benefit of Botulinum Toxin Type A is that once injected in selected areas you can improve the resting tone and position of other muscle groups in the area, thus by only partially treating certain muscles like the forehead we can sculpt beautiful eyebrow raises and define eyebrow arches with precision.

First, our experienced doctor spends time with you getting to understand what your concerns are, what your desires are and what improvements you are keen to have made. Here’s the procedure. After assessing your medical history thoroughly, Dr Thethi comes to a decision whether treatment with Botox® would be in your best interests or whether some other option will suffice. We do not use a numbing cream for the anti-wrinkle treatment procedure as its very quick and can be very well tolerated without anaesthetic agents. We gently and precisely target the problematic areas with Botulimun Toxin A in very small doses in very specific points to attain the result you desire. The effect does not take too long to set in. The Botox® treatment starts working straight away and most patients start to see changes on day 2-3. The treated area continues to improve in most cases for up to 2 weeks, which is when its maximum effect is observable. Most people will then continue to see this result for the next 12 weeks on average but every patient is different. In some, it may take longer or shorter lengths of time depending on many factors including lifestyle.

The active chemical that causes muscle relaxation is called Botulinum Toxin A. Different companies have produced similar but slightly variable types of products all containing slightly different types of Botulinum Toxin A. Here at Skin Radiance Clinics, we use both Botox® & Azzalure® brands of Botulinum Toxin A depending on your individual needs. What are those? Both are brands of Botulinum Type A; produced by a bacterium called Clostridium Botulinum, and freeze-dried and purified. Botulinum toxin naturally softens fine lines and is versatile enough for use in numerous areas of the face. These areas include the frown lines (glabella), forehead lines, the smile lines, or crow’s feet that develop around the outer aspect of the eyes. It has other uses, which include helping to subtly alter certain features in the lower face, and it can also improve and tighten the appearance of the neck and décolletage area.