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16th November 2022

Your Ultimate Guide to Getting Cosmetic Botox in 2023 and Beyond

Last Modified: May 29, 2023

Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium botulinum. There are currently two different types of botulinum toxin commercially available in the UK: Type A toxin: Botox (Vistabel), Dysport (Azzalure) and Xeomin (Bocouture) and Type B toxin: Neurobloc.

Botulinum toxin A is approved for cosmetic use and botulinum toxin B is used for various types of muscle disorders.

The focus of this blog is, of course, on the latter.

Accidental Discovery of Botulinum Toxin Type A

Botulinum toxin type A - or Botox as it is now commonly known - was not always the magic eraser for fine lines and wrinkles.

In fact, ophthalmologist Jean Carruthers, MD, FRCSC, FRC, had come across Botox's smoothing potential rather by accident in the late 1980s when she was treating a patient for eye spasms.


As she injected a nerve to calm her patient's erratic eye movements, Dr Carruthers noticed that the patient's forehead looked remarkably wrinkle-free.

Surprised and intrigued, she told her husband, dermatologist Alastair Carruthers, MD, PhD, DSC, FRCSC, FRC.


The husband-wife duo soon began collaborating on further research and testing, and were among the first doctors to formally document the anti-ageing benefits of Botox.

Their findings were published in an issue of the Canadian Journal of Ophthalmology in 1989 and immediately caught the attention of Hollywood's most famous A-list celebrities.


Word of Botox spread quickly and before long, it was Hollywood's best-kept beauty secret. Over the next three decades, Botox continued to evolve and improved, eventually making its way into mainstream beauty routines around the world.

Today, Botox is one of the most popular and trusted injectables on the market. More than 900,000 Botox treatments are performed each year in the UK.


You have Dr. Carruthers' accidental discovery to thank for that.


"I could never have predicted the impact Botox would have on our profession and on the lives of millions of people," says Dr Carruthers. "I guess I must have really been on to something!"


These days, Dr. Carruthers has her hands full as a practicing dermatologist, researcher, and professor at the University of Toronto.

But she still gets excited about the latest advances in the field of dermatology, which she hopes to bring to a wider audience through her writings and public lectures.


"I want to share my knowledge with others," says Dr. Carruthers. "I want to reach and educate as many people as possible."

Still, there's a lot to know about this injectable before you go under the needle.

If you have ever wondered about the ins and outs of Botox - including injection options, pricing, and potential risks - this is your guide.

What Is Botox Made Of?


Botox is the brand name of the first injectable neurotoxin - so in a way, it has become synonymous with the treatment- but there is more than one company that makes the product.

Before we get to that, however, we should first answer the frequently asked question: What exactly is botulinum toxin type A?

Scientifically speaking, it is a naturally occurring molecule derived from a bacterial culture and has been purified through a series of acid precipitations into a crystalline complex containing the toxin and other proteins.


Botox works by inhibiting the release of a neurotransmitter called acetylcholine, which is responsible for transmitting nerve signals to muscle fibres.

Acetylcholine is released by neurons and travels across the synapses between neurons and muscle fibres, where it causes the muscles to contract.

Injecting Botox into the skin blocks the release of acetylcholine, preventing the contraction of muscle fibres under the skin. As a result, the muscles relax and the wrinkles seemingly fade away.

What are the benefits of Botox?

As you probably know, there are two types of wrinkles: static and dynamic. The target of Botox is specifically dynamic wrinkles, which are caused by the contraction of muscles that are attached to the overlying skin.

Each muscle contraction causes the skin to bunch together and form lines between the muscle strands. The most common locations dynamic wrinkles form are between the eyebrows, forehead wrinkles and on the cheeks near the outer corners of the eyes, known as 'crow's feet'.

It follows that weakening these muscles can reduce the severity of facial wrinkles or even prevent them altogether if muscle-weakening occurs before the wrinkles form.

But that is not all it can do. Botox has many other functions. While the most popular use is to minimise muscle contraction (and therefore dynamic wrinkles), there are several amazing off-label applications.


These include treating excessive sweating (hyperhidrosis), reducing a gummy smile, softening and slimming a wide jaw, and minimising the side effects of migraines.

It is injected into the jaw to treat TMJ pain due to teeth grinding, prevent an overactive bladder, reduce eyelid twitching (also known as blepharospasm), and temporarily correct eye muscle disorders.

As always, it is best to talk to your medical aesthetician about the treatment options that are right for you.

Different Brands of Botox


While we are referring to Botulinum Toxin A under the brand name BOTOX®, which is manufactured by Allergan, there are other options you can consider: In the UK there are 3 commonly used brands, namely Botox (Vistabel), Bocouture (Xeomin) and Azzalure (Dysport).

What is the difference between the three?

The active ingredient - botulinum toxin A - is the same, but the protein structure of each is slightly different. Xeomin, for example, is considered a purified form with no added proteins.

Many injectors have reported that Azzalure diffuses slightly more - meaning it can cover a larger surface area, useful for places like the forehead.

The good news is that regardless of the brand (as long as the product is approved by MNRHA), this is a tried-and-true method.

At Dr Aesthetica, we use Botox and Azzulure, with the actual decision coming down to what we feel will give the best and most consistent results for the patient's specific needs

To learn more, you can read our post: Botox vs Azzalure.

Does Botox Hurt?

As many of us experience pain differently - what might be an unpleasant pinch for one person may feel like needles stabbing another - it's best to speak to your injector before having injections.

If you are particularly sensitive to pain, request them to apply a numbing cream to the area before the injection.

That being said, apart from slight discomfort, Botox is usually not painful when it's done correctly.

How Much Does Botox Cost?

Generally, the cost is calculated either per unit (i.e. how much of the actual Botox fluid you need) or by the area to be treated, although, in the UK, the latter, a flat rate pricing model is more common.

The actual cost will also be influenced by the location and experience of the injector.

The more experience an injector has - and the bigger the city they live in - the more money they will charge for their service.

Here in the UK, the cost of botulinum toxin injections varies from £150 to £450 for treatment of a single area, including consultation and in some cases a touch-up after two weeks.

How Long Does Botox Last?

After a Botox treatment, you usually have to wait 1-2 weeks before you see results. The wrinkle-relaxing effect then lasts for three to four months.

This means that you only need 3-4 treatments to have fewer and finer wrinkles all year round.
The length of time the effect of Botox lasts also depends on which area has been injected.

In areas with more motion, the faster the Botox fades away.

Some people get longer-lasting results - this means that genetics also play a role (i.e. how quickly your body breaks down the Botox).

How long the smoothing effect lasts also depends on the area injected and the specific dosage.

There are some studies that show that the longevity of Botox results increases when you use more units.

Though we have to be wary of this school thought, as we all know too well the outcome of overdone Botox.

It is important to have your next treatment before the effect of the previous treatment wears off, otherwise, the preventive effect of Botox, especially the improvement on static wrinkles, will be lost.

Book Your Botox Treatment With Dr Aesthetica

A qualified injector will provide a well-executed Botox injection treatment to your face, taking into account factors such as facial asymmetry, the frequency of certain facial expressions, your occupation and social activities, and what you hope to achieve. Achieving good results with Botox injections requires a steady hand, attention to detail and advanced knowledge of facial anatomy.

Dr Baldeep Farmah has been consistently rated as one of the best cosmetic doctors in Birmigham, UK. When it comes to your appearance, Dr Farmah understands no two patients are the same. He is committed to achieving results that are uniquely tailored to you, rather than an 'off the peg' approach.

Having performed hundreds of procedures, he has the highest possible level of knowledge and skill. He is also an accredited trainer for medical aesthetic treatments in the UK.

If you would like to learn more about what Botox can do for you, contact Dr Aesthetica on 0121 769 0242 or [email protected] to schedule a complimentary consultation.

Post Reviewed by: Dr Baldeep Farmah
Medically Reviewed on: 16th November 2022
Dr Baldeep Farmah is the Medical Director and lead Doctor of Dr Aesthetica, a Medical Aesthetic Clinic.

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