We are frequently asked this question, so put our questions about anti-wrinkle injections to a medical aesthetics practitioner
What is ‘Botox?’
There is a great deal of confusion around Botox and although it is quite often used to describe all injectable treatments, it is actually a brand name (like Apple & Hoover) and a registered trademark of Allergan. Not a generic term for other botulinum toxins. Botulinum toxin type A is a naturally occurring protein produced by the bacterium clostridium botulinum.
Brands of this type of botulinum toxin commercially available in the UK are Botox®/ Vistabel® (for cosmetic use) Xeomin®, Bocouture®, Dysport® recently approved for cosmetic use as Azzalure®.
How safe is BOTOX®/VISTABEL®?
Allergan’s Botox/Vistabel has been used in the medical field since the 1960s to treat conditions such as excessive blinking, excessive sweating, and cerebral palsy.
Allergan, the manufacturers of Botox®, gained UK approval for Vistabel (its cosmetic application) in March 2006.
Data shows that botulinum toxin type A is well tolerated and that it is an effective treatment for reducing the severity of frown lines with treatment achieving high levels of patient satisfaction.
With more than 2,000 publications on botulinum toxin type A in scientific and medical journals, botulinum toxin type A is a widely researched medicine and prescribed to patients who suffer from a range of serious or debilitating disorders, as well as to those with cosmetic needs.
A systematic review and meta-analysis of clinical trials published between 1986 and 2002 shows that botulinum toxin type A has a favourable safety and tolerability profile across a broad spectrum of cosmetic1 and therapeutic indications.
It is important to note that all brands of type A botulinum toxin are prescription medicines, and should only be administered by a qualified medical practitioner.
How does Botox/Vistabel work?
Botulinum toxin type A has been found to relax the specific muscles that cause frown lines, blocking the nerve impulses that trigger wrinkle-causing muscle contractions, creating a temporary smooth and improved appearance between the brows.
The effects of the treatment normally last for around 3 – 4 months.
What areas can be treated?
Botox/Vistabel is only licensed for the treatment of frown lines but is commonly used for the treatment of crow’s feet and horizontal wrinkles on the forehead as well as to reposition or lift the eyebrows by a few millimetres, which is often referred to as a “chemical brow lift” and to reduce “bunny lines” (the lines along the top of the nose).
In addition, some advanced practitioners are also using botulinum toxin to treat the lower face and neck. These treatments address fine vertical lines in the lip area around the corners of the mouth, a dimply chin, and horizontal lines around the neck. In addition sagging jawlines can also be lifted with the ‘nefertiti’ neck lift.
What should you expect during the treatment itself?
1. Make you sure you have a detailed discussion with your practitioner and you are clear about the effects you can expect from your treatment. A visual examination of your face, its movement and lines should be conducted by the practitioner and prescriber of the botulinum toxin.
2. Make sure your medical history is discussed in full, and that you have no underlying conditions which could make you unsuitable for treatment. You may find that your practitioner will always ask you to sign a consent form and take photos before (and after) treatments. This is completely normal.
3. Don’t be afraid to ask questions, and remember it is a medical consultation and don’t feel pressured into having the treatment if you’re not sure about it.
4. No anaesthetic or sedation will be used, although sometimes you may be given an icepack to place on the area prior to treatment. The area to be injected will be wiped with antiseptic and then using micro needles, tiny amounts of the botulinum toxin, will be injected into several points in the areas to be treated. For most people this is entirely painless and just feels like a ‘pinprick’.
5. Less is often more, and a good practitioner would prefer to see how you react to the treatment on your first visit, and offer a follow-up visit two weeks later with a ‘top-up’ if necessary.
6. Repeat treatments are normally needed around every 3 – 6 months to maintain the effects of the treatment.
7. The treatment and consultation usually takes no longer than 30 minutes and you are usually able to drive immediately afterwards and carry on with your day. It is not recommended that you lie down within 4 hours of the treatment, or embark in strenuous exercise on the day of treatment.
5 important questions to ask your practitioner
1. Are you a healthcare professional registered with the General Medical Council, General Dental Council or Nursing and Midwifery Council?
IMPORTANT: Always, always, always visit a reputable trained aesthetic healthcare practitioner who is experienced in facial injectable treatments. How long have you been trained in this area and do you have a certificate of accreditation?
IMPORTANT: It is vital that the aesthetic healthcare practitioner has been trained to administer facial injectable treatments. Great results achieved with wrinkle relaxing injections are dependent on the technique of the practitioner – training and precision are essential when carrying out such delicate procedures. Don’t be afraid to ask for proof of their experience and training in facial injectables.
2. What products are you recommending to me and why?
IMPORTANT: If you want a specific product, ask for it by name. If you don’t have a particular brand in mind, then your practitioner should always provide an explanation for the brand of treatment they intend using.
3. Can I see the original packaging so I am assured of receiving the genuine product?
IMPORTANT: You may see the original packaging of the injectable treatment you are receiving. However, if it’s not visible to you, just ask to see the packaging so you know you are receiving the authentic product you have either asked for or been advised you will be receiving. Ask for the patient information for the products as well.
4. What are the possible risks or complications with these treatments?
IMPORTANT: Your practitioner should talk you about the risks of the non-surgical treatments in detail prior to treatment.
5. What level of aftercare will I be entitled to following my treatment?
IMPORTANT: Most professional aesthetic healthcare practitioner should offer a complimentary follow-up appointment, particularly on your first treatment. This will be a good opportunity to highlight any concerns you may have.