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Anti Ageing Treatments

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Anti Ageing Treatments

After an initial consultation we will work together to plan the best and most effective way to treat the areas that bother you. The consultation does not necessarily mean we will go ahead with treatment, this could be because we feel that the risks are too great due to medical or surgical problems, we feel that treatment done in our clinic might not make you feel better about your appearance.

Antiwrinkle injections are available to the upper face. We inject tiny doses of medication called botulinum toxin into the muscle layer just under the skin. The three main areas are the glabella (frown lines between your eyebrows), frontalis (horizontal lines across your forehead), and the lateral orbicularis oculi (crow’s-feet around your eyes). These lines are known as dynamic lines.

Anti Ageing Treatments Pricing

During the consultation, we will assess if you are a candidate for these injections but as a rule, we can inject:

  • The frown lines between your eyebrows
  • The horizontal lines on your forehead
  • The crow’s feet around your eyes and just below
  • The creases on your nose – bunny lines
  • Lip lines to create a smoother or upturned lip
  • Gummy smile – when you show more than 2mm of gum on smiling
  • Marionette lines – disappointment lines to help lift your corners
  • Chin to relax its position and smoothen it out
  • Bruxism – teeth grinding or clenching
  • Vertical neck bands
  • Hyperhidrosis – excess sweating under the arms, soles of feet or palms of hands

Anti Ageing Treatments Injections

Please note that a face to face consultation with our registered prescribing nurse will be required prior to this treatment.

One Area of Toxin

£150

Two Area’s of Toxin

£200

Three Area’s of Toxin

£250

Treatments Menu PDF

Botulinum Toxin

Widely known to others as ‘Botox’ has been used in the NHS for over 30 years, treating a wide variety of medical conditions such as eye squints, muscle spasm and bowel and bladder disorders, migraine and excessive sweating – it is a safe medication when used correctly. It became approved in the United Kingdom for aesthetic purposes in 2006.

Botox® /Vistabel®- they are the registered trademark of the company Allergan Inc. They were the company that pioneered botulinum type A for cosmetic use in the USA before coming over to the UK in 2006.

Azzalure®/ Dysport®- they are the registered trademark of the company Galderma, licensed for cosmetic use in 2009

The newest brand of toxin one the market is Xeomin® /Bocouture® they are the registered trademark of Merz Aesthetics licensed for cosmetic use in 2010.

Essentially, they are all the same drug – botulinum toxin, but can work ever so slightly different for different people. Differences can vary in time it takes to work, its longevity, tolerance building and how strong or natural your desired effect. Its good practice to know what has been used for you if you have had it before so we can assess what will be the better choice of toxin for you in the future.

Botulinum toxin type A is produced by the bacterium/protein Clostridium botulinum, it is an organism found naturally in our environment where it is largely inactive and is nontoxic.

How it works

When we look at our faces, we can see how strong a muscle is, by assessing how deep the lines are on our skin. The lines are only there because there is a muscle pulling or contracting underneath it. For instance, your forehead – when you raise your eyebrows the muscle in the forehead that goes as far back as your mid skull pulls up leaving the skin above it to ruckle up – very much like a roman blind. Botulinum toxin type A works specifically on muscle activity- over a period of a few days the toxin knocks out the acetylcholine ( a neurotransmitter) which is what is required for a nerve impulse to reach the muscle fiber, without the acetylcholine there isn’t a bridge for that impulse to reach and cause the muscle to move.

Over a period of 12 weeks the body natural mechanics will always alter what was changed and will start to rebuild and release more acetylcholine and the bridge is slowly rebuild causing muscle movement to return. Some people can rebuild this protein quicker than others and may find that they need more regular injections to keep the desired smooth look if that’s what they want. This can depend on how much toxin vs how strong the muscle was in the first place and by metabolism. If you regularly exercise your body will reproduce acetylcholine quicker.

Skin Repair

After having treatment with either dermal fillers, toxins and other skincare regimes and treatments, the skin texture can change and look smoother and more youthful because the lines have been softened. In time the lines can disappear altogether, this is because we have allowed the skin to rebuild in these lines, collagen and elastin are the building blocks to our skin and when the skin is rested the skin can rebuild and you can be left with a smooth youthful area of skin. It can be noted also that the skins oils excretion can settle too in areas of toxin treated skin as the muscle activity reduction has also influenced how much oil is secreted to the skin. This is not an assurance, but many people do notice a marked improvement in this area.

F.A.Q

How soon will I see results?

After your injections and dependent on the product used you can start to see a difference from 3 to 5 days and will continue to improve up to day 14 when the drug is at its peak, this is when we will call you back to assess your outcome and decide if you require a free top-up injection.

How long does it last?

This varies from person to person but usually 3-4 months.    Results don’t just disappear overnight but gradually you will notice movement returning.  This can be expedited by consistent muscle activity – ie trying to move the relaxed muscles or by your own metabolism, generally people who do regular physical activity have increased metabolism and may find results disappear quicker.  Your wrinkles will not be worse after the toxin has fully worn off; they will return to how they were before your treatment.

Improved results can be seen by having multiple cycles of toxin injections because the muscle is not as strong as it was before your last treatment, as your skin is less creased, and the wrinkles are not being reinforced. We advise to book your subsequent injections at around three months post injection.
Insert chart

Free no obligation Consultation

If we haven’t met you before or it’s been more than 6 months since your last session with us you will need to meet Immacolata at Notaro Aesthetics so she can prescribe your toxin. This is a legal requirement as we are working with a prescription-only medication. Once we have gone through a thorough medical history and we agree toxin will be used, we will need to send off your prescription, in some cases the toxin can be delivered the next working day. But we will generally book you in for another day that is convenient for you to return to have treatment.

We cannot legally hold the medication in stock such as doctors can do. But this also gives you the opportunity to weigh over your options, to balance the risk vs benefit to the procedure and to ensure that this is the right course of treatment to go through with. Some also feel better about this as they do not feel pressurised into deciding there and then as they may feel awkward about saying no.

When you make your next appointment for your return visit, we will assess whether or not you need a new face to face consultation – if nothing has changed regarding your medical status and no adverse effects from your previous treatment we can order in your toxin in advance of your next appointment.

Follow up appointments

Follow up appointments are not always needed, however, if this is your first time having these injections, we would like to see you back in clinic at 2 weeks, just so we can assess how well the product has taken and to assess how you feel about your new look.  We will be in contact with you and your more than welcome to return to the clinic for a review, if required we will give you a top-up or tweak as part of the original price.  

Risks and side effects

There is a very rare chance that you can be allergic to the toxin itself, some people can however be allergic to some products such as local numbing cream is used, we generally do a small patch test first.
Some side effects generally are down to the injection procedure itself rather than the product, such as redness and swelling at each of the injection sites which generally disappear after a few hours. Bruising can occur if a little vessel is hit with the needle, some steps can be done to help reduce bruising if you are prone to bruising due to medications or medical conditions. This can be as easy as avoiding some home remedies the week prior to the treatment. Avoiding medications such as aspirin, ibuprofen, and herbal remedies and oils such as ginsing, cod liver oil, flaxseed/oil, vit A and E as these can increase the risk of bruising.

In rare cases infection at the injection sites can occur but reduced greatly by following the after-care advice such as basic personal hygiene.

Headaches and flu-like symptoms have been reported by some following the few days after injection, paracetamol can help with this.

Eyelid ptosis (droopy eyelid) is very rare and generally down to misplaced toxin injection. There are some eye drops that can be prescribed to help with this should it occur.

Heavy brows – Some people request that only their forehead is treated as they don’t feel the lines between their eyebrows need treating, although this may be the case we strongly advise not to treat these lines on their own because you can become very brow heavy. The frontalis muscle that creates the horizontal lines on the forehead is responsible for keeping your eyebrows raised (elevator muscle), if we stop its main job then you will have low brows on both sides. By treating the glabella complex (depressor muscles) with the frontalis it creates a beautiful balance between the two without the ‘heavy’ look.

Spock brows – occasionally if we miss an area to the side of the frontalis it’s very easy to have some extra lateral pull up at the tail end of the eyebrows creating an odd arch – much like Spock from Star Trek. This is very easily treated with a tiny dose of toxin to relax that odd raise.

After care advice

For the 4 hours after toxin treatment, it is advised:

  • Not to touch the injection sites
  • Don’t apply makeup
  • Stay upright

Toxin ?!?! isn’t that dangerous?

It is a neurotoxin made by the gram-positive bacilli Clostridium Botulinum.

Botulinum toxin has been used in the NHS for over 30 years and is a very safe medication when used correctly and in the tiny doses we are dealing with.

How does toxin work?

Botulinum toxin is injected into the muscles to reduce its activity and therefore stops the skin creasing lying on top. It works by preventing the nerve signal reaching the muscle by prohibiting the chemical acetylcholine (naturally made in our cells) from being released, this chemical is the bridge in which the signal needs to cross to reach the muscle. Without the bridge the signal cannot reach the muscle therefore no muscle activity creating smoother looking skin.

What’s the difference between toxin injections and dermal fillers?

Botulinum injections work on the deactivation of muscle activity. No movement can result in smoother-looking skin as the skin is no longer being folded.

Dermal fillers are a medical device containing hyaluronic acid which is a natural substance already in our skin. It is injected into the skin to lift and plump it to create volume where it has been lost.

How long does toxin take to work?

Some people can feel the start of toxin treatment working in as little as two days, but on average it takes up to 14 days to see the full effect.

Does it hurt?

The injections are given with a very tiny thin needle, you may feel the initial pinch as the needle pierces the skin and tiny bit of pressure as the dose is injected but it shouldn’t hurt. Most people manage this sensation without numbing agents. However, if this is something that really bothers you, we are happy to provide a small amount of local numbing cream to the areas being treated.

Where can I have toxin injections?

During the consultation, we will assess if you are a candidate for these injections but as a rule, we can inject:

  • The frown lines between your eyebrows
  • The horizontal lines on your forehead
  • The crow’s feet around your eyes and just below
  • The creases on your nose – bunny lines
  • Lip lines to create a smoother or upturned lip
  • Gummy smile – when you show more than 2mm of gum on smiling
  • Marionette lines – disappointment lines to help lift your corners
  • Chin to relax its position and smoothen it out
  • Bruxism – teeth grinding or clenching
  • Vertical neck bands
  • Hyperhidrosis – excess sweating under the arms, soles of feet, or palms of hands

I’ve heard people can be left with weird eyebrows, why is that?

As not everyone is as anatomically perfect as a textbook, we can get it wrong occasionally.

If the toxin wasn’t injected into all the desired areas, the muscle activity will remain and can create a pull above the tail end of the eyebrow creating a “Spock brow”. This can be very easily treated with a tiny bit of toxin above the pointy brow bit!

I’ve heard you can end up with a droopy eyebrow or lid!

Occasionally yes, this can be an effect of too much toxin, or the toxin being diffused into the muscles it wasn’t intended for.

This can occur if you didn’t follow the after-care instructions or because the toxin was injected a little bit too low.

We can help if this happens to depend on what muscle has been affected. We can add a little bit of toxin to the eyebrow to give it a lift. Or provide you with eye drops to open the eyelid if the problem sits with the lid.

The toxin treatments don’t last very long and the worst of these effects only lasts around two weeks with the aid of muscle stimulation activities.

What are the other side effects of toxin injections?

The most common and desired effect is muscle deactivation. Very occasionally other muscles can be affected too, see above.

Reactions around the injection site such as pain, tenderness, itching, swelling or bruising are common – most of these disappear before leaving the clinic except bruising may take a week or so to resolve.

Patients who are particularly nervous could experience generalised reactions such as fainting, circulatory problems, nausea, or noises in the ears. Relax we will assess you and make sure you leave the clinic well and at ease. Everyone can be afraid, but we won’t push you into anything you don’t want to do.

Occasionally some clients can get a headache or flu-like symptoms after their injections, these settle after a few days. No one really knows why the flu-like symptoms, but we have had a few.

What if I don’t like the effect of my toxin treatment?

Occasionally you can be left with an uneven result, but don’t worry, we are happy to review you on day 14. This is so we can assess the movement you have and make a few alterations. But once the toxin is injected, we cannot reverse it.

How long does it take to do a toxin treatment?

In general, the injections take no longer than 10 minutes but for a first-time client we suggest 45 minutes for your pre-treatment consultation.

Will I need a consultation?

Yes, you will need to come for a pre-treatment consultation to take a full history etc, and to order your toxin in. You will need to make a second appointment for your treatment. This gives you enough time to make an informed decision about whether this is the right treatment for you.

How much is it?

Your toxin injections are charged per muscle group, starting from £150 and £50 per additional area on top. If you need a top-up at review this is part of the original cost.

Other toxin treatments such as vertical neckbands cost £300 and hyperhidrosis will cost £350.

Will I look worse when it wears off?

No, you won’t look any worse than you did before your treatment. As the nerve cell starts to re-release acetylcholine, the muscle activity will slowly begin to reactivate, providing you with a slow gradual change to your skin, eventually, you will be back at what you were before the treatment, but no worse.

Why haven’t all my lines gone?

Toxin injections only work on lines affected by muscle activity or dynamic lines how we like to call them.

Toxin won’t be able to get rid of a line that has been deeply etched into the skin caused by super strong muscle movement over many years, we can soften them, but we can’t promise they will totally disappear. With repeat treatments before all muscle activity is returned you can get a much softer appearance, or we could advocate a different treatment option.

What if I’m allergic?

It is very unlikely you will be allergic to botulinum toxin, but we can never say never.

However, if you were to take ill in clinic rest assured, we are two very experienced nurses in emergency and acute care field and are fit to deal with an emergency.

My wrinkle free skin didn’t last very long!

Everyone is different, but the average person sees movement returning between month 2-3.

Depending on your metabolism or degree of physical activity you do, you may find your toxin treatment burns off quicker than someone with a more sedentary lifestyle.

What shouldn’t I do after my treatment?

Most people can resume normal activity straight away as there is very little downtime, but we suggest you leave the area treated alone for a few hours to reduce the risk of infection.

We suggest for 24 hours no vigorous exercise, drinking alcohol, or exposed sun exposure succeeding your injections.

Who can’t have toxin injections?

  • A pregnant or breast-feeding woman cannot have treatment.
  • Patients with neurological diseases such as Myasthenia Gravis, Eaton Lambert Syndrome or Parkinson’s.
  • People with hypersensitivity to human albumin, sodium chloride.
  • Patients on a course of antibiotics.

Can I fly after toxin injections?

Yes you can.

How long do I have to wait before my next injections?

You will have to wait 12 weeks between fresh injections, having more often can increase your risk of becoming desensitised.

What happens if it doesn’t work?

Very rarely client’s treatments don’t work, but sometimes people can become desensitised either because of their genetics or because you’ve had it too often. If this is the case, we can try you with a different brand of toxin.

Can I have other treatments after my injections like peels, needling or semi-permanent makeup?

Yes, you can have a peel immediately after a filler or toxin injection as long as it’s done by the same practioner. If you choose to have micro-needling or derma abrasion its best to wait a few days before getting your treatment.

If getting a treatment of filler or toxin by another clinician wait until your skin has stopped peeling before having your treatment.

It is fine to get a peel or micro-needling/derma abrasion before toxin or filler treatment.
Semi-permanent makeup and treatments ideally should be done first. This is because having the tattoo first can give you a lovely shaped eyebrow at natural rest and the toxin injections will just bolster the result.

Having an eyebrow lift with either toxin or filler before having the tattoo gives the tattooist or beauty technician a newly symmetrical face after two weeks, but to remain symmetrical you will need to keep up with toxin /filler injections – your finances will have to be considered. This is because as your face returns to a normal resting position i.e. the toxin has worn off your eyebrows could look a bit uneven/symmetrical.

If you do choose to have semi-permanent, make up such as lip line or eyebrows you should wait 2 weeks before having your filler to ensure you’re fully healed.