BOTOX®
Videos on Botox
What is Botox?
A video explaining what Botox does to the muscles as well as a live procedure.
What is Botox®?
Botox® is a formulation of botulinum toxin type A derived from the bacterium Clostridium botulinum. The active ingredient in Botox® is a highly purified protein. When injected into muscles Botox® blocks the release of acetylcholine and relaxes the target area resulting in a reduced muscle activity.
Who Makes Botox®?
Botox® is manufactured by Allergan Pharmaceuticals Ireland, Westport, County Mayo, Ireland. The product licence holder is Allergan Ltd, Coronation Road, High Wycombe, Bucks HP123SH.
From Medical to Cosmetic Use
Botox® is licensed for the use in the following medical conditions:
  • Muscle stiffness (spasticity) following a stroke in adults
  • Muscle stiffness (spasticity) associated with cerebral palsy in children
  • Dystonia (muscle jerking) of the neck (cervical dystonia)
  • Muscle spasm of the face (hemifacial dystonia)
  • Rapid blinking of the eye muscle (blepharospasm)
  • Excessive sweating of the armpits (hyperhidrosis)
  • Cosmetic treatments
For What Uses is Botox® Currently Approved (Licenced) in the UK?
Botox® has received regulatory approval from the Medicines and Healthcare Products Regulatory Agency (MHRA) for the use of Botox® in the following conditions:
  • Muscle stiffness (spasticity) following a stroke in adults
  • Muscle stiffness (spasticity) associated with cerebral palsy in children
  • Dystonia (muscle jerking) of the neck (cervical dystonia)
  • Muscle spasm of the face (hemifacial dystonia)
  • Rapid blinking of the eye muscle (blepharospasm)
  • Excessive sweating of the armpits (hyperhidrosis)
Botox® is now licensed in the UK for the cosmetic treatment of Glabellar lines. If your doctor has recommended this treatment for other areas as well, the following information may be of help to you:
  • A doctor is able to recommend and prescribe any prescription medicine even it is not approved for the use he/she is considering You should be provided with adequate information about the efficacy and safety of the product and consent in writing to receiving this treatment only when you have fully understood the likely benefits and likely side effects
  • Once you have agreed on your treatment with your doctor, he/she may ask another healthcare professional to administer (inject) on his/her behalf You should be reassured that the healthcare professional treating you is experienced in providing the specific treatment and is able to provide you with the necessary after-care advice and follow-up
  • Although not licensed for the purpose, Botox® is widely used very effectively as a cosmetic treatment to relax muscles under the skin, in particular on the upper face, but also in other areas such as the neck, to reduce wrinkling.
Botox Helps Reduce the Following Types of Wrinkling
Worry Lines
These are the horizontal lines on the forehead, most of which can be treated successfully using Botox®, but treatments using other products may be more suitable. The type of treatment which is appropriate in your case will be discussed with you during your free consultation with our doctor.
Glabellar Lines
These are the vertical lines on the forehead over the nose, most of these can be treated successfully using Botox®, but treatments using other products may be more suitable. The type of treatment which is appropriate in your case will be discussed with you during your free consultation with our doctor.
Periorbital Lines
Also known as crows feet lines, these are the lines radiating from the corner of the eye, most of these can be treated successfully using Botox®, but treatments using other products may be more suitable. The type of treatment which is appropriate in your case will be discussed with you during your free consultation with our doctor.
Neck
How Does Botox® Work?
Botox® works by inhibiting the release of the neurotransmitter acetylcholine from the motor nerve terminals. The mechanism is thought to occur in 4 distinct stages as shown below.
Stage 1: Binding
Botox® initially binds onto a distinct acceptor on the external membrane of motor cholinergic neurons via the heavy chain of the toxin molecule.
Stage 2: Internalisation
Once bound to the nerve terminal, Botox® is internalised by a process called endocytosis, to form a toxin-receptor vesicle. The light chain of the molecule is then released into the centre of the cell (cytoplasm).
Stage 3: Blocking
When inside the nerve terminal, Botox® cleaves SNAP25. As the SNARE complex cannot form, exocytosis of cholinergic vesicles is affected resulting in chemodenervation.
Stage 4: Re-establishment of neuromuscular transmission.
Botox® prevents affected terminals from stimulating muscle contraction. the synthesis and storage of ACh or the conduction of electrical signals along the nerve fibre is unaffected. Evidence indicates that chemodenervation by BOTOX® results in growth of the end-plate region, and the emergence of axonal sprouts. These sprouts may then begin to release ACh.

Stage 3: Blocking
This development of a new neuromuscular junction means that muscle activity resumes - usually after about three months. Repeated injections are thus required to maintain therapeutic effects. Eventually te original junction resumes activity, and sprouts regress.
What Side Effects May I Expect Following Botox® Treatment?
As with all prescription medicines, Botox® can cause side effects and your doctor will advise you about these in more detail. Most side effects experienced by patients are short-lived and are linked to the injections e.g. pain on injection, redness, swelling etc. Other side effects such as ptosis (drooping of the upper eyelid), whilst still temporary in nature can be caused by a spread of the injection into nearby muscles.
Choosing an experienced injector will minimise (but not eliminate) the risk of such side effects. A detailed list of side effects can be obtained from the Patient Information Leaflet in the product pack. Please ask your doctor for this leaflet.
Will the Treatment Hurt?
The needles used are very fine so most people experience only mild discomfort. It is uncommon for pain relief to be required although some physicians suggest the use of a topical anaesthetic cream before treatment.
How Long Will it Take to Work?
You may start to notice an effect after 1-2 days. However, this varies by patient. The full effect can take up to 2 weeks following treatment.
How Long will the Effects of Botox® Last?
Duration of effect varies by patient and depends on the severity of the condition being treated. Your physician will give advice on realistic expectations for you as an individual patient.
How Regularly Should I be Reviewed?
As with all prescription medicines, your physician will advise when he/she will need to review your treatment.
For further information about Botox® please visit the official Botox® website here.
Previously Used Treatments - Collagen
  • Associated with a relatively high rate of allergic reaction
  • Sensitivity testing is required for most brands
  • Rarely used now days