Botox! Nothing new really. Makes you look young, right? Gets rid of lines? Instant facelift! Triangle of Sadness, no more! People have known about botox for what seems like forever, too – or at least until the frozen faces of ITV populated our screens. Even in the recently cancelled Gossip Girl 2.0, there's talk of botox injections in your armpits. Sorry, what?
A bigger question still: what even is botox, other than an expensive habit that supposedly trumps top tier face cream? Is it true once you start, you can't stop? And when should you start using it? Is it safe to hit freeze the day after your 21st birthday?
We caught up with some leading aesthetic doctors to deliver the 411 on the cosmetic procedure.
“Botulinum toxin is a neurotoxin produced by the bacteria Clostridium botulinum. It temporarily relaxes the muscle by blocking the transmission of nerve impulses, meaning the muscle is unable to contract,” says Dr Jenny Doyle from The Clinic Holland Park. ."Overall, this gives the skin a softer, smoother and more youthful appearance. It does not travel around the body, and the effects wear off with time at an average of around three months."
“For those concerned about introducing a toxin into their bodies, for it to be harmful the amount used to treat 50 to 60 people, or 25 to 30 vials, needs to be injected in one single person,” says Dr Joney De Souza of the eponymous clinic.
"The amount of toxin in a vial of botox is almost impossible to conceive. Imagine one pinch of salt and divide it one billion times. One part is even more toxin used in a vial of botox. Yearly, the company that sells the brand Botox, Allergan, produces 800 million vials, using less than one gram of toxin."
“It is difficult for a lay person to know brands, effectivity or the correct concentration used — in addition to knowing the right points of injection," says De Souza.
“So, in my opinion, the most important and single advice: ensure your treatment are delivered by a suitably qualified, experienced and ensured medical practitioner, who is licensed to prescribe botox — a non-medical professional is not accountable for any aspects of any treatment. In relation to the product used, ask the name of the product and if it is licensed in the UK. The medical professional should also inform you of possible side effects and complications before treatment.”
“Most people are having three main areas of their face treated: frown lines, forehead lines and crows feet,” says Doyle. "By smoothing out all of these areas in the top third of the face, you get a much more natural result.
“Most clients are looking not to ‘freeze’ all movement in these areas however. They just want to reduce the movement and hence soften any lines on their face. Other areas that are popular is having injections in the masseter muscle to treat teeth grinding (bruxism), and is another example of botox being used to treat a medical condition."
“The aim of botox treatments in cosmetic medicine is for the treatment of lines that appear with facial expression, especially the one in the forehead, crows feet and frown. The moment to start having treatment, in my opinion, is when those lines start ‘etching’ the skin. However, even stronger lines of expression can be completely removed or at least significantly reduced in later stages. Folds and furrows, especially in lower face and that do not reduce when resting the face will not improve with botox treatment — lower face is also a riskier are for treatment, as it can cause smile or mouth movement changes,” says De Souza.
"Excessive sweating is treated with botox. Excessive facial sweating, in the hairline, is also treated with botox. An interning use of botox is to reduce facial oil production and enlarged pores.
“Botox needs to be avoided when pregnant or breastfeeding. People with any neuromuscular disorders, like multiple sclerosis and muscle dystrophy’s should also avoid botox treatment. The use of medications like certain antibiotics and drugs for autoimmune disorders, Alzheimer's and irregular heartbeats should not be treated with botox. Bell’s palsy is also an important contra indicator for treatment.”
“Facial botox needs to be repeated every three to four months to maintain treatment results. Some people, especially those having botox as a preventative treatment, might only repeat treatment every six months. Those getting botox to aid with hyperhidrosis (sweating excessively) and teeth grinding tend to require a new treatment at every six to eight months."
"The three areas most commonly treated are the frown area, foreheads and crows' feet. These areas respond well to treatment, with great impact in softening lines and wrinkles. The ‘bunny-lines’ tend to be treated, if needed, at the same time, especially if crows' feet are being treated. Jawline definition and neckbands respond really well to treatment and give a sharper contour of the lower face.”
Botox is a very simple treatment, with minimal risk of long term side effects and complications. It has significant impact in improving lines and wrinkles of expression, giving a more relaxed facial appearance. Results are visible in a few days and last for 3-4 months, needing to be repeated 3 times per year to maintain results.
The use of small doses of botox ensures natural results, normally noticed as a relaxed or fresh facial appearance. It also doesn’t produce any volume changes of the face, that can, in some cases, be noticeable.
Not necessarily and it depends on the person’s choice. Stopping treatment will just bring the lines of expression again. No dependency exists.
However, people that have botox will have less lines once botox treatment is no longer done. During the period in which botox is used, lines are prevented and they will be softer than if botox was not previously preformed.
"This idea started and spread quite quickly, especially amongst millennials. I believe that social media created excessive attention. However, in my opinion, there is no need to start botox treatment at such an early age. Most people will start showing lines of expression in their early 30s. Once botox treatment starts, all those initial superficial lines with completely disappear with botox. To prevent those lines to reappear and worsen, in my view, is what preventative botox is — when comparing someone who had botox treatment and stop having it, with someone who never had treatment, the results of the preventative botox is noticeable."
"Yes. A condition called hyperhidrosis is characterised by the excessive production of sweating in underarms, but also in hands, feet, face, hairline and scalp can be treated with botox. The full mechanism of action is still not fully understood but the reduction of sweat glands activity and the weakening of the very superficial muscles in the hair folicules play a part in this mechanism. The efficacy of this treatment brings an important impact on self esteem and reduction of social embarrassment for those suffering from the condition.
“Similarly, areas like the palm of the hands and plantar area of the feet are commonly treated. Excessive sweating of facial areas and hairline is effective and also for the treatment of teeth grinding or enlarged lower face resulting in the hyperactivity of the chewing muscle, masseter.”
"In my experience, thinking that anyone who has botox treatment will look unnatural and that everyone will notice facial changes. Treatment can be balanced to give natural results and there is no need for it to be overdone – that is a choice of the patient or the medical professional, or both. The so-called ‘baby Botox’ is a very subtle use of botox that soften lines, keeping some degree of expression, and maintains a very natural appearance.
"The second biggest myth is that botox is poisonous and that it will affect the body. Also that the long-term effect is unknown. The use of botox started in the Eighties and no long-term side effect has ever been observed and no toxic effects of the treatment.
"The third is that once treatment is stopped, lines will be worse. That is not only a myth but also mistaken information. Once botox treatment stops, lines and wrinkles will gradually return. That is all. However, lines will be softer with someone who had botox when compared with someone who never had the treatment.
“And the last myth that I hear is the view that botox and fillers are the same and that they produce the very same unnatural results and can be used to completely remove lines and revert the effects of ageing. That is an important point in my practice: keeping patients focused on what can actually be achieved, and avoiding treating them with unreasonable and unreal expectations.”
