What exactly is Botulinum Neurotoxin Type A (BoNT-A ) ?

Botulinum Neurotoxin Type A is a medication injected into the muscles in order to temporarily smooth out lines and wrinkles. It contains a highly purified botulinum-toxin protein and when injected in very small amounts, such as the amount used for cosmetic injections – it is very safe.

Do the injections for anti-wrinkle hurt?

Any injection can have a bit of discomfort, especially if you are stressed, tired, have consumed an excess of alcohol the night before. In addition, female patients at certain times of the month, around the menstruation cycle have proved to be a bit more sensitive. Never the less, it is a quick procedure and a very beneficial treatment, so any discomfort won’t be for long at all. The needles used for anti-wrinkle injections are very thin , so any discomfort is usually minimal.

Do I need to do anything before having anti-wrinkle treatment?

One week prior to your treatment, avoid taking aspirin, non-steroidal anti-inflammatory medications, Gingko Biloba, Vitamin E or fish oil supplements. These agents may increase bruising and bleeding at the injection site. Nurse Julie also advises against drinking alcohol 48 hours before as this also can increase the risk of bruising. Nurse Julie also advises to remove all make up before arriving for your treatment.

Will I look “false” or “done” if I have anti-wrinkle treatment?

It is impossible to look fake or false after one anti-wrinkle treatment. When performed properly, in experienced hands, anti- wrinkle treatments provide a very natural look. The main aim of anti-wrinkle treatment is to decrease the appearance of wrinkles and prevent deep wrinkles from developing at rest.  Nurse Julie’s work ethos and ethic is “less is more” and in Nurse Julie’s experience, with the age range she treats, most people opt for this.

Does anti-wrinkle treatment give you a shiny forehead?

The reason why you may see someone with a shiny forehead after anti-wrinkle injections is because of “over treatment”. Nurse Julie is renowned for providing her patients with a natural result.

Will I notice the difference right away?

The initial effect of Azzalure® treatment will begin to appear within 2 to 3 days.

How long will my treatment last?

As cosmetic injectables are used to soften the appearance of wrinkles, the result can last up to 3 months and up to 5 months in some patients. With some of Nurse Julie’s regular clients, they have a treatment every 10 months. However, everyone is different. You won’t see a difference right away as it can take up to five days for the injection to really take effect. Expect at least two weeks for the full effect.

Can anti-wrinkle injections take away all my lines?

Anti-wrinkle treatments cannot remove every facial line or wrinkle, because some lines and wrinkles develop for other reasons than just the repetitive dynamic movement and we refer to these lines’ as ‘static lines and wrinkles’. For example, if you have a line that remains with no movement (called a static line), it will be difficult for the anti-wrinkle treatment to completely reduce this.

When the anti-wrinkle treatment results wear off my smile lines, will the lines return overnight?

No, it will be a very gradual process.

Will anyone be able to tell I have had anti-wrinkle treatment once the results start to show?

No, the results of anti-wrinkle treatments should look very natural. An experienced and skilled professional will understand facial aesthetics and anatomy enough to make the treatment look natural. Nurse Julie will customize the injections by considering your facial muscles, the symmetry or asymmetry of your face, and your cosmetic goals. Once the results start to show, you may notice that people will say you look “well” or ask if you have got new make up and some will go further to try and fond out exactly what you have had done! Whether you tell anyone that you have had an anti-wrinkle treatment or not is entirely up to you.

Why do some people look frozen or overtreated after anti-wrinkle injections?

The common stereotype associated with anti-wrinkle injections is that the treatment makes your face look fake or frozen. In most cases, the results should be very natural. There are a number of reasons why some people look false or frozen:

– Over frequency of injections
– The product doesn’t match the patient/isn’t suitable
– Unethical practitioners
– Visiting a number of different practitioners
– The look is appealing to them
– The influence of celebrity culture
– Body dysmorphia

What is the difference between dynamic and static lines?

Dynamic lines and wrinkles form as a result of muscle motion, including the way we express ourselves. When our facial muscles contract, the skin over those muscles stretches to accommodate this movement. Static wrinkles are caused by gravity, the loss of fat and collagen as well as the loss of the skin’s elasticity. These types of wrinkles are visible regardless of any muscle action and are always there, hence the term “static.” It is important to know that dynamic wrinkles eventually become static wrinkles, which is why if you are concerned about the ageing process, it is important to catch these lines early on.

I have a bit of a phobia about needles, what do I do about this as I really would like to have some anti- wrinkle treatments

In Nurse Julie’s experience there is a difference between a fear of needles of and a phobia. Nurse Julie advises to discuss this with her at the consultation.

I am going on holiday /have a big event/wedding how far in advance should I plan for having anti-wrinkle treatment?

Julie does recommend planning ahead when it comes to big events anti-wrinkle treatment, especially if you are new to this treatment. The best thing to do would be to contact Nurse Julie and let her know your plans so she can advise you accordingly.

Can I fly after anti-wrinkle treatment?

There are concerns that the changes in air pressure in an aeroplane cabin can affect the results of anti-wrinkle treatments. Nurse Julie advise her patients to avoid flying for 24-48 hours after treatment.

Are there different brands of anti-wrinkle?

Yes, there are several brands of Botox® (Botulinum Neurotoxin Type A) injections available here in the UK and Nurse Julie provides all the brands, but it is the brand called Botox ® that is the most commonly known to the public and referred to in the press and media.

Botox® is a trademarked name for a specific botulinum toxin type A product, but other brands are available, including; Vistabel® Dysport®, Azzalure®,  Xeomin® and  Bocouture®

Which brands of anti-wrinkle does Nurse Julie use?

Nurse Julie uses Botox® and Azzalure®

Why is it prohibited to advertise Botox ® to the public?

Botox® is a prescription-only-medicine (POM) and is prohibited by law from being advertised to the public, (rule 12.12: Venus Beauty Lounge, 5 August 2015 and MyCityDeal Ltd, 14 March 2012). In traditional non-broadcast media, such as leaflets, press ads, brochures, posters and even on sponsored ads, the Advertising Standards Authority (ASA) considers almost every reference to Botox® and other Botulinum toxin products as promoting a POM and therefore a clear breach of rule 12.12. Unfortunately, many practitioners do still advertise Botox® as a brand which is against the Advertising Standards Authority (ASA) as well as the Medicines and Healthcare products Regulatory Agency (MHRA) that regulate medicines.

Are anti-wrinkle treatments permanent?

No – The effects of an anti-wrinkle treatment will eventually wear off and maintenance treatments are required about two to four times a year. However, some of Nurse Julie’s patients only have treatment once or twice a year so it is evident that some clients won’t need treating so frequently once they have undergone a period of maintenance treatments over time.

What are the side effects of anti-wrinkle treatments?

Although anti-wrinkle treatments are a toxin, there have been no serious side effects associated with its use. You may have heard of anti-wrinkle injections “migrating” (going to other muscle areas) and cause the temporary weakness of nearby muscles. In rare cases, there can be a drooping of an eyelid or asymmetry of facial expression. As Nurse Julie is an experienced injector, the risk is of this happening is very rare. To reassure you, the effects of anti-wrinkle treatments are completely reversible as the effects are temporary. Bruising can happen, but it is extremely rare in Nurse Julie’s experience.

What else is Botox® used for ?

There is a long list of FDA (Food and Drug Administration) approved indications for Botox®. It’s first clinical use was by ophthalmologists treating strabismus (“crossed eyes”). Other uses for Botox® are; cervical dystonia (a painful condition in which your neck muscles contract involuntarily), blephrospasm (an involuntary tight closure of the eyelids), primary axillary hyperhidrosis (excessive underarm sweating). Botox® is also used to treat other illnesses including hemifacial spasm, dystonia, cerebral palsy, and stroke.

Can Botox® be used for migraines?

Yes, Botox® is only for chronic migraine, not any other sort of migraine.

Who cannot receive anti-wrinkle injections?

– Women who are pregnant or breastfeeding
– If you have other neurological disease, for example Bell’s palsy, a neuropathy, Myasthenia Gravis or Lambert-Eaton syndrome
– The above is not an exhaustive list and a full medical history will be taken at the consultation

Is it possible that I could become immune to anti-wrinkle injections?

Occasionally, some patients may develop an immune response to an anti-wrinkle brand that may reduce the effectiveness of treatment. This is very rare and Nurse Julie has only seen this a less than a handful of times. This happens because anti-wrinkle treatments are a protein complex, and in some patients the body’s immune system may respond by producing “blocking” (or neutralizing) antibodies capable of inactivating the protein’s biological activity.

I’m in my 20’s and am concerned about aging – I’ve read that anti-wrinkle injections can be used as a preventive measure, is that right?

Yes, anti-wrinkle treatments are being used across the globe as a preventative treatment for wrinkles. The question of when to start having these treatments is more complicated. It depends on your facial structure and your predisposition for wrinkling. Many of Nurse Julie’s patients wait for the first signs of wrinkles to occur before having an anti-wrinkle treatment.  These injections are also very effective for treating dynamic wrinkles (that appear when expressing emotions, such as fear, worry, joy, sadness, or surprise). You will also notice them when you smile, laugh, frown, cry, or during moments of deep concentration. Dynamic wrinkles fade as quickly as they appear. Once the emotion passes and your face goes blank, you will no longer see them.

 I don’t have any lines, will Nurse Julie still treat me?

Nurse Julie does not recommend that you start having anti-wrinkle treatments if there are no lines to treat. You are very welcome to come and see Julie for a chat to discuss your concerns as she is very knowledgeable skin care and can advise on an effective skin routine for you.

If I want semi-permanent make up would I have the anti-wrinkle treatment before or after treatment?

You should have your anti-wrinkle treatment before having semi-permanent make up treatment on your eye-brows. This is because the Botox can move the position of your eye-brows temporarily.

What is the aftercare after having anti-wrinkle treatment?

– Avoid touching, massaging or any pressure on the treatment areas for the first 4 hours as this may change the placement of the Botox and cause undesirable effects. If you need to reapply makeup in the first 4 hours, do so gently.

– You may experience some small red dots or minor bruising around the injection sites. This is normal and will generally fade after a few hours. If you are on aspirin or other blood thinning medications, there is an increased risk of bruising which may also last longer. If you have any bruises, you can apply arnica cream or gel or cream to the area.

– Do not lie down for the first 4 hours to avoid the risk of pressure on the treatment areas.

– Avoid drinking alcohol for at least the first 12 hours as it can contribute to bruising and swelling.

– Avoid strenuous exercise or activities that might cause the Botox to be displaced (e.g. yoga) and sun exposure for the first 24 hours after your treatment.

– Avoid having a facial for 2 weeks.

– Do not take any long-haul flights for 24 hours.

– This is not an exhaustive list and will be discussed at the consultation.

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