Injections for wrinkles

The Cosmetic Dermatology Clinic is a leading provider of wrinkle injections, so you can be confident that you’re in expert hands. Our wrinkle injection treatments are hospital-based and doctor-led, delivered to the highest clinical standards. As dermatologists, we have an excellent understanding of your skin’s potential and of the ageing process, and we tailor each treatment to your individual needs.

How do wrinkle injections work?

Wrinkle injections use Botulinum Toxin Type A, which is a protein produced by the bacterium Clostridium Botulinum. The effects of botulinum toxin have been known for more than a century, but not until 1980 was the toxin found to be useful for a number of medical problems.

Injections of this toxin have been used in cosmetic medicine since the early 1990s. It has been licensed for the temporary reduction of frown lines and it has been used off-license for other lines and wrinkles on the upper face. Trade names of Prescription Only Medicines cannot be advertised on public websites.

Injection treatments are useful for movement-related creases around the eyes, known as crows’ feet. Our approach is to aim for a subtle relaxing of the wrinkles rather than a frozen startled look. Muscle relaxing injections can help with frown lines on the forehead and between the eyebrows. For wrinkles affecting the lower half of the face please, see the advice on fillers.

Can wrinkle injections help me?

Muscle relaxing injections are most useful in the treatment of creases between the eyebrows, on the forehead, and around the eyes. It softens deep frown lines and crows’ feet, which are the furrows produced by frowning and smiling. It does not remove them entirely.

The treatment should not radically change your facial appearance. The muscles are relaxed a little, so you can still frown, smile, or look surprised without the wrinkles and creases between your brows. It is best to aim for a subtle effect. Injection treatments should not be used if there is an infection at the injection site.

When we see you for your consultation, we can identify exactly where wrinkle injections would give you the best results and recommend what we believe to be the best course of treatment.

Why come to the Cosmetic Dermatology Clinic for wrinkle treatments?

The Cosmetic Dermatology Clinic has been providing professional consultant dermatologist appointments and treatments at the Royal Free Hospital in London since 1995. During this time, our team have collectively treated tens of thousands of patients and this wealth of experience will help us give you the best possible outcome.

Injection Treatments - Frequently Asked Questions

How do muscle relaxing injections work?

The natural toxin in muscle relaxing injections is a nerve impulse blocker. It binds to nerve endings and prevents the release of chemical transmitters that activate muscles. This way, the natural, purified protein relaxes the muscles that cause wrinkles.

The effect usually takes one to two weeks to develop. After a few weeks or months, the nerve endings grow new connections to the muscles and the effect wears off. The injections are typically repeated about two to four times a year, as directed by your doctor.

What is involved?

The first step is to have a pre-treatment consultation with a consultant dermatologist. They will evaluate whether prescription injection therapy is appropriate for you, discuss the risks and benefits, and answer any questions you may have. You will be given this written advice sheet and an appointment for treatment. No skin test is required.

The treatment consists of a few tiny injections; the discomfort is minimal. A typical treatment visit takes about 15 minutes. Anaesthetic is not needed but your doctor may choose to numb the injected area with a cold ice pack or anaesthetic cream beforehand. Most patients compare the sensation to an insect bite. Aside from the initial needle prick, you should feel little discomfort.

Slight tenderness and mild bruising are possible. Usually makeup can be reapplied before leaving the clinic, and normal activities can be resumed but strenuous exercise should be avoided for 24 hours. The results can sometimes be seen within the first few hours, but it may take one to two weeks for the full effect to become apparent.

For your first treatment, the number of small injections you need to get good initial results will depend on which areas are treated. Since the response to injections varies, you may need a top-up visit a few weeks later in order to get the best effect.

How should I prepare for the treatment?

Preoperative instructions

Please do not wear makeup to the clinic; if worn, please plan to remove it before treatment. To minimise the chance of bruising, please do the following:

  • Preferably stay off aspirin or aspirin-containing products for 10 days prior to your treatment.
  • Avoid alcohol for 24 hours before treatment.
  • Be sure to discuss with your doctor any bleeding tendencies and current medications being used.
  • Ice will be applied immediately following treatment. If you normally bruise easily, plan to go home and apply ice to the treated area(s) for an hour

Although the treatments are well tolerated by most patients, you may apply a topical anaesthetic cream to the area to be treated for one hour prior to the treatment. You can buy this cream at your local pharmacy.

Post-treatment advice

If you feel a headache or any pain at the injection sites you may use Paracetamol every four to six hours. It is best not to take aspirin or alcohol for 24 hours after the procedure.

Ice can be applied immediately following treatment. If you bruise easily, plan to go home and apply ice to the treated area(s) for a few hours.

After treatment you should avoid pressing or rubbing the injection areas for three to four hours. Also, don’t lie down or bend down for three to four hours to avoid spreading the toxin to other muscles.

You should use the treated muscles as much as possible (e.g. grimace, smile, frown) in the next one to two hours to secure a good uptake of the toxin.

Avoid strenuous exercise causing perspiration for 24 hours following treatment. You may otherwise resume normal activities. Most patients continue their normal activities immediately after the procedure. You may return to work the same day. However, please avoid the following for 24 hours: facial massage, sunbathing, saunas, peels, facials, laser treatment.

You may apply makeup upon leaving the clinic. Showering and facial cleansing are not restricted. There is no problem with travelling by car, train or aircraft after treatment.

A follow-up visit is normally scheduled four weeks after treatment to review results and top-up areas that need further treatment.

Are muscle relaxant injections safe?

The toxin is a purified protein that is produced from culturing natural organisms. Only very low doses are used.

The effects are usually confined to the injected region and do not travel throughout the body. This Prescription Only Medicine has been recognised by the American Academy of Neurology, American Academy of Ophthalmology, and American National Institutes of Health as a safe and effective treatment.

It has been used for eye spasm associated with movement disorders for over 20 years.

In cosmetic use there are more than 10 years of clinical experience, involving hundreds of thousands of patients who testify to the potential benefits of this treatment.

Are there any unwanted side effects?

Unwanted effects are rare. You may notice slight redness or bruising from the injections. This is only temporary and can be covered by makeup.

Other effects reported are headache, flu-like symptoms, nausea, drooping of the eyelid or brow, irritation of the treated area, weeping or dry eye, opening of the eyelid, double vision, and an outward or inward turning of the eyelid. These unwanted effects are uncommon in cosmetic treatments. Should they occur, they are usually transient in nature and should pass on their own. Botulinum Toxin Type A injections are generally well tolerated by patients.

The effects of muscle relaxant injections may be increased with the use of certain antibiotics or other drugs that interfere with neuromuscular transmission. Please let your doctor know about all the medication you are taking.

Is this therapy for me?

If, after reading this information carefully, you are interested in Botox therapy, you should arrange a consultation with a cosmetic dermatologist. This will be an opportunity to address any concerns you have and to discuss your expectations and whether the injections might help you achieve them. Precisely how or if it can help depends the severity of your wrinkles, your medical history, and the areas you would like to have treated.

Botox injections are not generally appropriate for smile lines, or for the lower face. It is used more successfully for deep frown lines, forehead creases, and deep crows’ feet. It is not the same as a surgical face lift. It is not a cure for wrinkles and the degree of correction will vary from person to person.

Botox Costs

  • Botox to one area: £190
  • Botox to two areas: £290
  • Botox to three areas: £360
  • Consultant Dermatologist opinion only: £200

If you would like to arrange a consultation with Dr. Papageorgio, please call 020 7435 7521.