Botox - The Complete Guide

If you are considering Botox, you may be looking for some more information regarding how it works. Many patients who visit City Skin Clinic wish to reduce the appearance of fine lines and wrinkles, and Botox anti-wrinkle injections are a treatment that can help. This guide will tell you everything you need to know about Botox. We cover a range of topics such as Botox materials, treatment, and aftercare. After reading this guide, you will have all the Botox know-how to decide whether this treatment could be the right course of action for you. 

What Is Botox Used For?

Botulinum toxin type A, commonly known as Botox, is an injection used to weaken the muscles in the face which stops them from pulling on the skin above. The injections are primarily used to smooth the appearance of fine lines and wrinkles, although they can treat other conditions like neck spasms and excessive sweating. Technically, Botox is a toxin. However, when used in small doses, it can offer a range of benefits for both medical and cosmetic purposes. 

Botox® is a branded name of the first and most widely used Botulinum Toxin but is often incorrectly used generally to band all similar products together – even those that are not technically Botox. Other brands of Botulinum Toxin available in the UK are Bocouture and Azzalure. At City Skin Clinic, we only use Botox and hence will use this branded name for the remainder of this article. Botox can be used for both medical and cosmetic purposes. Let’s delve into each one below. 

Cosmetic Botox

Cosmetic purposes are the primary use for Botox injections. Many people choose this method of treatment to reverse signs of anti-ageing and define the face. Botox minimises the appearance of fine lines and wrinkles, giving patients a more youthful-looking and rejuvenated appearance. 

It is most commonly used to treat dynamic wrinkles between the brows (also known as frown lines or 11 lines), on horizontal lines on the forehead and smile lines or crow’s feet around the eyes. The effects of cosmetic Botox are temporary and usually last for 3-4 months on average. 

To maintain the effects of treatment, you will need to repeat the treatment once it wears off, however, most people find this gives them peace of mind as they do not have to commit to a permanent change. Another key advantage to the temporary duration of Botox treatment is that as your face ages, the injections can be adapted to accommodate for these changes and hence give a better outcome over time. Most people will request Botox injections around their eyes, forehead and the frown area. Botox injections are also frequently used to smooth pebble chins and relax marionette lines, treat gummy smiles, lift brows, slim the jaw and tighten the neck.  

Botox is a prescription-only drug and good outcomes can only be achieved by highly-qualified medical practitioners. Only trained and experienced aesthetic dentists and doctors conduct Botox treatments in our team at City Skin Clinic. 

Medical Botox

Botox has many medical uses and its cosmetic effects were actually discovered when treating eye problems in stroke patients! It is commonly used to treat stroke victims and people with cerebral palsy who may be experiencing spasticity, particularly in the upper body. 

Spasticity is a condition that develops following damage to the brain and spinal cord. Muscles become tight and stiff, making it difficult for your body to move. Botox injections can treat spasticity by relaxing the stiff muscles and thereby minimising stiffness. In doing so, not only can Botox improve movement, but it can also reduce pain. 

Similarly, Botox is also used to treat bladder spasms, eye spasms, squints, and chronic migraines and reduce facial asymmetry after conditions like stroke or trauma. Botox is also used to treat hyperhidrosis, also known as excessive sweating and is one of the most effective non-invasive treatments for this. Botox has also been used to treat skin conditions like acne with good preliminary outcomes although more robust data is still needed. 

Check out this blog post if you’re interested in learning more about the history of Botox.

What Is Botox Made Of?

Botox is made of Botulinum Type A. This is a powerful neurotoxin that in nature is produced by a bacterium called Clostridium botulinum that causes an illness called botulism. The 

Botulinum type A in Botox is made and purified in the lab to produce a sterile and weaker product that is safe to inject and use for cosmetic as well as medical purposes. Although Botox is not made from animal products and is hence generally considered suitable for vegans or vegetarians. 

However, although it does not contain animal products, Botox is not considered cruelty-free. This is because Botox is a drug, and hence has undergone animal testing a requirement to ensure that it is safe and effective prior to being approved for use in humans. If you are in doubt in terms of the ingredients or manufacturing process of Botox, consult with a clinician who will be able to advise you if the product is suitable based on your clinical and ethical needs. 

How Does Botox Work?

Once Botox is injected into the skin, it targets the neuromuscular junction. Botox blocks the nerve signalling processes that usually encourage the muscles to contract. causing temporary muscle weakness or paralysis depending on how much is used. 

In order for Botox to be effective as an anti-wrinkle treatment, the wrinkles have to be dynamic which means only visible on movement or facial expression. In this situation, the muscles relaxed by Botox stop pulling on the skin and hence stop the wrinkles from appearing. If the wrinkles are static, meaning ingrained and visible all the time regardless of moving your face, then Botox will not effectively treat them. 

In these situations, it is best to consider treatments like dermal filler wrinkle injections, Tretinoin cream or skin boosters like Profhilo. Although Botox smooths dynamic wrinkles and treats them, generally speaking, Botox wrinkle injections are considered preventative. The preventative effects however are most useful when the wrinkles start to appear and are not necessary for prevention if you have not yet developed lines or wrinkles which is a common misconception among prospective patients. 

As such for years, Botox has been used to successfully treat wrinkles around problem areas of the face, like around the eyes, forehead and frown lines. As these muscles are relaxed it prevents the dynamic wrinkles from getting deeper and ingrained over time. 

How To Prepare For Botox And Fillers

You must understand how to prepare for Botox and fillers to achieve the best results out of your treatment and avoid complications further down the line. You should avoid drinking alcohol on the day of your treatment. Doing so can help you prevent facial bruising and it is important to be sober in order to consent to the treatment and follow the aftercare advice. 

You should also avoid taking anti-inflammatory medications such as aspirin or ibuprofen one week before your treatment, as they can also increase bruising. If you need to take anti-inflammatory medication regularly as a treatment for a health condition then you should discuss with your doctor whether it is safe to stop them. 

If it is not, you must bring this to your aesthetic practitioner’s attention, who will take even greater care in performing the treatment and advise on how to reduce the risk of bruising or help it resolve sooner.

Special occasion or Wedding Botox 

If you’re planning to have Botox ahead of an important event or a celebration such as a wedding then timing your treatment is very important. As a general rule, it takes 2-3 weeks for the effects of Botox to become fully apparent. After this period, a top-up may be needed to optimise or fine-tune the outcome and this needs an additional 2-3 weeks for the final outcome to appear.

If there is a problem with Botox, it is crucial that there is ample time to correct it. Whilst the vast majority of people love the effect of Botox anti-wrinkle injections, some people may not or they may prefer to have less or more movement. As such we recommend that if you can, you should have Botox at least once before you have the treatment for a special day as this will determine whether you like the outcome and how much smoothing vs facial movement you are happiest with. Then ahead of the wedding or special occasion, you should try to have the treatment 4-6 weeks before.

During Botox Treatment

Botox treatment is often praised for its ease and speed of application. The procedure only takes a matter of minutes, and you will not need to have an anaesthetic. You may feel some slight discomfort which is nothing to worry about although we provide numbing cream at City Skin Clinic to make the procedure more comfortable. Before your treatment, your clinician will talk you through the process and ensure that you are comfortable going ahead. 

Your clinician will use a small needle to inject the Botox into the treatment area using a series of tiny injections (the number of injections and units of Botox injected will depend on the area and desired outcome). Immediately after the treatment, you may have redness and small bumps over the treated area as well as injection marks. These usually settle within a few hours and you can expect to see results around 2-7 days after treatment with maximum results visible at the 2-3 week mark.

Botox Aftercare

You want to achieve the best results possible from your Botox treatment and although this is a low-maintenance procedure, we have a few aftercare tips that can help you minimise bruising and discolouration. Take a look at our aftercare tips below: 

  • Avoid touching and putting pressure on the treatment area for the first 6 hours
  • Wait at least 12 hours after treatment before applying makeup
  • Wait 24 hours to exercise to reduce the risk of bruising and botox migrating 
  • Do not sleep or lie flat for 6 hours after the treatment 
  • Do not massage the face for 24 hours after Botox treatment (you can gently wash it and pat it dry with a towel)

How Long Does Botox Last?

The effects of the treatment usually last for around 3-4 months although this varies from person to person. If you would like to enjoy the results for longer, you will need to get a repeat treatment once you start to see the results wearing off. 

There are no harmful long-term effects of regular Botox treatment and with time you may need less Botox and longer gaps between treatments as the muscles reduce in size due to long term relaxation. The beauty of this procedure is that you do not have to worry about permanent effects. 

So, if you change your mind further down the line or if you had a bad experience, the treatment effects will simply wear off. However, unlike dermal fillers, Botox can not be dissolved or made to wear off sooner. 

Side Effects Of Botox

Like all cosmetic procedures, Botox can have some potential risks and side effects. However, it is important to note that you minimise the risk of the procedure going wrong if you choose a highly skilled medical practitioner and a clinic with the right credentials. Always do your research on the clinic and practitioner before going ahead with Botox injections. Take a look at some of the potential risks and side effects below:

  • Swelling and bruising of the treatment area
  • Unevenness or asymmetric results
  • Unwanted effects such as eyelid drooping after upper face Botox
  • Headaches/flu-like symptoms
  • Vision problems
  • Allergic reaction

Swelling and bruising should be expected after your treatment, but this is often nothing to worry about as they resolve quickly. The more serious side effects like interaction with medications or drug allergies can be reduced by seeing a medical professional who will screen your medical history to avoid these and in the worst-case scenario will be able to quickly respond to emergencies such as an allergic reaction. 

Be aware that most of the potential risks are very rare but it is still important to be aware of them and know how your practitioner can reduce these risks and what they can do if anything happens. If you do have any concerns regarding your treatment, speak to your clinician, who will be able to put your mind at ease.

Why Choose City Skin Clinic?

We have years of experience in performing non-surgical aesthetic treatments and you can receive personalised  Botox injections here at City Skin Clinic. We pride ourselves on delivering bespoke aesthetic treatments to enhance and celebrate the beauty of our diverse and growing clientele in London. 

Not only do we provide high-quality Botox injections from experienced clinicians, but we also provide better education about aesthetic and skincare treatments to our clients. We strive to empower our clients to help them find the best treatments for them. If you would like to discuss Botox injections in person with one of our aesthetic doctors, don’t hesitate to book a consultation today. 


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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