What is BOTOX®?


BOTOX® is actually the leading trade name for Botulinum Toxin A: a specially prepared, naturally occurring protein that originates from bacteria. The protein works as a muscle relaxant to treat frown lines and wrinkles as a popular no-knife facelift – sometimes called a ‘liquid facelift’.


Botulinum Toxin A was first used in 1973 by ophthalmologists to treat eyelid spasms. It is now widely used by doctors for certain medical problems such as hyperhidrosis (excess sweating), migraines, post-stroke spasticity and cerebral palsy, as well as at non-surgical aesthetic clinics, such as at the Urban Aesthetix Clinic, to treat lines and wrinkles by temporarily paralysing facial muscles.


There are four main brands of Botulinum Toxin A in the UK, which are licensed for different indications: BOTOX® (Vistabel), Dysport®/Azzalure and Xeomin®/Bocouture. Dr. Unnati will advise on what is best for you.


What is Botulinum Toxin?

Botulinum Toxin is a naturally occurring protein that is produced by the bacterium Clostridium botulinum. There are two types of Botulinum Toxin available in the UK:

  • Type A: BOTOX®, Dysport®/ Azzalure and Xeomin®/ Bocouture – common preparations in the UK
  • Type B: Neurobloc® – not currently licensed for use in cosmetics

The most commonly known brand in the UK is BOTOX®, but they are all licensed for different indications. They all have different concentrations of the clostridial protein +/- complexing proteins:

  • BOTOX®: contains 5ng of clostridial protein/ 100u vial, human albumin and a higher amount of complexing proteins. This gives a greater immune response.
  • Dysport®/Azzalure®: contains 4.35 ng of clostridial protein/ 500u vial, human albumin, lactose and a lower amount of complexing proteins. This will often give effect in non-responders to Botox®.
  • Xeomin®/Bocouture: ® contains 0.6ng of clostridial protein/ 100u vial, human albumin, sucrose and no complexing proteins. This gives a softer look and is good for sensitive patients.

Dr Unnati generally uses BOTOX®, but will advise on whether a different brand is better for you.

What is BOTOX® used for?

BOTOX® treatment smoothens out existing skin creases and results in preventing premature lines and wrinkles.


BOTOX® is used to relax the muscles mostly in the upper third of your face:

  • Glabella: to smooth frown lines between your eyebrows
  • Forehead lines: to eliminate horizontal forehead lines
  • Crow’s feet: to target those ageing smile lines around your eyes.


BOTOX® can also be used to relax muscles in the lower face and neck:

  • Eyebrows: to lift the edge of your brows and open up your eyes for a refreshed appearance
  • Bunny lines: to treat lines at the side of the upper nose
  • Perioral lines: to banish lines around your lips caused by lip pursing
  • Bruxism: to prevent teeth grinding and clenching teeth by relaxing the jaw muscles
  • Gummy smile: to fix excessive gum visibility for a more confident smile
  • Lips: to correct down turning lip corners and a drooping mouth, and to plump lips for lip enhancement
  • Dimpled chin: to minimise the appearance of chin dimples caused by the unevenness of the chin on movement
  • Platysmal bands: to treat those unwanted horizontal neck creases which appear as stringy vertical bands in the neck, sometimes known as ‘necklace lines’ or ‘vertical ridges’.


BOTOX® can also be used to decrease excessive sweating:

  • Underarms: to treat excessive sweating (axillary hyperhidrosis) by preventing the nerve signals from stimulating the sweat glands.


What does BOTOX® treatment involve?

Treatment is simple and safe if carried out by Dr Unnati, who is an experienced and fully qualified clinician, following a detailed consultation to examine the areas to treat and decide on what is best for you. The Botulinum Toxin A protein used has no effect on the body or central nervous system – only on the specific muscle injected.


As we age, permanent creases can arise through a combination of repetitive muscle movement, skin creasing and skin matrix degeneration. The BOTOX® injection temporarily prevents nerve signals from reaching the specific muscle, so that it becomes inactive, and the relaxes the skin overlying the area needing treatment so that wrinkles soften. Untreated muscles can move as normal so that your facial expressions still appear natural.


Dr Unnati will inject a small amount of the purified protein solution into specific areas of your face with a very fine needle. The BOTOX® treatment can take a few minutes and you can resume most normal daily activities immediately afterwards. No anaesthetic is needed as any discomfort is only mild.

How soon should you notice a difference?

After BOTOX® treatment, the muscles will begin to relax over a period of 3-14 days. A further treatment may be needed at 14 days to maximise the anti-wrinkling effect. The result will be a softer and more relaxed looking you.

How long does BOTOX® treatment last?

BOTOX® treatment usually lasts between 3 – 4 months and can be repeated when needed. Most patients require less frequent treatments over time as the muscles ‘re-train’ and weaken from disuse.


Points to consider

Any clinical procedure carries a risk of complications, which is why it is always highly advisable to have non-surgical cosmetic treatments safely performed by a doctor. Dr Unnati is a GP and specialist Non-Surgical Aesthetic Physician, trained in dermatology and medical cosmetics.


The Urban Aesthetix Clinic follows strict guidelines in making patients fully aware of any possible cautions and complications, and in offering post treatment advice. Dr Unnati will undertake a full consultation before any new treatment can be given.

Are there any side effects to BOTOX®?

The short-lived side effects associated with the injection process include bleeding, swelling and redness which settle within an hour, and bruising which settles within a few days. Occasionally a mild headache may develop for 48 hours, depending on the extent of treatment carried out.


There is a minimal risk of infection as the injections break the natural barrier to infection when creating a small wound in the skin. Please therefore avoid touching the area treated, or using any unsterile make-up, for 6 hours after treatment, although mineral make-up or sterile medical make up can be used immediately.


There is a risk that the solution injected could diffuse into neighbouring muscles, causing their paralysis. If this occurs, the resulting paralysis is temporary for between 2-3 weeks, and can cause ptosis (drooping) of the upper eyelid or eyebrow, or diplopia (double vision) when looking to the side. To minimise this risk, it is important to not bend down or lie down for 6 hours, do any strenuous exercise for 24 hours or massage the area for 72 hours after treatment.


Please avoid flying for 72 hours following treatment. If you’re an overseas patient, advance booking is highly recommended in case a course of treatments is required.

When should BOTOX® not be used/be used with caution?

  • While pregnant or breast feeding
  • If you are highly sensitive/ allergic to ingredients in the compound
  • In generalised disorders of muscle activity: muscular dystrophy/ myasthenia gravis
  • In current Bell’s palsy
  • In bleeding disorders
  • If the areas to be injected are inflamed or infected
  • In combination with certain medications: anticoagulants/ aminoglycosides/ steroids/ aspirin/anti-inflammatories.