What is Botox anyway?

So you have decided on having facial injections to help deal with those lines that have been bothering you for a while now (how long has it been anyway?). Ok great but what to have? And what is Botox anyway? This is your face, your look, your body. You need to know what it is you are asking for and what it is you can expect.

Honestly, I’ve probably heard it all with regards to Botox – ‘rat poison’, ‘I won’t be able to move my face anymore will I?’, ‘will I look different’, ‘will I still look like me?’, ‘will I still be able to smile?’, ‘will it cause me a medical problem if I use too much?’. Let me clear a few things up for you.

Botox is actually a trade name for the neurotoxin botulinum toxin type A but as most people know it best by the former, we shall use Botox in this discussion.

Botox is, as I have said, a neurotoxin derived from the bacterium Clostridium Botulinum which is a naturally occurring organism found in the environment. In this state, it is relatively harmless but as botulinum toxin, it is a powerful toxin which blocks the transmission of signals from nerves to muscles. In fact just 2kg of botulinum toxin is enough to wipe out the entire human race! Scary right?

Well yes, so Botox is a paralyzing agent and yes, it is deadly in large quantities but in the doses used in cosmetic application (which are TINY) it is just enough to relax the muscles in the face which pull the skin and cause those pesky lines and wrinkles! The body is able to eventually fight off and process the Botox which is when you know you need to come back for more – the lines return as power returns to the muscles.

Cosmetic use is just one of a host of uses for Botox in fact. Other uses (in much greater doses than those used for lines and wrinkles) include relaxation of spastic limbs in patients with brain injury, migraine  and some bladder and bowel problems.

With regards to how much you will be able to move your face after injections and whether you will still look like you and be able to pull facial expressions; yes. The amount of Botox and its placement is key in this. I aim for just enough Botox to relax the muscles and allow the lines to settle but not enough to stop your face from moving.

As for Rat poison……No.  That is probably Warfarin you are thinking of. And that has good medical roots too!

So now you know and hopefully you can make a more informed decision.


The natural botox look

Ok, so botox is not necessarily natural. And obviously everyone expects those who have had botox to be unable to move their face or make expressions. The frozen look is generally regarded as what you get with botox right? Wrong! The frozen look is generally something that is asked for specifically by the client and personally it is not something that I am keen to do. Of course it can be a result of the inconsiderate practitioner and that is one reason to research the practitioner you are looking to use and especially to look at their ‘before and after’ portfolio.

In my opinion, if you are spending this much money to improve how you feel about yourself and freshen up your looks, you really shouldn’t be left with a flashing, neon sign advertising that you have done so. My ethos is simple, spend the money on someone who will take the time to look at what you want and make you look like you have been on a wonderful holiday and are fabulously rested. Static lines (those which are there all the time whether moving your face or not) will never be removed completely by botox. Over time they will improve as the skin is allowed to relax – think of a crumpled shirt, if you leave it to hang then the creases will settle – but they won’t necessarily disappear completely. But then would you really want them to? Is it natural to have no wrinkles at all in your 60s and above? Would it not be noticeable if all of your wrinkles completely disappear overnight?

Botox is especially good for the dynamic lines (those which appear when you move your face but then disappear) and therefore very good for preventing the formation of dynamic lines. In my own opinion (and other people’s do vary!), you should still have movement in your face after botox injections. You should still be able to frown, raise your brows and smile. This is all part of the ‘natural botox’ look I endeavour to achieve. Of course, at the end of the day if you are paying the money you should get the final say. As I keep saying, your consultation is an open dialogue and you should tell your practitioner honestly what you want.

Description: Decode secret of wrinkles Static lines/creases–.aspx


Brow lift saves eyes

I have noted over my time working with botox that people can sometimes have a problem with a brow droop. In fairness, this can often be predicted due to eyebrow setting, lid heaviness and previous surgeries or related eye problems but it cannot always be expected. This side effect is something to be discussed at the consultation stage.

If this does occur when having your Botox done, it is very important to talk to your practitioner and let them know, and as always it is very important to attend the two week top up! There is an option to help treat this little set back.

Although it may be disappointing after spending money to have your face ‘freshend up’, let me shine a positive light on this problem: we now know two things -1) smaller doses are needed to achieve the desired effect, 2) you need your injections slightly higher up. Knowledge is power so never think of it as a negative!

At the two week top up, if you feel your lids are dropping, discuss this with your practitioner. Small doses (maybe one or two units) of botox can be injected to the under side of your eyebrow along the obicularis oculi which will relax the muscle which is pulling the eyebrow down (remember the muscle which opposes this action and elevates the eyebrows has already been weakened with botox to relieve the frown wrinkles). These injections can be targeted to provide a lift in the brow wherever it is needed to raise the brow.

Equally, it is possible to help with heavy lids – where the skin of the eyelid sits on the eyelashes – with small doses of botox under the eyebrow. The eyebrow can be lifted by up to 2mm which makes a big difference. Definitive treatment is surgical and is probably the most cost-effective option in the long run but botox is also an option.

Botox concerns

A common concern I get with new clients who have never had any botox treatments before is ‘how can I be sure that it won’t end up a mess’. Concerns over asymmetry and ‘wonky eyebrows’ and generally fear of the unknown are usually the first and biggest stumble block. I think mostly, people are concerned about how the final effect will look. Will money be spent making things worse?

Let me put your mind at rest right now. No, things won’t end up wonky and unnatural. How do I know this? Well because for a first visit, I will be putting in equal amounts of botox on each side of the face so nothing will be uneven. That is not to say there will be no asymmetry at all – I cannot correct any original imperfections – but I will not cause any asymmetry. Also, the reason I insist on a top up 2 weeks after the initial injections is so I can top up where needed and should any problems arise – drooping eyebrows for example (let me just clarify, this has never happened yet), I can correct this.

I can add more but I can’t take away so my ethos is ‘less is more’.

Again, research your practitioner. Ask questions. Be clear about what you want.

When bad lips happen to good people

A client came to see me recently because she had had her lips filled by another practitioner and was really unhappy with the outcome. From what she told me, she had been encouraged to have more than the 0.5ml she was used to and the technique used was one which is more suited to shaping the lips rather than plumping which is what she had wanted. The outcome was over-filled, lumpy lips which she was not pleased with.

I was asked if I could rectify the problem. The answer is yes and no. It is never ideal for one practitioner to correct another practitioner’s mistake as the outcome is rarely optimal. There are options but these would all cost the client more money to try to distract from an already present problem.

Firstly (and here is something everyone who is considering having lip fillers but is terrified of a bad job), there is an ‘antidote’ to hyularonic acid (which is the main component in fillers). Hyaluronidase is a chemical which will dissolve fillers, so you can be reassured that if the worst happens something can be done. However, getting another practitioner (as in not the one who performed the original treatment) is costly.

Another option is to have more filler applied to fill out the areas where the lips are uneven but again, you run the risk of worsening the problem and also, this is costly.

The best option, and the option I would generally recommend, is just do nothing. Leave it all well alone. The body will absorb the filler over time – usually within 6 months – so leaving it alone will ensure you don’t end up further out of pocket and more importantly, that you won’t end up with a smile that doesn’t make you smile.

My other (and most important) piece of advice on this subject: DO YOUR RESEARCH and be very clear about what you want. If you have any doubts about the technique used or product used then do not proceed.