Botox is a non-surgical treatment in which small doses of botulinum toxin type A are injected into the expression muscles to reduce their contraction temporarily. It is used to soften forehead lines, frown lines between the brows and crow's feet.
This page explains how botulinum toxin works, which areas are treated, how the procedure is carried out and what to bear in mind afterwards.
What is Botox?
Botulinum toxin is a protein that temporarily blocks the signal transmitted from the nerve ending to the muscle. When applied to the expression muscles, the muscle contracts less and the "dynamic" lines that appear with contraction soften. The effect wears off on its own within a few months.
Deep, established lines that are visible even when the face is at rest may not respond to toxin alone; in that case additional treatments such as filler are considered.
| Area | Target muscle | Expected effect |
|---|---|---|
| Forehead lines | Frontalis | Softening of horizontal lines |
| Frown lines (glabella) | Corrugator and procerus | Reduction of vertical "angry" lines |
| Crow's feet | Outer fibres of orbicularis oculi | Reduction of the radiating lines that appear when smiling |
| Bunny lines | Nasalis | Reduction of lines on the side of the nasal bridge |
| Chin | Mentalis | Reduction of the dimpled "orange peel" texture |
| Neck bands | Platysma | Softening of vertical bands |
Who is a candidate?
- People with forehead, frown or crow's-feet lines that become prominent with expression
- Those looking for a short, non-surgical treatment
- No active skin infection at the injection site
- Not pregnant or breastfeeding
- No condition affecting neuromuscular transmission
The licensed indications of botulinum toxin products vary by product and country; this page is for general information only.
How is the treatment performed?
The treatment is carried out in the practice and takes 10–20 minutes.
- Assessment: which muscles create lines during expression is observed; injection points are marked.
- Preparation: the skin is cleaned; numbing cream is applied if wished.
- Injection: small doses are placed at the marked points with a very fine needle.
- Afterwards: no pressure or massage on the area; the patient returns to normal activities the same day.
- Review: once the full effect has settled, usually at 2 weeks, a small top-up is given if needed.
Published meta-analyses report that botulinum toxin gives clear improvement in frown lines compared with placebo, with a side-effect profile that is generally mild and temporary.
How does the effect develop?
The times below are typical ranges; they vary with the person, the area and the dose, and are not a personal guarantee.
| Period | What to expect |
|---|---|
| Treatment day | Small bumps and redness at the injection points, gone within 30–60 minutes |
| Days 3 – 7 | Muscle movement begins to decrease |
| Week 2 | Full effect; top-up if needed |
| Months 3 – 4 | Muscle movement gradually returns |
| Months 3 – 5 | Effect wears off; repeat if wished |
What are the risks?
The list below is not exhaustive; individual risks are discussed at the consultation and during the informed-consent process. Side effects are mostly mild and temporary.
- Redness, bruising or mild pain at the injection site
- Headache or a flu-like feeling in the first days
- Temporary drooping of the brow or eyelid (spread of toxin to a neighbouring muscle)
- Asymmetry, less or more effect than expected
- Rarely, an allergic reaction
- Rarely, loss of effect with repeated treatments (antibody formation)
How is the decision made?
At the consultation the lines that form during expression, muscle strength, brow position and facial symmetry are assessed. Whether toxin alone will be sufficient for established lines is discussed.
The treatment plan sets the areas and doses so that expression is preserved. The 2-week review after the first treatment helps to fine-tune the dose for subsequent treatments.
The information on this page is for general guidance only and does not replace a medical consultation. Whether botulinum toxin treatment is suitable for you can only be determined after an in-person examination.
