Botox and Dermal Fillers

People often put it the same way: "I look angry, or tired, and I'm not." Usually it's the vertical lines between the eyebrows, or cheeks that have lost some fullness so the folds beside the mouth look deeper. Both can be softened with injections, without surgery.

The two treatments work differently. Botulinum toxin (widely known by the brand name Botox) is a purified protein injected in tiny doses into chosen muscles. It blocks the nerve signal to those muscles so they relax, and the lines they crease into the skin smooth out. Dermal fillers are gels, most often hyaluronic acid (a sugar found naturally in skin), placed under the skin to replace lost volume, lift a fold or reshape an area such as the lips or chin.

Neither is permanent. Botulinum toxin usually starts working in 3 to 5 days, peaks at about 2 weeks and wears off over 3 to 4 months. Hyaluronic acid fillers last roughly 6 to 18 months and can be dissolved if needed. A good result makes you look rested, not "done". This page covers cosmetic use. For medical uses of botulinum toxin, such as chronic migraine and muscle stiffness after a stroke, see Botox for neurology.

Anti-ageing treatments are part of the cosmetic work of our skin and hair department, carried out by trained dermatologists. Before any injection we look at your face at rest and in movement, explain what the treatment can realistically do and how long it will last, and say so if we think you don't need it.

Botulinum toxin treats lines caused by movement. Fillers treat lines and hollows that are there even when your face is still.

Your main job afterwards is to leave the treated area alone.