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Muscle Relaxants (Botox)

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Anti-wrinkle treatments - Botulinum Toxin Type A (Botox)

Additional information:

How does it work?

Our facial expressions change because the muscles in the face contract or relax. This is caused by the brain sending a signal via our nerve endings that we want to, for example, frown or laugh. When muscle relaxants are injected into a specific muscle they block the signal from the nerve to the muscles in the face. This means that the nerve ending cannot tell the muscle to move. This is not a permanent condition, however, but it will last for around 3 to 6 months. 

After muscle relaxant injections, your skin around the area which has been treated will look smooth and less wrinkled; but do not worry, the rest of your face will not be affected. Muscle relaxants allow the untreated areas of your face to move as normal and you will still be able to smile, laugh and frown, but with less wrinkling of the skin in the areas treated.

What areas can be treated?

The upper third of the face is where the best treatment results are obtained, commonly for reduction in the appearance of crow's feet around the eyes, frown lines and wrinkles on the forehead and between the eyebrows.

Preparing for treatment.

This treatment is simple, quick and safe. You can resume your normal activities immediately after the procedure. Many people have their treatments in their lunch-time, for example, and return to work straight afterwards. 

The first time you visit our clinic, a detailed discussion with Jolanta (our Aesthetic Nurse Practitioner) should realistically and clearly highlight your expectations of the cosmetic effect from this treatment. Jolanta should then be able to tell you if this is how she sees the treatment working for you. If your expectations and hers do not match each other, do not proceed until you are entirely happy with what she is telling you. 

Jolanta may then take a medical history to make sure that there are no reasons why you are not suited to be treated with muscle relaxants. You would then normally be asked to sign a consent form indicating that you have understood what the treatment may do, the potential side effects and also that the drug is not currently licensed for this specific use in the UK. 

Photographs may also be taken by the practitioner with you smiling, frowning and with your face at rest. This will be used as 'before and after' images to show you how successful your treatment has been. 

The injections.

First, the area to be injected will be cleaned with an antiseptic wipe. You do not require any anaesthetic or sedation. Then, using micro needles and disposable syringes, tiny amounts of muscle relaxants will be injected into several points in the agreed area. 

Repeat procedures.

Depending on the area treated, dose used, and how you respond to muscle relaxants, repeat treatments will be required around every 3 to 6 months. These will maintain and potentially improve upon the initial effect observed.

Recovery time.

The whole treatment should usually take no longer than 10 - 15 minutes and you can normally drive immediately and go about your usual activities.

Does it hurt and what could go wrong?

Most patients find that muscle relaxants cause little discomfort. Many compare the feeling to a little insect bite! As the treatment is very quick, the needles used are tiny and only minute amounts of liquid are being injected into the skin; few patients experience any significant pain. A few patients do, however, prefer to have a cream called EMLA applied half an hour or so prior to treatment to help numb the skin. 

Other risks or side effects include a small amount of temporary bleeding or mild swelling which may occur at the injection site. In some cases more extensive bruising may occur, especially around the eyes, but this can usually be covered up with make-up, and is only temporary. Occasionally, patients experience a headache after treatment, and, very rarely, double vision. 

When muscle relaxants are injected into the forehead area, there is a very slight possibility that it may cause weakness of the muscle holding up the eyelid causing a 'partial ptosis' or drooping of the upper eyelid. This tends to happen in less than 1% of patients and will disappear over a period of 2 - 10 weeks. 

All patients should remember that because the results of muscle relaxants are not permanent, any unwanted effects will disappear usually within a 3 month period.

Anti-wrinkle injections ( Botox ®, Azzalure ® ) smooth facial lines caused by muscle contraction and give a more relaxed and youthful appearance. This non-surgical procedure smoothes lines between your eyebrows, on your forehead and on your outer eye area. 

Small injections of muscle relaxants are made into the specific muscles of the face that create wrinkles. This reduces the muscular activity and therefore softens the skin's creasing. 

Some patients may also need or require a treatment with fillers for best results. This is not permanent and will last for around 3 to 6 months. As this is a very individual treatment, all patients are encouraged to return for a free post-treatment check after 14 days.

What should you do after treatment with muscle relaxants?

Post-treatment advice may include:

  • For a few hours after injections actively contract and use the muscles in the treated area. Work your face and practise frowning and smiling! There is some evidence that this helps the treatment to work better by speeding up the absorption of muscle relaxants.
  • For a few hours after injections do not rub, or massage the treated area, or undertake vigorous exercise. Avoid any form of facial treatment or massage to reduce the risk of the muscle relaxants spreading to adjacent muscles where it might cause the eyelid to droop.
  • Waiting for up to two weeks for the treatment to work fully, so be patient! Most people will find that, even after this period, if they try really hard, they can still move the muscles to a small extent in the area treated. This is quite normal. The aim of the treatment is not to prevent you from moving the muscles in your face, but merely to reduce the number of times that your muscles contract as this is when wrinkles occur.
  • Contact South Coast Aesthetic Clinic if, after 14 days, you find that you can still use the muscles treated to the same extent as before the treatment and you cannot see any apparent improvement. Sometimes Jolanta will ask you to return two weeks after your first treatment so that we can monitor the results. This is good medical practice and nothing to be afraid of.

Who should not have treatment with muscle relaxants?

  • Muscle relaxants should not be used in women who are pregnant or breastfeeding. 
  • Patients who have any diseases that affect muscle activity, may not be suitable for muscle relaxant injections. You must discuss this with your practitioner. If you have any bleeding disorders or are taking drugs that affect bleeding time, or certain aminoglycoside antibiotics, the practitioner may advise against treatment. 
  • You should be prepared to tell the practitioner about any medication which you are taking and any allergies you have.

What are muscle relaxants?

Muscle relaxants are naturally occurring proteins produced by the bacterium Clostridium botulinum. This bacterium makes several different types of protein which are called type A to type F. These varying proteins cause muscles to relax at different levels.