What are anti-wrinkle injections?

Anti-wrinkle injections use a purified botulinum toxin type A to temporarily reduce the activity of selected facial muscles.

When certain muscles contract repeatedly over time, they create expression lines such as frown lines, forehead lines and crow’s feet.

By relaxing these muscles, the skin above them is able to smooth, resulting in a softer and more refreshed appearance.

The aim isn’t to remove every line or eliminate facial movement. My goal is always to achieve a natural result that still looks like you.

Which areas can be treated?

The most common treatment areas include:

• Frown lines (between the eyebrows)

• Forehead lines

• Crow’s feet

Depending on your assessment, anti-wrinkle injections may also be used for:

• Brow lift

• Bunny lines

• Lip flip

• Chin dimpling

• Downturned corners of the mouth

• Pebbly chin

• Jaw slimming (masseter)

• Excessive sweating (hyperhidrosis)

• Neck bands (platysma)

Not every treatment is suitable for every patient, which is why a consultation always comes first.

What happens during the appointment?

Your appointment begins with a consultation.

We’ll discuss:

• Your concerns

• Your medical history

• Previous treatments

• Your goals

• Whether anti-wrinkle injections are the most appropriate option

I will examine your facial movement while you smile, frown and raise your eyebrows before deciding where treatment should be placed.

The injections themselves usually take around 10–20 minutes, depending on the areas being treated.

Does it hurt?

This is probably the question I’m asked most often.

Most patients are pleasantly surprised.

The needles used are extremely fine and most people describe the sensation as a small pinprick rather than pain.

No local anaesthetic is usually required.

Some areas may feel slightly more sensitive than others, but treatment is generally very well tolerated.

When will I see the results?

Anti-wrinkle injections don’t work immediately.

Most patients begin to notice changes within 3 to 5 days, with the full result usually developing over 10 to 14 days.

This is why I normally recommend reviewing the result after around two weeks if a follow-up is required.

How long do anti-wrinkle injections last?

Results vary from person to person.

For most people, the effect lasts approximately 3 to 4 months.

This depends on several factors including:

• The muscles being treated

• Individual muscle strength

• Metabolism

• Lifestyle

• Previous treatment history

As muscle movement gradually returns, expression lines slowly reappear.

There is no sudden “wearing off” overnight.

Which brands are available in the UK?

Several licensed botulinum toxin type A products are available in the UK.

The ones you may come across include:

• Botox® (AbbVie)

• Azzalure® (Galderma)

• Bocouture® (Merz Aesthetics)

• Nuceiva® (Evolus)

• Alluzience® (Galderma) — the first ready-to-use liquid formulation

• Relfydess® (Galderma) — a newer formulation licensed in the UK

You may also hear about Dysport®, which is widely used internationally. In the UK, however, Dysport is licensed for therapeutic indications rather than cosmetic use, while Azzalure is the Galderma product licensed specifically for aesthetic treatment.

Patients sometimes ask which brand is “the best”.

In reality, there isn’t a single best product for every patient.

Each has its own characteristics, and an experienced practitioner will choose the product they believe is most appropriate for your treatment rather than simply using one brand for everyone.

Will I still look natural?

This depends far more on the treatment plan than the product itself.

One of the biggest misconceptions about anti-wrinkle injections is that they automatically create a frozen appearance.

In my experience, frozen results usually happen because too much product has been used, the wrong muscles have been treated, or the patient’s desired level of movement wasn’t discussed beforehand.

My approach is conservative.

The aim is to soften unwanted lines while preserving natural expression.

People should notice that you look well rested—not immediately know you’ve had treatment.

Aftercare

For the first few hours after treatment, I recommend:

• Avoid rubbing or massaging the treated area.

• Avoid strenuous exercise until the following day.

• Avoid saunas, steam rooms and excessive heat on the day of treatment.

• Remain upright for around four hours.

• Avoid applying pressure to the treated areas.

You can usually return to work and normal daily activities immediately.

Tiny bumps at the injection sites usually settle within 20 to 30 minutes.

Small bruises can occasionally occur but are generally minor.

Are anti-wrinkle injections safe?

When performed by a suitably qualified medical professional following an appropriate consultation, anti-wrinkle injections have a well-established safety profile.

Like any medical treatment, however, they are not completely risk-free.

Potential side effects include:

• Temporary redness

• Mild swelling

• Small bruises

• Headache

• Temporary asymmetry

• Eyelid or eyebrow drooping (uncommon and usually temporary)

These risks should always be discussed during your consultation.

When shouldn’t anti-wrinkle injections be performed?

Treatment is generally postponed or avoided if you:

• Are pregnant or breastfeeding

• Have certain neuromuscular conditions

• Have an active infection at the treatment site

• Are allergic to one of the product ingredients

Your medical history will always be reviewed before treatment.

My approach

Anti-wrinkle injections are incredibly effective when they’re used for the right reason and in the right way.

For me, the consultation is just as important as the injections themselves.

Sometimes anti-wrinkle injections are exactly the right treatment.

Sometimes another treatment—or no treatment at all—will achieve a better result.

The goal is never simply to inject.

The goal is to understand what you’re hoping to achieve and recommend the approach that’s most likely to give you a natural-looking result.

Frequently asked questions

Will I look frozen?

Not necessarily. A natural result depends on careful assessment, conservative dosing and understanding how much movement you want to retain.

Can I stop having treatment?

Yes. If you decide not to continue, muscle movement gradually returns and your appearance returns to its usual baseline over time.

Can men have anti-wrinkle injections?

Absolutely. Treatment is increasingly popular among men, although dosing and treatment plans often differ because facial muscles tend to be stronger.

Can I exercise afterwards?

Discover what to expect from anti-wrinkle injections, how long they last, whether they hurt, the different brands available in the UK, aftercar and realistic expectations from Registered Nurse Prescriber Elise Bernard.

Can I have anti-wrinkle injections and dermal fillers at the same appointment?

Often yes. Depending on your treatment plan, they can frequently be performed during the same visit.