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					                        A guide to

Castle Dental & Facial Aesthetics Clinic, 35 Castle Square, Caernarfon, Gwynedd LL55 2NN
                                   Tel. 01286 673174
INTRODUCTION                                What areas can be treated?
                                            Anyone can benefit from Botulinum
Wrinkles and fine lines result from         toxin, both men and women. It is most
ageing, muscle activity (and over-          commonly performed in the upper face.
activity)      and     your      generic    The most common areas requested are
predisposition. In addition, excessive      the horizontal forehead lines, vertical
sunshine         exposure,       alcohol    frown lines between the eyebrows and
consumption, emotional and hormonal         crow’s feet, (or laughter lines),
influences and smoking can also             radiating away from the eyes. While it
increase the likelihood of wrinkles.        would probably work around the mouth
Whilst you may be able to reduce or         and chin, it would undoubtedly weaken
control some of the factors associated      the smile and Mrs Humphreys does not
with wrinkle formation you cannot           recommend its use around the mouth.
influence all factors and we all develop    Creases around the mouth may,
some wrinkles as we age.                    however, be improved by filling them out
Mrs Humphreys can offer professional        with a dermal filler such as Restylane.
consultations and treatments to             How long does the treatment take?
reduce the appearance of facial lines       In most cases the treatment will take
and wrinkles. She has expert knowledge      between 10 and 20 minutes.
of head and neck anatomy and                Approximately two weeks after the
physiology together with training in the    first treatment, the effects will be
use of cosmetic treatments which can        reviewed by Mrs Humphreys and any
subtly enhance your appearance and          further treatments or top-ups can
make you look younger.                      be discussed.
Where Botulinum toxin is injected it        Is Botox safe?
reduces the facial movements which          Botox injection is currently the most
result in wrinkling. This gives a           popular cosmetic procedure with over
smoother, more rested appearance to         1.6 million Botox injections being
the face. Botox also has a preventative     performed last year. The treatment is
effect when used repeatedly to reduce       now 15 years old and therefore has a
the onset of wrinkles forming in the        well established safety record. In the
long term. This is partly due to the        USA      the     Food     and      Drink
effect of re-educating the facial           Administration, (the FDA), now licenses
muscles not to make expressions which       Botox for cosmetic use. For many
result in wrinkling.                        people, Botox represents their first
                                            experience of cosmetic surgery. As a
What is Botulinum?                          quick and effective treatment, with
Botulinum is a substance that is            excellent results and virtually no down
produced by a bacteria; it is then highly   time, it is perfect for those patients
refined, purified, diluted and used in      who have minimal signs of facial aging
therapeutic doses. Botulinum is             such as forehead furrows and crow’s
administered by injecting it into a         feet. Whilst Botox can often delay the
specific facial muscle where it acts as     need for more extensive surgery, it is
a muscle relaxant.                          important to stress that it does not
achieve the same            results        as aminoglycoside antibiotics, penicillamine
surgical procedures.                          and calcium beta blockers (Calan,
What should be expected after Cardizem,                        Dilactor,      Procardia
Botox Therapy?                                and Verelan).
Botox is a remarkably safe treatment Known allergy to human albumin (egg
for wrinkles with little down time white) or Botox; currently there are no
associated with the treatment. documented cases of allergy to Botox.
Occasionally slight bruising may occur
where the Botox is injected and a mild What are the risks?
headache may follow. Bruising may be As with any sort of injection, there can
greater in patients who are taking be some bruising and minor swelling
aspirin or any blood thinning medicines. although this is not severe and usually
These products should be avoided settles within a few days. Very rarely if
during the 5 days preceding treatment; the Botox reaches the upper eyelid
you may need to check with your GP muscle there may be some transient
first. Muscle weakness is first noted at drooping. This is the most significant
between the 3rd day and the 10th day risk and occurs in about 1 in 1,000
after injection, it is not immediate.         injections. It occurs from the local
                                              spread of the Botox from the injection
                                              site and can be minimised by accurate
                                              dosage, proper placement as well as
                                              keeping in an upright position for 3 – 4
                                              hours after the injection. If drooping
Before and after treatment for crows feet.    eyelids occur, it usually resolves over a
                                              few weeks. Special eyedrops may
Who should not receive Botox?
Pregnant women; although there have temporarily reduce eyelid droop if
been no reports of birth defects with it occurs.
this medicine, no pregnant women will
                                              What do I do after the treatment?
be treated.
Breastfeeding; similarly there is no Do not massage the area of the
evidence that Botox is expressed in injection. Do not lie down for a nap –
breast milk but it is best avoided keep upright for about 3 – 4 hours.
if breastfeeding.                             Using the muscle intentionally makes it
Patients       with     a      history     of contract and may help to localise the
neuromuscular         disease      (multiple
                                              Botox to the selected muscle. Do not
sclerosis and myasthenia gravis) or
other types of diseases involving take aspirin for five days before the
neurotransmission          should       avoid injections as this may help to reduce
this medicine.                                the chance of bruising. It is also advised
Patients       taking     the      following not to perform any vigorous exercise
medicines should not receive Botox: for 24 – 48 hours after the treatment,
How long does Botox last?                      BOTULINUM TOXIN
Successful therapy is signalled by             TREATMENT PRICES
muscle weakness that begins 3 – 10
days after injection with the main             Initial Cosmetic Botox/Restylane
effect visible at about 7 days.                Consultation fee
                                               Including digital photographic records
How often is Botox needed?
Repeat treatment is suggested every
4 – 5 months to keep the muscles               Treatment of glabellar complex
sufficiently frozen to allow furrows to        (furrows between the eyes)
smooth out. In practice this means                                       £200.00
coming three times in the first year.          - addition of crow’s feet treatment
After using Botox for one year the
intervals between injections may be a
little longer so that you need it only         - addition of forehead furrows
twice a year.                                                                £60.00
What are the alternatives to Botox?
                                               The fee will include a follow-up visit
Filling agents such as Restylane may
                                               2 weeks after treatment to assess
help to eliminate the finer expression
                                               the result and administer any ‘top-
lines. Depending on the severity of the
                                               ups’ as necessary. Final digital
skin changes it may be more
                                               photographic records will also
appropriate to recommend lifting
operations of the forehead, temporal           be taken.
region or face which would also have           Good results may be obtained after
the longest lasting effect.                    a single session and may last from
What unexpected benefits have come             3-6 months. Repeat treatments will
from Botox?                                    not require a consultation
Tension headaches and migraine for             appointment prior to the
some patients have disappeared.                administration of the Botulinum
These occurred in patients who were            Toxin, unless more than 12 months
recruiting forehead and brow muscles           have elasped since a previous session.
during stress and tension. When                * Please note the fee for the
these muscles were relaxed, the
                                               consultation will be deducted
headaches faded.
                                               from the cost of any treatment
How painful are the injections?                undertaken.
The smallest needles are used and the
medicine itself does not tend to sting.
Most patients feel it as painful as
having their eyebrows plucked.

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