Facial wrinkles are caused by a number of factors, some of which we can control. Age, muscle action, sun exposure, genetic tendency, smoking, gravity and illness are the seven major culprits responsible for our wrinkles. Obviously good nutrition and hydration are also extremely important. Wrinkles caused by the action of facial muscles on the skin can be effectively treated with Botulinum extract. This treatment has revolutionised the medical discipline of Cosmetic Medicine since its introduction. Indeed, rarely a day goes past now without this treatment receiving some form of national media attention. Every time we smile, laugh or frown facial muscles contract which wrinkle the overlying skin causing dynamic facial lines. With time, use of our facial muscles will lead to permanent lines and creases developing.

Botulinum extract is a safe proven effective treatment to dramatically soften dynamic facial lines. The procedure uses a purified extract produced by the bacterium Clostridium Botulinum. Although the extract is the same as the one that causes a serious form of food poisoning (Botulism), the amount used in Cosmetic Medicine is so minute that toxic reactions are not seen. The injected extract is not "alive", but is a highly purified protein produced by the Clostridium Botulinum bacterium.

Botulinum extract has been used very safely and successfully since 1982 by Ophthalmologists to treat twitching of the eyelid and squints. Each year thousands of patients receive Botulinum treatments for a variety of medical conditions including muscle dystonias and spasms, muscle tension headaches and back pain caused by muscle spasm. Use of this agent is likely to rocket in many other medical spheres shortly, for instance to help reduce scarring after some forms of surgery. Although it is renowned in the media for treating wrinkles, Botulinum extract is also used successfully treat axillary hyperhydrosis (excessive underarm perspiration).

How does it work?

When injected into a muscle, Botulinum extract reversibly blocks the impulses from the nerves to the tiny facial muscles that are related to expression lines. By doing this, the muscles cannot contract and therefore tend to relax. When muscles relax, the overlying skin remains smooth and unwrinkled while the untreated facial muscles continue to contract in a normal fashion, allowing normal facial expression to be unaffected.

Which areas can be treated?

Botulinum extract injections are most commonly given for dynamic lines in the upper face, particularly forehead lines, vertical frown lines between the eyebrows, and crows' feet or laughter lines radiating away from the eyes. It is used less for lines in the lower face, but I find it very useful to treat vertical lines affecting the upper lip.

How is it done?

The procedure itself is simple and safe. Botulinum extract is injected with a very tiny needle into the desired area.

Depending on the area treated, between four to 16 injections are necessary. Because the needle is so fine and only a small amount of liquid is used the pain is minimal, like a sting for a few seconds. Once the injection is complete there is no discomfort. No sedation or local anaesthesia is required and as no recovery is required, you can resume normal activities immediately. You can even drive yourself home or back to the office, or even go out to dinner! Very occasionally some patients experience a slight temporary bruising or redness at the injection site. This can be covered with makeup.

How long does it last?

The full effects of Botulinum extract treatment are not apparent for three to 14 days. The effects of Botulinum extract are temporary as it is slowly removed by the body in approximately three to six months. As most patients are delighted with the effects of Botulinum extract, a top up injection will be required after this period of time to maintain the effect. Subsequent treatments with Botulinum extract do tend to last progressively longer. Most people would need three treatments in the first year, two in the second, and just one per year after that. This is because the muscles treated become progressively weaker, the effect being that you forget to frown!

Are there any side effects?

There are very few side effects to this procedure. Allergy to Botulinum toxin is possible, but very rare. There is a small risk (2%) of very slight brow or eyelid drooping if the forehead is treated. If this were to happen, it usually only lasts two to three weeks.

Am I a suitable candidate?

Obviously only a consultation will be able to establish this. However, while Botulinum toxin is well tolerated by most people, patients who are pregnant or have a neurological disease should not be treated.