What is botulinum toxin treatment?
Botulinum toxin is a purified protein that temporarily reduces the signal from nerve to muscle. Injected in small, measured doses into specific facial muscles, it softens the movement that creates certain lines.
The important word is temporary. The effect builds over about two weeks, holds for a few months, and then fades as nerve signalling recovers. Nothing is removed and nothing is permanently altered.
It is a medical treatment, given by a physician, using a prescription product — not a cosmetic in the everyday sense.
Which areas can be treated?
| Area | What it addresses |
|---|---|
| Glabella (between the brows) | The vertical "frown" lines |
| Forehead | Horizontal lines from raising the brows |
| Crow's feet | Lines fanning from the outer corners of the eyes |
| Bunny lines | Creases across the upper nose on scrunching |
| Brow position | A slight lift of the outer brow, by relaxing the muscles that pull it down |
| Chin | Dimpling or "orange peel" texture of the chin |
| Masseter (jaw muscle) | Reducing bulk in an overdeveloped chewing muscle |
| Gummy smile | Excessive upper lip elevation on smiling |
Not all of these suit every face, and some — brow position, gummy smile, masseter — depend heavily on accurate assessment of how your own muscles work. That assessment happens before any injection.
What it does not treat
This is worth stating plainly, because it is the most common source of disappointment:
- Static lines — creases visible when the face is completely at rest — respond partially at best. They are a skin problem, not only a muscle problem.
- Volume loss in the cheeks, temples or around the mouth is not treated by relaxing muscle; that is what fillers address.
- Loose skin and jowls are not lifted by botulinum toxin. Beyond a certain point, only surgery changes them.
- Sun damage, pigmentation and skin texture are unaffected.
A consultation that promises botulinum toxin as an answer to all of the above is not being straight with you.
What does the evidence show?
Botulinum toxin for facial expression lines is among the most studied treatments in aesthetic medicine. A systematic review and meta-analysis by Rahman and colleagues examined efficacy and duration in upper facial expression lines with dose optimisation, published in the Aesthetic Surgery Journal in 2023.
The consistent findings across this literature are that it works for dynamic lines, that the effect is temporary, and that duration varies with dose and with the individual. That is the whole honest summary.
How is the treatment performed?
- Assessment. Your face is examined at rest and in movement — frowning, raising the brows, smiling. Muscle strength and asymmetry are noted. Medical history and medications are reviewed.
- Planning. Injection points and doses are marked according to how your muscles actually behave, not to a standard template.
- Injection. Very fine needles; the appointment usually takes fifteen to thirty minutes. Anaesthesia is not normally needed.
- Aftercare. Stay upright for several hours, do not rub the area, and postpone strenuous exercise and saunas until the next day.
- Review at two weeks. The effect is fully developed by then. Any small adjustment is made at this appointment.
What happens afterwards?
| Period | What is usual |
|---|---|
| Immediately | Small raised bumps at injection points, settling within an hour; occasional pinpoint bruising |
| Days 1–2 | No visible change yet; normal activity |
| Days 3–7 | Movement begins to soften |
| Week 2 | Full effect; review appointment |
| Months 2–3 | Effect stable |
| Months 3–4 | Movement gradually returns |
There is no downtime. Most people are treated and go straight back to work.
What are the risks?
- Bruising or swelling at injection sites, usually minor and short-lived.
- Headache in the first day or two.
- Drooping of the upper eyelid (ptosis) or of an eyebrow — uncommon, caused by spread to a neighbouring muscle. It is temporary but can last several weeks.
- Asymmetry, usually correctable at the two-week review.
- An unnatural or over-treated appearance where the dose is too high — an argument for starting conservatively.
- Dry eye or altered smile, depending on the area treated.
- Allergic reaction, rare.
Treatment is not given in pregnancy or breastfeeding, in certain neuromuscular disorders, or where there is infection at the injection site. The risks that apply to you are discussed before treatment and again during consent. Results vary between people and no specific outcome is promised.
What affects the price?
The number of areas treated and the dose required, which depends on muscle strength. No prices are published on this site; any figure quoted before an assessment is indicative only. See the Medical Disclaimer.
Can it be combined with other treatments?
Frequently. Botulinum toxin addresses movement; fillers address volume and contour; skin treatments address quality and texture. They answer different problems and are often planned together.
If your concern is the shape of your nose rather than the lines around it, that is a surgical question — see rhinoplasty.