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Busting Botox Myths!

I thought it would be a good idea to explain the Myths and Truths behind anti wrinkle injections. I see so many patients who have treatment and often I hear…. My BOTOX hasn’t worked I can still move a little. When I frown I have this little line still there……I can still move my eyebrows……….It only lasted 10 weeks…………I still have movement at 2 weeks so you haven’t made it work…… My friends BOTOX isn’t like mines………..Why is it so EXPENSIVE……. I have the FLU so the BOTOX has given me this…….My BOTOX has worn off and my wrinkles are much worse…..After my first session I should see results for 6 months to a year……….I have these odd looking lines above my eyebrows during the 2 weeks of treatment…..

Please let me explain about Toxin Injections and hopefully clear up a few things to help you understand better.

#1- My BOTOX hasn’t worked atall I can still move some. You have had your treatment and you have returned at the clinic for your review. We look at the before pictures and examine the results. You have had extensive dynamic lines of the face and you are able to move slightly. This does NOT mean your treatment hasn’t worked. What we are trying to achieve is an improvement of the dynamic lines not perfection. Where we feel you will benefit from additional toxin we will administer this FOC. Some clients will not achieve full relaxation of the areas treated and again this does not mean the treatment hasn’t worked. Each patient is an individual and what works for some may not work for others. Adding in more toxin than safe is not something a reputable practitioner will do and will not make the treatment last longer.

#2 When I frown I still have those little lines present. Let me explain about what toxin actually works on and what it doesn’t work on. Toxin is a muscle relaxant therefore relaxes the dynamic lines of the face. Static lines are lines at rest meaning those lines are present without having to move our forehead or frown to create them. When we inject toxin into the muscles we will see over the period of 14-21 your muscles relaxing. Static lines are softened with the toxin as you are not frowning making them appear less but they are not removed with the toxin. When you return for your review and you point out that the botox hasn’t worked as you have those static lines present this is simply not the case. When you have your consultation we will always point out the static lines and grade them on the Merz scales of 1-4. We will always advise that they will not be removed with toxin and something like dermal fillers or medical grade skincare like Retin A is better used on static lines. Static lines are like a piece of paper folded in half. As much as you try to iron out the line it won’t. It is the same with static lines one the face. We would advise a little filler after botox to soften further. This would be several weeks after toxin treatment.

#3- I can still move my eyebrows. When we treat you with toxin and you return and explain that your eyebrows are still moving then this is a good sign. Having a natural relaxation is the goal and you this does not mean that your treatment has not worked.

#4 It only lasted 10 weeks. When we treat you for the first time and you begin the journey with toxin this may well happen. Toxin will not simply wear off at week 12 to the day and will continue to wear off over the coming weeks reverting back to your full muscular activity by around week 16. This is when we will advocate a repeat treatment (12-16 weeks). You may well see lines appearing around this time and sometimes as soon as week 8 but this does not mean that you require a further treatment at this time. We will only repeat a further treatment at week 12 onwards. Once your muscle is repeatedly blocked with toxin it will weaken over time and you may get longer. However this is not the case for everyone and again does not mean the treatment has not worked. We for one as a clinic will only use your prescription for your use only and use the recommended dilution as per the manufacturers guidelines. BOTOX is a brand name as is Azzalure and Bocouture. If we use Azzalure we are not using a cheap version. All toxin is the same and we will use whatever we feel best suited to the client. If a client prefers BOTOX(Allergen) we will use this and vice versa.

#5 I still have movement at week 2 so it hasn’t worked. We always advise clients to come back at week 3-4 for review of the toxin. This is in order to assess the level of relaxation and administer if required. Some clients require no additional toxin where as others do. Some clients also require a further full dose due to the excessive muscular activity and we will administer this FOC. If you have to return for a 3rd time we will advise to wait until week 12-16 for a further dosage. Again this is improvement in the dynamic lines and not perfection. If we feel that you are not responding to toxin we will advise of this and try to offer an alternative treatment. We cannot simply keep adding toxin into the muscle as you may develop anti body resistance . Practitioners know the dosage for toxin and simply asking to administer ‘Bucket Loads’ (Yes this is the term I hear) will not make the treatment work or last any longer. We would not refund on treatment once administered and your consent will advise of this. We strictly adhere to the max 28 days post treatment. Our team of receptionists will always ask you to book in your review at the time of checkout. If you have missed the deadline of 28 days we will be unable to administer further treatment and you will be advised to wait a full 12 weeks for a further full paying treatment.

#6My friends botox isn’t like mines. That may well be the case as everyone is an individual and what works for them may not work for you. They may appear with less dynamic movement than you and they may well have had toxin treatment for many years. We treat every client as an individual case.

#7 Why is it so EXPENSIVE. Actually toxin prices are very cost effective to the client. We also cannot discount on prescription only medication and is unethical for a clinic to do so. When a clinic sets prices of toxin they take into consideration many factors.

1. Research- The company that manufactures botulinum toxin for cosmetic use has invested hundreds of thousands of pounds in developing, researching and providing evidence of its safety and effectiveness. They also continue to invest in further research and development, discovering new ways their medicines can be used and developing new products. The cost of this investment is reflected in its price.

2. Training- Responsible non-surgical cosmetic practitioners will invest heavily in training and ongoing education in order to expertly deliver safe treatments, and having received initial training will continue to invest in further education, attending conferences, workshops, training updates and meetings.

3. A Safe Environment- The overheads of providing a safe environment to administer non-surgical cosmetic procedures can be extremely costly, as practitioners must ensure that they comply with health and safety legislation, are able to safely supply and store medicines, that they can securely store medical records to protect confidentiality. They must also implement and uphold relevant policies and procedures to minimise risks.

4. Assessment- When you meet with a properly qualified, responsible practitioner, they will invest time in consultation and assessment to ensure that you receive the correct treatment for your individual needs. They will also take time to answer any questions that you may have in order to provide you with the information you need to make an informed decision about whether to proceed with your treatment.

5. Quality of care- Once you have decided to go ahead with your treatment, a qualified practitioner will also provide you with quality service and after care, which will include a follow up consultation(free) to ensure that your treatment has been a success.

6. Insurance-All good non-surgical cosmetic practitioners will have insurance, and this is another cost associated with quality care. Medical malpractice insurance is vital for anyone working in healthcare, as it provides public liability and professional indemnity cover to safeguard against claims of clinical negligence and medical malpractice, protecting both the practitioner and the patient.

7. Registration with regulatory bodies-As well as the above mentioned costs, there are other expenses involved in setting up, running and maintaining a non-surgical cosmetic clinic, many of which underpin its safety. Registration and revalidation with regulatory bodies such as the Nursing and Midwifery Council (NMC), is a mandatory expense, as these bodies are responsible for regulating medical practitioners. In addition practitioners often choose to join and pay membership fees to professional associations which provide peer-to-peer support, education and training, and keep their members updated on industry standards, regulations and policies as they develop.

8. Sundries- Needles, cleaning skin agents, swabs, extra toxin at review, gloves etc

9. Cost of product including saline on prescription, delivery costs

Making the profit little to the clinic.

#8 My toxin treatment has given me the FLU. This is simply not true and toxin cannot give the FLU. Some of the literate says that you can experience flu like symptoms. We will always explain at your consultation that you that you may experience a headache but you will not get the FLU. We will always advise of side effects prior to your commitment to treatment.

#9 My toxin has worn off and my lines are much worse. When your toxin wears off the neurons that have been blocked will grow back and revert back to normal muscular activity. Normally, to make a muscle contract, a nerve sends a signal to the muscle. The point where the nerve and the muscle meet is called the neuromuscular junction. When the signal gets to the neuromuscular junction a chemical called acetylcholine is released from the nerve side of the junction and binds to the muscle side of the junction causing more chemical reactions that make the muscle contract.

Toxin works by blocking the acetylcholine receptors on the muscle side of the junction. Then when the nerve sends a signal to the muscle to contract, acetylcholine is released as before, but it can’t bind anywhere on the muscle.
The muscle has no idea it is supposed to contract. It is essentially paralyzed, but not because it or the nerve have been damaged.

This acetylcholine blockade is not reversible and begins within 48 hours. The clinical effects of a Botox injection become noticeable between 5-10 days. Over the next 2-4 months the muscle gradually develops new receptor sites and is able to contract again. You may start to notice the movement coming back at week 8 however this is not full movement which will return around the week 12 mark. This is especially true for those starting out their journey with toxin or for those who have had a break from treatment. Once you begin he journey you may start to see longer

#10 After my first session it should lsat 6 months to 1 year. Toxin treatment average is around 12-16 weeks. Some clients will retain longer and some clients will have less time. This does not mean that it hasn’t worked and as explained every client is individual and what may work for them will not work for you. You will need a further treatment around this time to maintain the results and this is charged at full cost again. It is not a further review or top up for free. If we feel that you are getting short time with toxin (6 weeks or less) we will try an alternative toxin. If this happens repeatedly we will advise of either stopping treatment. We will not repeat treatment within an 6 week period.

#11- I have odd looking lines above my forehead. This is a very common thing to happen with toxin and will be corrected at review. The term for this is called Mephisto. When a practitioner carries out toxin treatment they are very careful not to drop the brow giving a brow ptosis. When the practitioner assesses the muscular activity and the level of movement will determine where to place the toxin. You may well not get complete relaxation of the forehead due to the extent of the lines and location. We will always advise of this at your consultation when we assess the face. Often clients as for a brow lift and complete relaxation of the forehead. This is not always possible due to requiring part of the frontal muscle needed to to lift the brow. Again this is patient dependent and will be explained at your consultation.

#12. Lastly I want to explain about side effects. Side effects occur in treatment and you will sign a consent to make you fully aware of those risks. With every treatment comes risks and we will make sure you are fully aware before treatment is carried out. When we relax the muscle it may be that other muscles will compensate making other areas more noticeable. This is not the fault of the practitioner but simply other muscles coming into play. We may be able to relax them and we may not. You may have bruising and this is a common side effect. Headaches also occur and we advise to treat with medication like paracetamol. You may also feel a heaviness at the area and this is all normal post treatment. You are advised not to use sunbeds and we will take no responsibility for clients not adhering to our post treatment advice. We will give you a post treatment care advice sheet on leaving and we advise following this to avoid side effects. With 9 years experience in toxin administration I have had very minor issues(all corrected at review) making it a very safe, affordable and excellent treatment.

I hope this has cleared up some myths surrounding toxin treatment.

Source: Renu Skin Clinic

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