Botulinum Toxin (Botox)

How it works

Tiny amounts are injected into specific muscles with a fine needle. The medicine reduces the muscle's ability to contract, so the skin above it moves less and lines may look softer. Effects usually begin after several days and build over one to two weeks. They wear off gradually over a few months, and the muscle moves normally again. The amount, called units, and the places injected are chosen by the doctor based on your face and goals. Different products are measured differently, so units from one brand cannot be compared directly with another.

Who it may suit

• Frown lines, forehead lines or crow's feet that show when you move your face
• A strong jaw muscle linked to a square lower face or teeth grinding
• People who want a short, repeatable treatment with little downtime
• Some cases of underarm sweating, when the doctor finds it suitable

The treatment day

1. Facial movement check. The doctor asks you to frown, raise your brows and smile to see which muscles are active.
2. Marking and planning. Injection points may be marked and the plan, including units, is explained.
3. Injections. Small injections are made at each point. This usually takes only a few minutes.
4. Short observation. The area is checked for bumps or bleeding, and written aftercare is given.

Aftercare

• Stay upright for about four hours and avoid lying flat if the doctor advises it.
• Do not rub or press the treated areas for the first day.
• Avoid intense exercise, saunas and heavy heat on the day of treatment.
• Small bumps usually fade within hours. Bruises may last a few days.
• Return for a check if one side looks very different after about two weeks.

Things to know first

• Bruising, headache, a heavy feeling or an uneven result can happen. A drooping eyelid or brow is uncommon but possible.
• Not suitable during pregnancy or breastfeeding, or with certain nerve and muscle conditions.
• Tell the doctor about any medicine you take, including antibiotics and blood thinners.
• Results are temporary and vary by person, and repeated treatment is needed to maintain them.
• Seek urgent care for trouble swallowing, breathing or speaking, or widespread weakness.

Talking through botulinum toxin in English

Say what you want in terms of movement, not only lines. For example: I want to frown less but still look expressive. The doctor can then plan units and points. Botox is a brand name, and other products exist, so ask: Which product is this? Ask to see the vial or packaging, and for the product name in your written notes.

Ask how many units will be used in each area, and who will inject. Ask for the plan to be repeated back in English. Say if you have had toxin before, when, and how it went. Mention pregnancy, breastfeeding, nerve or muscle disease, and any eye or brow concerns. If you plan a flight, ask whether it matters to travel soon after.

Terms you may hear include units, glabella (the area between the brows), frontalis (forehead muscle), masseter (jaw muscle) and onset, meaning when the effect starts. Ask when to contact the clinic if something looks uneven, and keep the product name and units for any future doctor.