Botulinum Toxin
Thank you for booking with The Clybaun Clinic!
Knowledge is POWER so let us explain your treatment in full
This is your information pack. We ask that you read this before attending your treatment and keep it as it contains your aftercare.
To the left you can scroll through the photos and see some before and after pictures of botulinum toxin. If you scroll down you will find all the information on your treatment, before care, after care, frequently asked questions, manufactures information and our clinic terms and conditions.
We use a range of botulinum toxin products in the clinic and your dedicated medical practitioner will help you chose which one is best for you.
Finance options coming soon. Please see our packages pages to see if you could save money by combining treatments
WHAT IS ? BOTULINUM TOXIN?
Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium Botulinum. In a purified form,; as is the case with many drugs/medications such as Penicillin, Botulinum toxin is a very safe, effective treatment not only used in cosmetic clinics, but also for a number of medical conditions, including migraine and excessive sweating.
All botulinum toxins are prescription only medicines (POM) and can only be prescribed by doctors, dentists and nurses with the prescribing qualification, following a face to face assessment and consultation with the qualified prescriber.
Botox® is a licensed brand of Botulinum toxin A. Other licensed brands include Azzalure®, Dysport®, Xeomin® Bocouture® .
Botulinum toxins contain albumin, which comes from human blood. No cases of contamination of licensed botulinum toxin products with infectious diseases have been reported.
How does it Work?
The toxin blocks the transition of chemical messages from the nerve to the muscle so that the muscle stays in a resting state for a period of 8 to 12 weeks on average.
This may be only a partial reduction in movement allowing some remaining movement or a full block in which case there is very little remaining muscular movement in the area – this very much depends on the amount administered and location of product placement –treatment may be tailored to suit your individual requirements. Your expected treatment outcomes and whether they can be achieved will be discussed at the time of consultation.
Used to Treat
The aim of the licensed treatment is to significantly reduce the movement of the muscles causing expression lines (dynamic lines) specifically the frown and crow’s feet and worry lines on the brow may also be treated as an ‘off label indication. Successful treatment may not cause the expression lines themselves to disappear completely. It may not ‘completely freeze’ the expression, particularly if extreme effort is exerted to make an expression.
Botulinum toxin is not suitable for lines present without expression (static lines), your practitioner will advise you.
Advanced and off-label indications include; horizontal brow lines, lip lines, chin ‘poppling’, muscles on the lower face and neck, to lift the mouth corners, improve the jaw line and the appearance of the neck. The ‘chewing muscle’ may also be treated to soften a square jaw or to prevent teeth grinding or jaw clenching at night.
How Long will it Last?
Results tend to last 3-4 months. Movement will begin recovering from 8 weeks. Frequent treatment at intervals of less than 3 months is not recommended. Repeating treatment when movement recovers will deliver optimum results over time. Frequency of treatments may be reduced according to the quality of your skin and your response to treatment. Should you choose not to maintain the results and not have further treatment, your muscles and skin will return to their pre-treatment state.
Does it Hurt?
A very fine needle is used and generally this treatment is not described by most as painful and can be well tolerated with no anaesthetic. Please request an anaesthetic cream or ice, if you are nervous about needles.
After Treatment
You are advised to keep the target muscles active for a few hours and to avoid lying down or leaning over for 4-6 hours.
After treatment it is expected that you will start to see an improvement within 3 to 5 days. For some people this may take longer. The full result may be judged at 14 days. You are invited to request a free review appointment between days 14-21 post treatment, should you so wish, where the success of the treatment may be assessed and discussed. After 21days the clinic will not provide adjustments.
BEFORE YOUR BOTULINUM TOXIN
- All make up will need to be removed prior to treatment, attend ‘fresh faced’ if possible. Contamination with makeup can cause infection.
- Taking the following within 72 hours of treatment may increase your risk of bruising – Alcohol, Aspirin, Ibuprofen, St. John’s Wort, Fish oils, Gingko Biloba, Vitamins C and E.
- Do cancel if you are at all unwell, even minor coughs and colds can increase your risk of post treatment complications.
- Treatment cannot be administered if there is an active skin infection, including acne or cold sores.
- Reschedule if you think you have or are developing a cold sore. Treatment around the mouth can trigger or spread cold sore infections. If you are prone to developing cold sores then it is important to inform your practitioner as they may wish to prescribe some prophylactic medication.
- Do contact the clinic to discuss any illness or new medicines prior to attending.
BOTULINUM TOXIN AFTER CARE
So you`ve had your botulinum toxin treatment what now ?
Thank you for choosing the Clybaun Clinic to have your treatment with. We endeavor to assure you have an excellent experience from start to finish and this aftercare advice has been devised from the frequently asked Do`s and Don’t`s of post treatment. Please understand this advice is to ensure you achieve optimum results and by not following your aftercare advice your desired treatment effects may be affected and you may incur unwanted complications. Should you have any concerns please contact a member of the team.
AFTERCARE ADVICE
Most people are able to continue with normal activities with immediate improvement in their appearance. Some will have some redness, pin prick marks, possibly swelling- particularly in the lips. Possibly bruising. Any swelling and bruising may be more apparent the day after treatment.
Make-up should not be worn for 12 hours’ and the skin should be kept clean, with normal cleansing. Do not use cleansing wipes which may irritate the skin.
Avoid extremes of heat or cold, sunbathing, vigorous exercise and massage (unless specifically asked to do so) on the day of treatment.
Avoid sun bathing and extremes of heat for 14 days as this has been shown to increase and prolong swelling.
You may experience pain after the anesthetic wears off this is normal as there has been trauma to your skin. You can take paracetamol if you feel the need to but avoid taking ibuprofen as it can cause swelling and bruising. The majority of any pain should settle after the first day and when the swelling starts to go down.
Bruising may take a few days to appear, arnica is often helpful to heal these bruises should you develop any. It is advisable to avoid aspirin, ibuprofen and alcohol for 12-48 hours after treatment. Tenderness should settle as swelling goes down.
Athletes should be aware some ingredients in the product may show a positive in ‘anti-dope tests’
Emergencies
There have been a handful of true anaphylaxis events arising from botulinum toxin , therefore it carries and extremely small risk of anaphylaxis (a severe allergic reaction) which in itself is life threatening and requires immediate medical attention. Clients have access to our 24 hour phone number (07809902432) should an emergency arise. However, as explained to you if you experience any shortness of breath, wheezing, coughing, difficulty speaking, swallowing, swelling of the tongue, eyelids, lips, hoarseness of the voice, stomach pain, nausea or diarrhoea you should ring 999 immediately do not wait.
Scroll down to find the answers to frequently asked questions and the recommendations you should follow.
- Is there anything I should not do after BOTOX®?
- How soon after BOTOX® can I go back to my normal exercise regime?
- Are there any possible side effects to BOTOX®?
- How soon can I drink alcohol after BOTOX®?
- Am I allowed to touch/wash my face after having BOTOX®?
- Are BOTOX injections long lasting?
- Can I keep having BOTOX®?
- What happens when BOTOX® wears off?
- Can I wear make-up after my BOTOX® treatment?
- What if my BOTOX® results are not what I expected?
- Can I fly directly after having BOTOX®?
- What should I do if I have any concerns after my BOTOX® treatment?
- Can I sleep after BOTOX®?
- How soon after BOTOX® can I have a facial?
- Can I/Should I move my muscles after treatment.
- Is there anything I should not do after BOTOX®?
BOTOX® is a quick and safe procedure which has very little impact on usual activity on the day of injection. To allow the BOTOX ®to work optimally in the target muscle, the following precautions are usually suggested:
- No touching or rubbing of the injected area for 6 hours after treatment.
- No facials or massage for 72 hours.
- Avoid skin irritants such as acids, vitamin A, C or E, Gingko Biloba, Garlic, fish oils, St. Johns Wort for 72 hours. It would be best to cleanse with a non-perfumed, antibacterial face wash.
- No strenuous exercise for 24 hours after treatment.
- Avoid excess heat environments, hot showers, sauna, steam room etc for 72 hours.
- Keep your head upright for at least 4+ hours — no lying down or bending forward.
- Avoid headwear across the forehead or injection sites.
- Avoid alcohol, ibuprofen or medically necessary blood thinning medication (unless doctor advised) 24 hours before and after the treatment to prevent bruising.
- How soon after BOTOX®can I go back to my normal exercise regime?
Normal daily activity can be resumed immediately following treatment. Light exercise can be performed after 6 hours but it is recommended that strenuous activities are avoided for 24+ hours.
After 4 hours you may perform light exercise such as:
- Walking
It is recommended that you wait 24+ hours before attempting any strenuous exercise, including:
- Weight training
- Cross training
- Long distance running
- Yoga (positions where the body is inverted)
- Are there any possible side effects to BOTOX®?
In most cases there will be no side effects to a treatment of BOTOX®. However, because everybody’s physiology is different, people can be affected in different ways. A small minority of people reported the following symptoms.
- Bruising / redness — For the majority of patients, the area of injection will appear no different. For a small minority, some minor bruising may occur.
- Bumps / swelling — A few minutes after treatment small bumps may be visible on the skin. These will disappear within a few hours.
- Headache — True BOTOX® allergies are exceedingly rare. Temporary headache is the most commonly reported symptom following BOTOX® injection, though the numbers of patients who report headaches is very small compared with the amount of treatments performed. Any headache can be treated with usual painkillers but not ibuprofen.
- Infection — Not following the above instructions in section 1. can lead to skin, muscle or blood infections.
- Drooping eyebrow or upper eyelid — this is a temporary adverse effect and should correct itself in a few weeks its caused by product migration and must resolve itself.
These are the most common side effects, the full list of possible side effects can be found in your “Botox POM Patient Package Leaflet” also contained in this email.
Although emergencies involving botulinum toxin are rare all clients have access to our 24 hour phone number (07809902432) should an emergency arise. However, as explained to you if you experience any shortness of breath, wheezing, coughing, difficulty swallowing, swelling of the tongue, eyelids, lips, hoarseness of the voice, stomach pain, nausea or diarrhoea you should ring 999 immediately do not wait.
- How soon can I drink alcohol after BOTOX®?
We advise no alcohol 24 hours before and after treatment. This is because alcohol can thin the blood much like an aspirin and result in bruising.
- Am I allowed to touch/wash my face after having BOTOX®?
No. Your face will not feel overly sore or tender but your skin will need 72 hours to properly close the holes made by the injections or you risk causing infection. You can continue your normal skin care routine but no touching or rubbing of the injected area for 6 hours after treatment. No facials or massage for 72 hours. Avoid skin irritants such as acids, vitamin A, C or E, Gingko Biloba, Garlic, fish oils, St. Johns Wort for 72 hours. It would be best to cleanse with a non-perfumed, antibacterial face wash. Avoid excess heat environments, hot showers, sauna, steam room etc for 72 hours. Try to keep your head upright for at least 4+ hours — no lying down or bending forward. Avoid headwear across the forehead or injection sites.
- Are BOTOX®injections long lasting?
Although some people experience longer lasting results, scientific evidence shows that the effect of BOTOX® injections usually last 12-16 weeks. This can be affected by your lifestyle choices (diet, smoking, exercise etc), muscle/skin integrity and metabolism. The Botulinum Toxin named Botox has given the most effective, safest, long lasting results of all the toxins on the market. It is therefore more expensive but saves money and disappointment in the long run which is why we use it in our clinic.
- Can I keep having BOTOX®?
Yes. BOTOX® does not ‘build up’ or accumulate in your system. Recommended treatments are scheduled at about 12-16 weeks. Once the effects have worn off it is safe for you to top up treatments in the same area. It is also perfectly safe to have multiple treatments in different areas at the same time. However, having too frequent treatments can lead to the drug not working so we recommend you schedule every 12-16 weeks or when you start to notice movement again.
- What happens when Botox®wears off?
Once BOTOX® wears off, your muscles will function as they did before the BOTOX® treatment. This means that the wrinkles you smoothed or reduced will slowly begin to appear again; no new wrinkles will have been formed due to the treatment, you will simply be witnessing old wrinkles reappearing.
- Can I wear make-up after my BOTOX®treatment?
Yes. Ideally, avoid make up for as long as possible to stop the risk of infection (24 hours). However, some clinics advise mineral make up can be applied an hour after BOTOX®. But again, it is recommended that you do not apply too much pressure during these activities in order to ensure that the BOTOX® does not move from the treated area. If you can… avoid makeup for the rest of the day.
- What if my BOTOX®results are not what I expected?
BOTOX® usually develops over 3–5 days but takes two weeks to reach maximum effect, at which point you can book a review appointment to check technical and aesthetic results. No alterations will be made before two weeks or after 21days post treatment and are at the discretion of the accessing medical practitioner. You should be aware that sometimes botulinum toxin can; stop working over time; can need changed to a different product; can not activate fully/and or at all or have a reduced activation time and the reasons for these can be explained by your practitioner.
- Can I fly directly after having BOTOX®?
Yes. BOTOX® treatments are not affected by changes in altitude or cabin pressure so flying will have no adverse effects.
- What should I do if I have any concerns after my BOTOX®treatment?
Our practitioners are always available at the clinic if you have any concerns regarding the aesthetic outcome of your treatment. Please ring the 24 hour phone number in emergency (07809902432) this is an emergency line if your query is not an emergency please phone between clinic opening times.
- Can I sleep after BOTOX®?
BOTOX® injections should have little impact on usual day-to-day activity and will not affect your sleeping patterns. Although, to allow the BOTOX® to settle, you should avoid putting pressure on the injected area or laying on your front for around four hours, longer were possible.
- How soon after BOTOX®can I have a facial?
To allow the BOTOX® to settle in and begin working, it is recommended that you do not rub the treatment area for up to 6 hours after the procedure. This includes the gentle rubbing associated with a facial treatment. We advise not having a facial within 72 hours post-procedure.
15 . Can I move my muscles after the treatment?
Yes, after treatment you should continue to move your muscles as normal, Botox is attracted to this movement but we advise no excessive expressions so as not to move the product.
Manufactures Information
Allergan Botox
BOTOX® is indicated for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines); moderate to severe lateral canthal lines (crow’s feet lines) seen at maximum smile; moderate to severe crow’s feet lines seen at maximum smile and glabellar lines seen at maximum frown when treated simultaneously in adults, when the severity of these lines has an important psychological impact for the patient.
Like all medicines, BOTOX® can have side effects, although not everybody gets them. In general, side effects occur within the first few days following injection. They usually last only for a short time, but they may last for several months and in rare cases, longer. These adverse reactions may be related to treatment, injection technique or both.
Diffusion of botulinum toxin into nearby muscles is possible when high doses are injected, particularly in the neck area.
As expected for any injection procedure, pain/burning/stinging, swelling and/or bruising may be associated with the injection. Speak to your doctor if you are worried about this.
Adverse reactions possibly related to the spread of toxin distant from the site of administration have been reported very rarely with botulinum toxin (e.g. muscle weakness, constipation, difficulty in swallowing, food or liquid accidentally going into the lungs which in some cases may lead to pneumonia). Injection of BOTOX® is not recommended in patients with a history of dysphagia (difficulty to swallow) and impaired swallowing.
The chance of having a side effect is described by the following categories: Common – More than 1 out of 100 persons and less than 1 out of 10 persons. Uncommon – More than 1 out of 1,000 persons and less than 1 out of 100 persons.
Injections in the forehead for vertical lines
Common side effects are: Headaches, drooping eye lid, skin redness, localised muscle weakness, face pain.
Uncommon side effects are: Infection, anxiety, numbness, dizziness, inflammation of the eyelid, eye pain, visual disturbance, nausea (feeling sick), dry mouth, skin tightness, swelling (face, eyelid, around the eyes), sensitivity to light, itching, dry skin, muscle twitching, flu syndrome, lack of strength, fever. Injections in the fan-shaped lines from the corner of the eyes
Common side effects are: Swelling of the eyelid, injection site bleeding and/or bruising.
Uncommon side effects are: Injection site pain and/or tingling or numbness.
Injections in the fan-shaped lines from the corner of the eyes, when treated at the same time as injections in the forehead for vertical lines
Common side effects are: Injection site bruising.
Uncommon side effects are: Injection site bleeding and/or pain. The following additional side effects have been reported for BOTOX® since it has been marketed: allergic reactions, which can be serious (swelling of the face and airways, difficulty in breathing), loss of nerve supply to/shrinkage of injected muscle, respiratory depression and/or respiratory failure, aspiration pneumonia (lung inflammation caused by accidentally breathing in food, drink, saliva or vomit), chronic disease affecting the muscles (myasthenia gravis), blurred vision, difficulties in seeing clearly, slurred speech, strabismus (squint), numbness, tingling and pain in hands and feet, fainting, pain/numbness/ or weakness starting from the spine, drooping of the muscles on one side of the face, weakness of the face muscles, difficulty moving the arm and shoulder, decreased skin sensation, muscle pain, abdominal pain, diarrhoea, vomiting, loss of appetite, dry mouth, feeling sick, fever, different types of red blotchy skin rashes, feeling generally unwell, speech problems, itching, excessive sweating, hair loss, loss of eyebrows, decreased hearing, noises in the ear, feeling of dizziness or “spinning” (vertigo).
Allergic reactions, difficulties to swallow, speak or breathe, have been reported rarely when botulinum toxin type A has been used for other uses. Visit your doctor immediately if such signs develop after BOTOX® treatment.
If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor, pharmacist or dial 999.
BOTOX® should only be administered by medically qualified physicians with appropriate qualifications and expertise in this treatment and having the required equipment.
Too frequent or excessive dosing of BOTOX® may increase the risk of antibodies in the blood which may lead to failure of treatment with botulinum toxin when used for this and other conditions.
The aesthetic effects of BOTOX® last for an average of 3-4 months but will vary depending on the condition of the skin, area treated, amount of product injected, injection technique and lifestyle factors such as sun exposure and smoking. After treatment, please avoid extreme facial expressions, alcohol consumption and applying make up for 12 hours. Please avoid extreme sun exposure, UV light, freezing temperatures and saunas for 2 weeks after treatment.
Azzalure
Azzalure, 125 Speywood units, powder for solution for injection (botulinum toxin type A)
Read all of this leaflet carefully, before you start using this medicine, because it contains important information for you.
If you get any side effects, talk to your doctor, pharmacist or other healthcare practitioner. This includes any possible side effects not listed.
In this leaflet:
1. What Azzalure is and what it is used for
2. What you need to know before you use Azzalure
3. How to use Azzalure
4. Possible side effects
1. WHAT AZZALURE IS AND WHAT IT IS USED FOR
Azzalure contains a substance, botulinum toxin A, which causes muscles to relax. Azzalure acts at the junction between the nerves and muscle to prevent the release of a chemical messenger called acetylcholine from the nerve endings. This prevents muscles from contracting. The muscle relaxation is temporary and gradually wears off. Some people are distressed when lines appear on their face. Azzalure can be used in adults under 65 years to temporarily improve the appearance of any moderate to severe glabellar lines (the vertical frown lines between the eyebrows) and lateral canthal lines (crow’s feet lines).
2. WHAT YOU NEED TO KNOW BEFORE YOU USE AZZALURE
Do not have an Azzalure injection if:
• You are allergic to Clostridium botulinum toxin A or any of the other ingredients of this medicine (listed in section 6)
• You have an infection at the proposed site of injection
• You have myasthenia gravis, Eaton Lambert Syndrome or amyotrophic lateral sclerosis.
Warnings and precautions:
Talk to your doctor, pharmacist or other healthcare practitioner before you have the Azzalure injection if:
• You have any neuromuscular disorders
• You often have difficulty swallowing food (dysphagia)
• You find that you often have problems with food or drink getting into your airways causing you to cough or choke
• You have inflammation at the proposed site of injection
• The muscles at the proposed site of injection are weak
• You suffer from a bleeding disorder which means that you continue to bleed for longer than normal, such as haemophilia (hereditary bleeding disorders caused by deficiencies of clotting factor)
• You have had surgery on your face, or are likely to undergo facial or other types of surgery soon
• You have already had other botulinum toxin injections
• You had no significant improvement of your lines after your last treatment with botulinum toxin. This information will help your doctor or other healthcare practitioner to make an informed decision about the risk and benefit of your treatment. When you are treated with Azzalure, your eyes may become dry. Azzalure may make your eyes blink less often or produce less tears, which could harm the surface of your eyes.
Special warnings:
Very rarely, the effect of botulinum toxin may result in muscle weakness away from the site of injection.
When botulinum toxins are used at more frequent intervals than 12 weeks or at higher doses to treat other conditions, antibody formation has been noted rarely in patients. The formation of neutralising antibodies may reduce the effectiveness of treatment.
If you are seeing a doctor for any reason, make sure that you tell them that you have been treated with Azzalure.
Children and adolescents Azzalure is not indicated for subjects under the age of 18 years.
Other medicines and Azzalure:
Tell your doctor, pharmacist or other healthcare practitioner if you are using, have recently used or might use any other medicines, as Azzalure may affect other medicines, especially:
• Antibiotics for an infection (e.g. aminoglycosides, such as gentamicin or amikacin), or
• Other muscle relaxant drugs.
Pregnancy and breast-feeding:
You should not get Azzalure during pregnancy. Treatment with Azzalure is not recommended if you are breast-feeding. If you are pregnant or planning to become pregnant, or if you are breast-feeding, ask your doctor, pharmacist or other healthcare practitioner for advice before taking any medicine.
Driving and using machines:
You may experience temporary blurred vision, muscle weakness or generalised weakness following treatment with Azzalure. If affected, do not drive or use machinery.
3. HOW TO USE AZZALURE
Azzalure should only be administered by a doctor or other healthcare practitioner with appropriate qualifications and expertise in this treatment and having the required equipment. Your doctor or other healthcare practitioner will prepare and give the injections. The effect of the treatment should be noticeable within a few days after injection.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Azzalure can cause side effects, although not everybody gets them.
Ring 999 immediately if:
• You have difficulties breathing, swallowing or speaking.
• Your face swells or skin goes red or you get an itchy lumpy rash. This may mean you are having an allergic reaction to Azzalure.
Tell your doctor or other healthcare practitioner if you notice any of the following side effects:
For glabellar lines: Very common (affects more than 1 user in 10) • Redness, swelling, irritation, rash, itching, tingling, pain, discomfort, stinging or bruising at the site of the injection
• Headache Common (affects 1 to 10 users in 100)
• Tired eyes or dim vision, drooping of the upper eyelid, swelling of the eyelid, watering eyes, dry eye, twitching of muscles around the eye
• Temporary facial paralysis Uncommon (affects 1 to 10 users in 1,000)
• Disturbed, blurred or double vision
• Dizziness
• Itching, rash
• Allergic reactions Rare (affects 1 to 10 users in 10,000)
• Itchy and lumpy rash
• Eye movement disorder
Not known (frequency cannot be estimated from the available data):
• Muscle wasting • Generalised weakness • Fatigue • Flu-like symptoms
For lateral canthal lines: Common (affects 1 to 10 users in 100)
• Headache
• Swelling of the eyelid
• Bruising, itching and swelling around the eyes
• Drooping of the upper eyelid
• Temporary facial paralysis Uncommon (affects 1 to 10 users in 1,000)
• Dry eye
Not known (frequency cannot be estimated from the available data):
• Allergic reactions
• Numbness • Muscle wasting • Generalised weakness • Fatigue • Flu-like symptoms
Usually these side effects have occurred within the first week following injections and did not last long. They were usually mild to moderate in severity.
Very rarely, side effects experienced in muscles other than the ones that were injected have been reported with botulinum toxin. These include excessive muscle weakness, difficulty swallowing, due to coughing and choking when swallowing (if food or liquid enters your airway as you attempt to swallow, respiratory problems can occur, such as lung infections). If this happens, speak to your doctor or other healthcare practitioner immediately.
