WHAT IS IT AND HOW DOES IT WORK?

Botox and Dysport are the trade names for Botulinum toxin, which is produced by the bacterium Clostridium botulinum. Botulinum type A, which is used commercially, is the most potent. Botox acts by blocking acetylcholine, a chemical that is responsible for transmitting the electrical impulses that cause muscle contraction. This results in muscle paralysis, but only temporarily, as the new growth of nerves re-innervates the muscles.

THE PROCEDURE Botox is injected in highly diluted doses into the belly of the muscle using a small needle. This causes it to relax, which softens lines and contours. The most popular areas to have treated are crow’s-feet, forehead lines, neck muscles, the corners of the mouth and upper lip lines. Several injections are usually needed at specific sites, depending on the area treated.

TIME TO HEAL Make-up can be worn immediately.

THE RESULTS Botox usually takes effect 1-3 days after the injections, with maximum effect 1-2 weeks later. The effects last for about three to four months. When injected into the muscles that are responsible for expression wrinkles, it gives the face a more relaxed and smoother appearance.

ARE THERE LIMITATIONS? Botox is effective in reducing wrinkles that have been caused by muscle contractions, but it has no effect in reducing fine lines on the face due to sun damage and those caused by sagging facial skin.

RISKS AND CONTRAINDICATIONS Possible side effects include headaches, eyelid droop, swelling and bruising. Botox should not be used by pregnant or breast-feeding women, anyone with neuromuscular disorders or people taking certain muscle relaxants.

HOW TO AVOID FROZEN-FACE SYNDROME Nobody minds losing the odd frown, but be wary of removing all expression, particularly around the eyes. In other words, pick the expressions that you want to take out, carefully and sparingly.

IS IT SAFE? Long-term evaluations have not been conducted, but the overall safety of Botox is well established — it is approved by health authorities in 70 countries. However, it is important to note the following: in the UK, Botox can only be prescribed by doctors. Nurses can perform the procedure under the direct supervision of a doctor, provided the patient is counselled by a doctor first.

In addition, in the UK, Botox is only licensed to treat squinting, facial and neck muscle spasms, cerebral palsy and excessive sweating. Injections for cosmetic use are considered “off label”, and a doctor is obliged to tell a patient this and take responsibility for the drug administered. This underlines that Botox is a medical procedure that requires appropriate training to ensure safety as well as a favourable aesthetic result. That said, according to the British Association of Aesthetic Plastic Surgeons, it is not dangerous when used properly, and even if the use of Botox resulted in the wrong muscle being paralysed, the effects would be temporary.

WHO TO GO TO Patrick Bowler, 30b Wimpole Street, W1; 0870 850 3456, www.courthouseclinic.com. Tracy Mountford, Cosmetic Skin Clinic, The Lanes Medical Practice, Plough Lane, Stoke Poges, Buckinghamshire; 01753 665206.

COSTS From £250 per area treated.