What is BOTOX®?
BOTOX® is a muscle-relaxing toxin extracted from the bacteria Clostridium botulinum. It is a safe and effective technique for the treatment of the wrinkles and unsightly facial lines that are caused by over activity of facial muscles (eg: frown lines, horizontal forehead furrows and “crow’s feet” around the eyes). It is made by a company called Allergan and is also known as Botulinum Toxin Type A.
How is BOTOX® administered?
BOTOX® is administered by injection into the overactive muscle or the skin overlying it. The injections only take a few minutes. Usually no anaesthetic is required and very little, if any, pain or discomfort is felt.
How does BOTOX® work?
BOTOX® works by temporarily and partially weakening the muscle injected. As a result of this the face adopts a more relaxed and pleasant appearance and the wrinkles/lines become smoother or disappear altogether.
How quickly is the effect of BOTOX® seen?
Following injection the initial effects of treatment become apparent within 2-3 days, the maximum effect usually being reached by 1-2 weeks.
How long does the effect of BOTOX® last?
On average each treatment with BOTOX® will last 3-6 months. In some patients the effect may last for a longer or shorter period. It gradually wears off and the muscle weakness reverses.
How often do I need to have treatment?
On average every 3-6 months if a continued effect is required. Some patients prefer to undergo further treatment before the toxin wears off so the initial correction is maintained.
Can anyone have BOTOX®?
Treatment with BOTOX® is contraindicated if you are pregnant or breastfeeding. It is not advised for patients with some neuromuscular and blood coagulation disorders or those with pre-existing muscle weakness or paralysis. Some drugs may also prevent a patient receiving BOTOX®.
Are there any side effects?
Side effects can occur, but are usually minor and almost always reversible. They have been reported in 1% patients. They include bruising, swelling at the injection site, mild pain, headache and under or over correction. Rarely drooping of the eyelid may occur which usually only lasts for a week or so.
What aftercare is required?
Following BOTOX® injection patients are advised to refrain from touching the treated area and to remain upright for 3-4 hours. The toxin works better in active muscles so the treated muscles may be used. Most patients return to work following treatment and resume normal activities. All patients will be provided with an aftercare sheet.
Is BOTOX® safe?
Yes. In 2004 safety data from a 15-year retrospective study was presented at the American Academy of Dermatology summer meeting. 99% of patients reported no adverse effects following treatment with BOTOX®. The adverse effects reported by 1% of patients studied were not rated, by the patients, as severe and all were temporary. They included bruising, injection related pain and eyelid droop. The risk of adverse events did not increase with the number or frequency of treatments. Other studies have reproduced similar findings.


What is a Filler?
A filler is a substance that is injected into the skin to correct and smooth lines, wrinkles and folds. As it is injected into the part of the skin known as the dermis the fillers may also be referred to as dermal fillers. They are also used for lip and cheek enhancement and for shaping other facial, hand and neck contours.
The Juvéderm® VYCROSS® Collection
The Juvéderm® VYCROSS® Collection (VOLIFT® Retouch, VOLIFT®, VOLBELLA®, VOLUMA®, VOLITE® and VOLUX®) are sterile gels consisting of non-animal hyaluronic acid. They are made by a company called Allergan and each syringe of filler contains local anaesthetic to reduce/prevent any pain or discomfort from the injections themselves. They are used to fill out or plump up lines on the face, hands and neck that have been created by the ageing process. By restoring volume to these areas the skin will look smoother and softer resulting in a fresher and more youthful appearance. The site to be treated will determine which of the VYCROSS® Collection products are used.
What is hyaluronic acid?
Hyaluronic acid is a natural polysaccharide, (complex carbohydrate), which is found in all tissues in the human body. It is identical in all living species. Nearly 60% of the body’s hyaluronic acid is found in the skin where it acts to provide volume and fullness. As the amount of hyaluronic acid decreases with age it is not surprising that the results of this loss are seen most noticeably in the skin with the appearance of lines, wrinkles and folds.
How is the Juvéderm® VYCROSS® Collection administered?
The Juvéderm® VYCROSS® products are injected into the skin. Each syringe has a local anaesthetic incorporated into the syringe which reduces/prevents any pain or discomfort from the injections themselves. The injection technique used will depend on the area being treated.
How do the Juvéderm® VYCROSS® Collection fillers work?
The Juvéderm® VYCROSS® Collection are volumisers. They replenish the hyaluronic acid lost from the skin as part of the ageing process.
How quickly is the effect of Juvéderm® VYCROSS® Collection seen?
The effects of Juvéderm® VYCROSS® Collection treatment are visible immediately and continued improvement can be seen up to 4 weeks after the procedure. However there may be some injection related redness and swelling that could take a day or so to settle (a little longer with lip treatments).
How long does the effect of Juvéderm® VYCROSS® Collection last?
Depending on the area treated, skin type and the injection technique the effect of treatment with the Juvéderm® VYCROSS® Collection products can last up to 12-18 months. In some cases the duration of the effect can be shorter or longer.
How often do I have to have treatment?
On average every 12-18 months. Some patients prefer to undergo further treatment before the filler has worn off to maintain the initial correction.
Can anyone have Juvéderm® VYCROSS® Collection treatment?
You should not receive treatment with Juvéderm® VYCROSS® Collection if you are known to be allergic to any of its ingredients including the anaesthetic (lidocaine), if you are pregnant or breastfeeding or if you are undergoing laser or chemical peel treatments. If you suffer from facial herpes (cold sores) the needle puncture from the injection may precipitate a recurrence of the cold sore. Pre-dosing with aciclovir (Zovirax®) or an equivalent agent is advised. Some drugs may also increase the risk of bruising after the injections.
Are there any side effects?
Side effects can occur, but are usually minor and almost always reversible. Common injection related reactions might occur, such as swelling, redness, bruising, pain and very occasionally a temporary lumpy feeling at the implant site. They typically resolve spontaneously within 1-2 days after injection into the skin and within a week after injection into the lips.
What aftercare is required?
Very little aftercare is required after Juvéderm® VYCROSS® Collection injections. Most patients return to work immediately after the procedure but some may need a little cover up to conceal any injection related redness. All patients will be provided with aftercare information
Are the Juvéderm® VYCROSS® Collection fillers safe?
Adverse effects are very rare so much so that no allergy test is required before the use of these products. Hypersensitivity reactions can occur but these are extremely rare.