
What is botulinum toxin and how does it work?
Botulinum toxin A is a chemical produced by the bacteria Clostridium botulinum. botulinum toxin is a protein derivative of the toxin. When injected into a muscle it partially blocks the nerve impulses to muscles and reduces excessive contractions of these muscles. By using facial muscles repeatedly, over the years skin creases develop in areas. Overtime these areas form lines which are permanent due to a combination of over use and loss of collagen and elastin. By reducing the movement of muscles in these areas, skin creases reduce and the area softens resulting in a smoother appearance.
How safe is botulinum toxin?
In high concentrations botulinum toxin is a potent poison and can be fatal. However, botulinum toxin used in minute doses as in aesthetic medicine has a very high margin of safety although there can be adverse side effects. Please ask your practitioner about these if you have concerns.

What happens during treatment?
The procedure will take about 15 minutes. First you will be asked to complete a medical history as well as a consent form prior to treatment. This is a good time to ask the practitioner any questions you may have. Firstly the practitioner will ask you to use certain facial muscles to assess potential areas of treatment. With your consent, photographs will then be taken before the treatment and stored securely. A very fine needle will be used to inject the product into the muscles in order to reduce skin damage. This may feel uncomfortable but should not be painful.
What happens next?
Patients may notice some swelling or redness around the area treated, this normally resolves after 2 hours. It is advised that you do not use excessive facial expressions, drink alcohol or apply makeup for the first 24 hours. You should also avoid exercise and massaging the area during this time. Treatment is effective from 2-14 days. It may take up to 2 weeks to see the full effect of the treatment. The effects can last up to 3 months, this will vary between people.
What are the side effects?
Like all medicines, this medicine can cause side effects, although not everybody gets them. In general, side effects occur within the first few days following injection. They usually last only for a short time, but they may last for several months. Please ask your practitioner for an information leaflet on botulinum toxin for a full list of side effects. Most common side effects occur immediately after treatment and include: swelling, discomfort, pain, redness, bleeding, bruising. In extremely rare cases patients can develop an allergic reaction or resistance to the treatment.
When should I seek medical attention?
If there are any signs of allergic reaction including; difficulty in breathing, swallowing, or speaking; hives, swelling including swelling of the face or throat, wheezing, feeling faint and shortness of breath.
When should I not receive botulinum toxin?
If you had any previous reaction to treatment, currently (or possibily) pregnant, breastfeeding, current infection of area to be treated; if you have ever had problems with swallowing; if you are over 65 years of age and have other serious illnesses; if you suffer from any other muscle problems or chronic diseases affecting your muscles (such as myasthenia gravis or Eaton Lambert Syndrome); if you suffer from certain diseases affecting your nervous system (such as amyotrophic lateral sclerosis or motor neuropathy); if you have significant weakness or wasting of the muscles which your doctor plans to inject; if you have had any surgery or injury that may have changed the muscle to be injected in some way; if you have had any problems with injections (such as fainting) in the past; if you have inflammation in the muscles or skin area where your doctor plans to inject; if you suffer from cardiovascular disease (disease of the heart or blood vessels); if you suffer of have suffered from seizures; if you have an eye disease called closed-angle glaucoma (high pressure in the eye) or were told you are at risk for developing this type of glaucoma; if you are about to be treated for overactive bladder with leakage of urine and you are a male with signs and symptoms of urinary obstruction, such as difficulty in passing urine or a weak or interrupted stream.