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Botulinum toxin

What is Botulinum toxin?

Botulinum toxin is a neurotoxin that is now commonly used to help reduce wrinkle lines. The botulinum temporarily reduces the action of the muscles just under the skin, reducing movement and thus reducing wrinkling. It gives a smoother, more rested appearance to the face. It is commonly used as an alternative to surgery in younger patients.

The most common site for its use is the vertical frown lines between the eyes and the 'crow's' feet (laughter lines), which are found just outside the outer aspect of the eye. It is also used to reduce the horizontal forehead lines.

It is now one of the most popular cosmetic procedures and has been in use for over 15 years. It can give excellent results in young people who have minimal to moderate signs of facial ageing. It may also delay the need for more extensive surgery but it does not achieve permanent results.

The main effect of the toxin takes 2 to 3 days to be visible with the main effects usually present at 7-10 days. The effect of the injection lasts between 3 and 6 months in the majority of patients.

Why have it?

In younger patients, with aging, wrinkles first appear in the forehead and around the eyes, from the movement of the facial muscles. There may be no overt signs of ageing of the skin or sun damage at this stage. Botulinum toxin in these patients helps to smooth out the dynamic wrinkles by reducing the movement of the muscles, which cause them. It can give excellent results and virtually no downtime following the injection, apart from minor bruising.

Reasons not to have it

Botulinum toxin injections should be avoided in pregnant women, women who are breastfeeding, patients with a history of neuromuscular disease, those with a known allergy to human albumin or Botulinum toxin in the past. There are a number of drugs in which the use of Botulinum toxin would be contraindicated.

Further information


Mr. Roblin will discuss with you which area of your face you are concerned with. He will then carry out a thorough examination of your face, looking for signs of sun damage, droopiness and ageing of the skin. He will also try to differentiate between dynamic wrinkles that are amenable to Botulinum toxin, and static wrinkles, which are not. He will then discuss with you whether he thinks Botulinum toxin is an appropriate treatment in your case.

You will be asked about your general health, and Mr Roblin will want information about your medical history and any previous surgical procedures.


Very small volumes of the Botulinum toxin are injected with a fine needle into the areas of muscle that are causing the wrinkles. There are usually 3 to 4 injection sites in each of the areas of concern.


Due to the very fine needles the injection itself tends to sting less than injections of local anaesthetic, so an anaesthetic is not needed.

Length of stay

Clinic visits only.

Risks/Possible complications

Early (1-2 days):

  • Minor bruising
  • Minor swelling
  • Transient drooping (very rare)

Later (after one week):

  • Failure to respond


Immediately after the operation
  • Minor bruising and swelling only
After return home
  • Socialising with friends 1 day
  • Return to work at 1 day
  • Driving at 1 day
  • Swelling and bruising 2-3 days (occasionally)
  • Return to gym and strenuous activity 2-3 days

Permanence of results

The effect of the toxin takes 2 to 3 days to be visible, with the maximum effect usually by 7 days. This effect lasts between 3 and 6 months in the majority of patients.