TOX (XEOMIN®)

Botulinum toxin (commonly referred to as Botox, though this is just a brand name) - is a naturally occurring substance produced by bacteria. When injected, it relaxes the surrounding muscle. It works by blocking the release of a chemical, acetylcholine, which is responsible for the contraction of muscles, leading to a temporary and gradual reversible paralysis. This has the effect of smoothing out lines and wrinkles in the skin caused by facial expressions. Botulinum toxin is a prescription-only medicine that can also be used to treat several medical conditions. It can also relax overactive muscles such as with gummy smiles. Xeomin is TGNs preferred toxin as it is free from complexing proteins, meaning you are less likely to develop a resistance over time.

There are potential side effects such as bruising, headache, redness, slight swelling, and mild pain at the injection site - which all usually resolve within a few days. More serious yet rare side effects will be discussed during your consultation as part of informed consent.

Everyone is so different and this is not a cookie cutter treatment. As an advanced injector, TGN does not just follow the recommended pattern and dosage for every patient. A consultation with TGN is the only way to determine the exact units required. This will depend on the area you’re targeting and the size/strength of the muscle, combined with your desired result. Men, for example, generally require a greater dose. You may also require a "touch up" appointment where additional units are injected. Remember - we can always add more but we can't take it out! 

Again, this is not the same for everyone! On average. Lifestyle factors such as smoking, heavy cardio & even genetics play a part in reduced longevity. Generally speaking, the PEAK effect lasts around 6-8 weeks and then movement very gradually begins to return. It is unlikely you would have no movement for a whole 3 months, as often misunderstood. Most people re- treat every 3-4 months. Having more units will mean that the muscle has less movement & will generally last longer. If you prefer to retain some expression this requires less units, but will usually not last as long. 

The results of your treatment can take up to 14 days to take full effect. Usually patients notice a change in 4-5 days. It takes time for the muscles to lose strength and the lines to fade following treatment. Please wait until 14 days have passed before assessing if you are pleased with the results.

Your treatment will be tailored to your desires (less or more movement). Either way, treatment should never look “overdone” or weird - a lot of this is due to the injection pattern/location of injections too. TGN will assess your unique face & also take into consideration your preferences! (Minimal movement versus retaining more expression).

BoNT-A treatment is unsuitable if you have/are:

• Myasthenia Gravis 
• Allergy to Botulinum Toxin Neuromuscular disorder 
• Pregnant or breastfeeding 
• Allergy to human albumin
• Under 18 years old

(this list is non exhaustive)

Everybody’s pain tolerance is different! However, TGN has a few tricks up her sleeve to ensure a near painless experience -  with comfortable injection techniques taught by master trainers. She also uses the thinnest needles available & utilises preserved saline as opposed to normal saline (which does not have that burning/stining sensation!) Most people find tox treatment with TGN near painless & are pleasantly surprised.

• Thoroughly remove any makeup before your anti-wrinkle treatment to minimise risk of infection after treatment.
• Do not drink alcohol on the day before treatment as this can increase your risk of bleeding and bruising.
• Inform us of any medications you are taking, both prescription and over-the-counter.
• Fully disclose any previous or current health conditions during the consent process.
• Inform us if you have had any other aesthetic procedures in the past week (eg. dermal fillers, chemical peels, microneedling, IPL/laser treatment)
• Inform us if you have taken anti-coagulant medication, such as Warfarin or aspirin recently. 
• Do not take Ibuprofen, Fish oil, Ginko Biloba, St. John’s Wort and high doses of vitamin E for 7 days prior, unless prescribed.
• Ensure you have eaten & are well hydrated!

• Remain upright for 4 hours 
• Do not wear makeup on the area for 12 hours
• Do not rub the area firmly/apply pressure for 24 hours (e.g be gentle applying products & don't wear tight hats)
• No heavy exercise for 24 hours
• No saunas/sunbeds/steam rooms/excessive heat for 48 hours
• Inform TGN immediately if you are concerned about side effects
• Avoid facials, chemical peels, micro-dermabrasion for at least 14 days.
• Be patient with results! Full results take up to 2 weeks & mild asymmetries usually correct themselves in this time.

BoNT-A can prevent sweating under the armpits and the effects last up 6-9 months. It is important to first investigate any medical causes for hyperhidrosis with your GP. BoNT-A is injected into the skin, which enters the sweat glands and specifically blocks the nerve impulses to these. Other functions of the nerves such as the sensation of touch are not affected.

If your forehead muscle is more active on one side & causing a strong pull, then we may be able to soften a brow asymmetry slightly. However, most people do have some asymmetry (across the whole face) & unless significant (which would require surgical intervention to address) - it is important not to focus too much on minor small facial asymmetries as they are very normal!

Younger clients may seek treatment with a lower dose of BoNT-A to prevent static/"set in" lines in the future. They may also choose to have other treatments such as for TMJ pain or excessive sweating. Older clients can of course still have BoNT-A treatment! However treatments may need to be adjusted slightly - for example, some clients may need to avoid treating the forehead as this muscle may be supporting our eyes staying open wide. To experience the full benefit of wrinkle relaxing, skin tightening may be required for some clients. The right treatment is always assessed on an individual basis.

In rare cases, some individuals can develop a resistance to BoNT-A due to an immune response built over time. You can try to switch brands or have a break and hope that this helps. It is important to leave safe intervals between treatments (a minimum of 3 months). In even rarer cases, some individuals have a resistance to BoNT-A from the very beginning due to their existing antibodies. Other treatments such as PDO smooth threads, exomide therapy, PRP or skin boosters may help them to feel better about their skin. You may find that your toxin treatments do not look as great as before due to a loss of collagen/elastin & reduced skin quality (due to age, environment, lifestyle, genetics etc). We cannot simply treat with BoNT-A alone forever & ignore the skin itself - collagen boosting is required or the results will not look as they should.

 If you have a set budget please be aware that the recommended amount of units will give best results. If TGN feels that your budget will not match your expected results, you may be advised to return when you can afford the suggested amount (or advice treating fewer areas). During consultation we will discuss budget versus expected results together. The dose I suggest we use, is the bare minimum to achieve the desired result/ outcome - this is a basic, sound medical principle, and dropping that dose to suit your budget often means you’ll get less than ideal results or need retreatment sooner.