Adhering to WPATH Standards of Care

0207 487 0910

54 Wimpole St, Marylebone, London W1G 8YJ

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Treatment of Active Facial Lines

Overactive facial muscles, especially between the eyebrows, forehead and around the eyes can often contribute to the formation of active facial lines and wrinkles. With the loss of collagen and elastin in the skin due to aging, or because of sun damage, these lines become increasingly apparent and permanent. The use of a botulinum toxin (BOTOX or Bocouture) to relax the underlying muscles is an effective method to improve these lines and wrinkles. In some individuals, the use of dermal filler injections in combination with botulinum toxin treatments will be necessary to achieve the optimum rejuvenation. Skin rejuvenation programmes using products and lasers are also available to enhance overall improvements.

Summary of Top Surgery

Procedure Time
1 hour
No exercise for 48 hours
Back to Work
Lasting Effects of Treatment
3 – 4 months
Not needed
image description
Minimal discomfort at the time of enhancement


  • What is Botulinum Toxin Treatment?
    Botulinum toxin blocks the transmission of nerve impulses to the specific treated muscle(s) and therefore induces relaxation of the muscle in a dose dependent manner. Botulinum toxin also blocks nerve impulses to sweat glands and can subsequently be used to treat excessive sweating – Hyperhidrosis of the underarms (axilla), face, hands and feet. Because receptors that are blocked by the botulinum toxin are continually being replaced, the effects are never permanent, but typically last 3–4 months in muscles and 6–12 months in sweat glands.
  • Am I suitable for Botulinum Toxin Treatment?
    If you are particularly concerned about the appearance of facial lines or wrinkles in areas with over-active muscles, such as the frown lines or crow’s feet, then treatment with botulinum toxin to the underlying muscles will have a beneficial effect on these concerns. It should be noted that deep lines may not disappear with muscle relaxing injections alone, but may require an injectable dermal filler product further soften these areas. For more information about dermal fillers click HERE Botulinum toxin treatments should not be used during pregnancy or breastfeeding
  • How is the treatment performed?
    An initial consultation will be carried out to determine the goals for your treatment, make note of any associated asymmetries/abnormalities, and a treatment plan will be determined to achieve the ideal result for each individual. Photos will be taken before your treatment in order to document your concerns efficiently. The treatment is carried out in an outpatient setting, taking approximately 30-45 minutes depending on the number of areas treated. Facial mapping will be completed, and a cold pack applied to the treatment areas. Botulinum toxin will then be injected through a very fine needle into each specific treatment area, with only minor discomfort experienced.
  • Will the treatment be painful/cause bruising?
    The use of skin cooling with a cold pack or, occasionally, a topical local anaesthetic cream will ensure minimal discomfort during the treatment. Very minimal to no bruising should occur due to the careful, experienced techniques and fine needles used by our practitioners; however, please be aware that any breach of the skin may result in small bruises.
  • When will the results be seen?
    Botulinum toxin becomes effective in 5–7 days and reaches its peak 14 day after treatment. Most patients notice a softening of lines and wrinkles at approximately 2 weeks, and a further improvement in deeper lines or wrinkles at 4–6 weeks.
  • How long will the results last?
    Most improvements seen will last for approximately 3 months after initial treatment. To achieve an optimal result, it is recommended to repeat the treatment every 3 to 4 months for longer term effects to be noted.
  • What are the risks of Botulinum Toxin treatment?

    Botulinum toxin is a very safe and well tested drug, with minimal side effects or risks; provided the treatment is performed by a qualified and trained practitioner. Common side effects include mild pain and redness (erythema) at the injection sites and occasionally mild bruising; however, these are temporary and limited. Do not massage or rub the treated areas following your procedure for the first 24 hours.

    Further risks include ‘over treatment’ of an area, which may give a frozen, undesirable appearance. Weakness of muscles in close proximity to the treated areas can also occur if individuals are non-compliant to post-treatment advice and aftercare.

    Allergic reactions to botulinum toxin are rare. A small percentage of patients go on to develop natural antibodies to some forms of botulinum toxin and, therefore, may not achieve optimal results following treatment. Usually, switching to an alternative form of botulinum toxin resolves this matter.


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London Bridge Plastic Surgery & Aesthetic Clinic

54 Wimpole Street, London W1G 8YJ.
2 minutes walk from Harley Street.