Botox cosmetic treatment is designed for individuals looking to reduce the appearance of facial wrinkles and fine lines. Individuals in their 20-30s use it to delay the signs of aging. Individuals in their 30-60s use it to treat existing wrinkles and to prevent new ones from forming.

While Botox can be a highly effective treatment for reducing the appearance of wrinkles and treating certain medical conditions, it is not suitable for everyone. The following are key factors that may make someone unsuitable for Botox treatments:

1. Pregnant or Breastfeeding Women:

• Safety Concerns: There is insufficient evidence to guarantee the safety of Botox for pregnant or breastfeeding women, so it is generally recommended to avoid treatment during these periods.

2. Allergic Reactions:

• Allergy to Botox Ingredients: Individuals who have had allergic reactions to any ingredients in Botox or other botulinum toxin products should not undergo treatment.
• History of Allergies: Those with a history of severe allergies or anaphylactic reactions may need to avoid Botox or proceed with extreme caution.

3. Neuromuscular Disorders:

• Conditions: People with neuromuscular disorders such as myasthenia gravis, Lambert-Eaton syndrome, or amyotrophic lateral sclerosis (ALS) are at higher risk for serious side effects and complications from Botox.

4. Infections or Skin Conditions:

• Active Infections: Anyone with an infection or inflammation at the proposed injection site should wait until the infection has cleared before receiving Botox.
• Skin Conditions: Severe skin conditions or diseases in the treatment area can increase the risk of complications.

5. Certain Medications:

• Blood Thinners: Individuals taking blood thinners (anticoagulants) may have a higher risk of bruising or bleeding at the injection site.
• Muscle Relaxants: Those taking muscle relaxants or certain antibiotics (e.g., aminoglycosides) should inform their doctor, as these can increase the risk of side effects.

6. Medical Conditions:

• Chronic Illnesses: People with certain chronic illnesses or underlying health conditions should consult with their healthcare provider to determine if Botox is safe for them.
• Poor Health: Generally poor health or weakened immune systems may also increase the risk of complications.

7. Unrealistic Expectations:

• Expectations vs. Reality: Individuals who have unrealistic expectations about the outcomes of Botox treatments may be unsuitable candidates. It is crucial for candidates to understand the limitations and temporary nature of the results.

8. Psychological Conditions:

• Body Dysmorphic Disorder: Individuals with body dysmorphic disorder or other severe psychological conditions may not be suitable candidates, as they might not be satisfied with the results of any cosmetic treatment.

Botulinum toxin injections are mainly indicated for dynamic wrinkles. These wrinkles are obvious with facial movements; smiling, frowning and looking surprised. Static wrinkles, on the other hand, do not respond to botulinum toxin injections. From studies, static wrinkles are better treated with laser or energy-based resurfacing procedures.

Between the 3 common brands (Botox, Dysport, Xeomin), the average time to see results is 3-7 days. Some individuals would be able to appreciate a difference within 24hours.

The cosmetic effect of botulinum toxin treatments initially lasts for 4 months, but gradually increases to 6 months or more with regular treatments as the muscles are more relaxed.

For the treatment of axillary hyperhydrosis, a significant reduction in sweating is noticed within 2 weeks, and results lasts 6-7 months.

• Mild injection site redness and swelling are common, which fades in a few hours. Mild bruising may be encountered and resolves in a 7-10 days. 
• Some individuals may experience a headache following treatment. This is common and simple painkillers will usually address the issue.
• Some patients may notice asymmetry in certain areas due to differences in muscle strength and dosage applied.  The Mephisto (spock)  effect is a relatively common side effect where the sides of the of the forehead muscles are still active where the central parts are relaxed. Fortunately, these can be corrected at follow up visits by injection to the active areas.
• Uncommonly, some individuals may notice a lowering of the eyelid or eyebrow (ptosis). These effects are temporary taking a few weeks to resolved.
• Peri-orbital swelling
• Compensatory muscle hypertrophy
• Rarely, one may be allergic to botox treatments, which can range from mild rashes to anaphylaxis.

Botox is injected into the muscle causing the muscle to relax, improving the appearance of the lines. Botox works by binding to receptors that send nerve signals for muscles to contract. Since your body is constantly making new receptors and neurotransmitters all the time, future Botox treatments will be needed to maintain the relaxed and smooth appearance.  If treatments are not kept up the wrinkles will slowly return as the muscle regains function over time. Botox takes generally two weeks to start working optimally and lasts for up to six months.

Studies have shown that treating multiple facial wrinkles are associated with improved outcomes. For example, simultaneous treatment of lateral canthal lines (crow’s feet) and glabellar (frown lines) revealed better cosmetic benefit.

For some reasons, some patients may develop antibodies to botulinum toxin treatments. The risk of immunogenicity is higher with top ups within a short period of time and re-treatments less than 4 months.

• Do not touch the area 4 hours after the procedure to avoid infection and avoid make up for 12hours.
• Use a mineral based sunscreen (SPF 30-50) post treatment. UV radiation can potentially degrade the toxin.
• Stay upright for 4hours following the procedure to avoid unwanted migration of the product to other areas of the face.
• Avoid massaging the area following the botulinum toxin injection.
• To ensure safe and long lasting results, you will be asked to exercise certain muscle groups after injection. Raising your eyebrows, frowning and smiling for 20 minutes after the procedure has shown to enhance effectiveness. This is because with increased muscle activity, the botulinum toxin proteins will concentrate around the targeted muscle group.

The price of botulinum toxin wrinkle treatment per area is from $150 per visit. 

Common areas include the forehead lines, glabellar (frown lines) and wrinkles around the eyes (Crow’s feet)

A review is done within 2 weeks, and a touch up is done free of charge within this time if necessary.