Botulinum toxins work by temporarily blocking signalling from nerve fibres to the targeted muscles. The muscles which are targeted for cosmetic reasons are those which are responsible for creating wrinkles of expression, otherwise known as dynamic wrinkles. Once the effect of the toxin takes on, depending on the dosing and patient’s requested desired results the movement of the treated muscles is either reduced to soften the wrinkles or completely arrested in movement to ensure no wrinkles are visible at all.

15 mins total treatment time, with a total 30-minute appointment slot for each session.

The treatment is for all adult patients who want to soften wrinkles in areas of expression such as the frown, the forehead, the bunny lines, the crow’s feet and also wrinkles in the chin region.

Results can be seen as early as three days post-treatment, however, the average time frame taken to show the full result is 14 days. The results gradually show and are not immediately evident after the treatment.

Result longevity varies between patients and is dependent on the dose used, desired results of the individual and other patient-related factors. However, the average longevity is between 2-5 months.

The treatment produces only a mild degree of discomfort given very small needles are utilised in the treatment. If a patient is particularly sensitive to pain, topical numbing creams and ice can be incorporated to further improve comfort levels.  The treatment itself feels like a pinch at the time of injecting and it is possible for a patient to experience minor tenderness in the treatment area for 24 hours post procedurally.

Common Side Effects Associated with the Injections Include:

• Pain or stinging sensation when the injection is performed.
• Localised swelling, redness, tenderness
• Bleeding at the sites of injection
• Bruising
• Numbness or itching of the area following injection.
• Headache *upper face only

​The above usually resolve spontaneously within hours or days but may persist for longer.

Asymmetry of expression – Perfect symmetry may not be achievable; that caused by the treatment can often be corrected at your review appointment.

​Common side effects associated with treatment with botulinum toxin to the upper face.
1%-10% risk

• Eyelid ptosis (a drooping or heaviness of the eyelid, one or both), brow ptosis (heaviness and or lowering of the brow).

​Uncommon Side effects
0.1-1% risk

• Swelling/ puffiness around the eyes
• Altered skin sensation, muscle twitching or spasm in the treated area.
• Eye pain, dry eyes, tearing, sensitivity to light, blurred vision, strabismus.
• Itching or dry skin
• Muscles not targeted may be affected, specifically, the muscles which lift the eyelid (frown treatment) and those which lift the corners of the mouth (crow’s feet treatment).

Lower Face

• Asymmetry of expression or function of the lips either in eating, drinking, smiling, or speaking
• Asymmetry of the chin muscle

Neck

• Aching
• Loss of muscle strength- to lift the head from a lying position.
• Altered voice.
• Difficulty swallowing

Armpits

• Aching
• Heaviness or weakness of the arms
• Infection

Other side effects reported (rare)

• Infection
• Nausea
• Anxiety
• Dry mouth
• Flu-like symptoms
• Muscle spasm

This list is not exhaustive, you may ask for a copy of the patient information leaflet in the pack or check the Summary of Product Characteristics online.

Adolescents, patients that are pregnant breastfeeding or planning to fall pregnant, and patients who are feeling unwell with common cold/flu/covid at the time of treatment. It is important to disclose any prior complications experienced with botulinum toxins at your consultation.

Dr Jonathan Hopkirk

The cost varies based on the number of areas being treated and the total dose required to achieve desired results, hence why a consultation is most important for costs to be established prior to making a treatment commitment. Costs can vary from $300 – $800 depending on the above variables.

The treatment requires a consultation first as with any of the performed procedures with Dr Hopkirk. Once the patient has been fully consulted and a management plan has been made and baseline photos have been taken, the treatment is performed.

The area of the face or body which is being treated will be sterilized by utilising chlorhexidine and alcohol swabs to remove any makeup and debris. The treatment zones are numbed with a topical anaesthetic to improve the comfort levels of the patient during the procedure.

The targeted areas are then injected with very small needles at very specific points to administer the dermal filler into the tissue. The area is then massaged and assessed post procedurally, aftercare instructions are provided, and a follow-up review appointment is scheduled.

Hyaluronic Acid dermal fillers are a clear sterile gel in a syringe for injection into the skin providing instant correction. Hyaluronic acid attracts and binds water in the skin, providing volume and hydration, but also ‘cushioning’ and supporting collagen and elastin fibres and providing a medium, or carrier, for chemical messages between the cells.

Dermal fillers used with Dr Hopkirk are hyaluronic acid based, which is essentially a sugar-based gel that holds its form when injected into facial tissue. Different HA fillers are designed to model the tissue that it is being injected into. For instance, for more rigid areas like the jawline, a thicker filler with more lift and rigidity is utilised to mimic the bone that makes up the jawline contour, whereas a soft silky mouldable filler is used for the lips which are mobile and supple.

The filler is injected into the area of concern and in areas where there is hollowing or ‘volume loss’ it restores the lost volume, and in areas where there are deep creases it works to smooth out or soften these creases by exerting upward pressure from beneath the crease itself therefore smoothing it out.

Treatment time is dependent on the treatment plan itself however on average for a single treatment area the average is 30 mins total treatment time, with a total 45-minute appointment slot for each session.

The treatment is for all adult patients who want to soften deep creases of the face and restore youth and structure to the areas listed in prior paragraphs such as cheeks, jawline, chin and lower face.

Results can be seen immediately after the treatment, as filler unlike neurotoxins takes its form in the facial tissue right away. It is important to allow for any swelling to settle for final results (can take up to 2 weeks for full final result once everything has settled). Some areas take several treatments to achieve desired results as it is better to build up over time for a natural aesthetic.

Longevity does vary between products, and between individuals, but most will last, on average between 6-12 months. It depends on the amount used and the area of the face being treated.

Lips for instance will usually last around 8 months sometimes less if a smaller dose is used for subtle results. HA dermal fillers slowly dissolve over time and are not permanent. Life-style factors can affect longevity as well.

If you choose not to maintain the results with further treatment, your skin will return to its pre-treatment state over time.

The treatment is very comfortable as pain is minimised with topical anaesthetic creams applied prior to the treatment and local anaesthetic is contained within the filler so the treatment area will be numbed before, during and for 30 mins after the treatment.

Common (expected) Side Effects Associated with the Injections Include:

• Pain or stinging sensation when the injection is performed.
• Localised swelling, redness, tenderness
• Bleeding at the sites of injection
• Bruising
• Numbness or itching of the area following injection.​

The above usually resolve spontaneously within hours or days but may persist for longer. Common side effects are expected to resolve spontaneously, within the first few days of treatment. Whilst not expected, it is possible that the side effects described may persist for longer than expected and may inhibit your confidence to attend work or social events. You are advised to schedule treatment with this in mind, allowing time for common side-effects such as bruising and swelling, to settle.

Uncommon Side effects

• Infection
• Inflammation
• Skin discolouration
• Infection or skin discolouration may occur within a few days, or weeks to months following treatment.
• Allergic or sensitivity reaction. Symptoms include itching, rash, red itchy welts,
• Abscess formation
• Prolonged swelling may occur early or present after several weeks.
• Persistent lumps, nodules, or papules
• Acne-like formations
• Temporary irritation of nerves (altered sensation or pain). Usually settles within weeks but may persist for longer.
• The blood supply to the skin may be interrupted by swelling or inadvertent injection into a vessel, causing an obstruction, if not addressed promptly, this can lead to skin damage and possible scarring.
• Though extremely rare, temporary visual disturbance or permanent blindness has been reported following injectable cosmetic treatment.

Any adverse reactions usually occur within a few minutes or days of treatment, some may be delayed by months and are managed directly with Dr Hopkirk who is an international expert member of the global Complications Medical Aesthetic Collaborative group.

Adolescents, patients that are pregnant breastfeeding or planning to fall pregnant, and patients who are feeling unwell with common cold/flu/covid at the time of treatment. It is important to disclose any prior complications experienced with botulinum toxins at your consultation as well as any medical issues such as auto-immune diseases or ongoing medical issues you’re being treated for by a health professional.

Dr Jonathan Hopkirk

The cost varies based on the number of areas being treated and the total dose required to achieve desired results, hence why a consultation is most important for costs to be established prior to making a treatment commitment. Costs can vary from $650 – $2000 depending on the above variables.

Do read all the information provided to you and highlight anything you need to ask about. Check the clinic terms and conditions before attending.

Make-up

Make-up will need to be removed prior to treatment, so please come ‘fresh-faced’ if possible.

Check medicines and supplements

Aspirin, Ibuprofen and a range of dietary supplements including St. John’s Wort, fish oils, Gingko Biloba, and Vitamins C and E- may all contribute to bruising and are best avoided 24 hours before treatment.

Alcohol

Don’t drink alcohol the night before, it will increase your risk of bruising.

Healthy skin and feeling well?

Check with the clinic before attending if any of the following apply;

• Cold sore brewing, active or recent and not quite healed.
• Acne break-out
• Feeling unwell- including colds, coughs, sore throats etc.
• New diagnoses or medicines
• New injury for which you are taking pain medicines.
• Appointments with the dentist; recent, or planned within 10 days of the treatment.
• Travel plans within 10 days of the treatment.

Glasses

Bring your reading glasses with you.

Jewellery

Leave jewellery at home, especially large earrings, or facial piercings, and bring a purse to keep them safely if you have to remove them.

Botulinum toxins work by temporarily blocking signalling from nerve fibres to the targeted muscles. The muscles which are targeted for novel and therapeutic reasons can be treated with a specific dose that is enough to safely manipulate their function and provide therapeutic relief (and in some instances cosmetic benefits).

For the masseters and muscles implicated in issues such as migraines, reducing the function of these muscles with neurotoxins has good evidence for providing relief of bruxism (teeth grinding) and also minimising migraine symptoms in sufferers.

The underarm when treated with neurotoxins reduces the production of sweat for up to 6-8 months, which provides therapeutic relief for these patients who suffer anxiety over the cosmetic burden of excessive sweating in this area.

The neckbands can produce a string-like prominence when contracted which can be minimised when neurotoxins are injected directly into the bands. The result can smooth out the neck aesthetic and also lead to a minor lifting effect of the lower facial features.

15 mins total treatment time, with a total 30-minute appointment slot for each session.

The treatment is for all adult patients who suffer from teeth grinding/jaw clenching, migraines (that have been investigated first medically), or excessive underarm sweating. Also, for patients who have prominent neckbands.

Results can be seen/experienced as early as three days post-treatment, however, the average time frame taken to experience the full result is 14 days. The results gradually show and are not immediately evident after the treatment.

For large muscles such as those involved with teeth grinding, results can sometimes take 3-4 weeks to take effect.

Result longevity varies between patients and is dependent on the dose used, desired results of the individual and other patient-related factors. However, the average longevity is between 2-5 months and up to 6-8 months for excessive sweating.

The treatment produces only a mild degree of discomfort given very small needles are utilised in the treatment. If a patient is particularly sensitive to pain, topical numbing creams and ice can be incorporated to further improve comfort levels.  The treatment itself feels like a pinch at the time of injecting and it is possible for a patient to experience minor tenderness in the treatment area for 24 hours post procedurally.

Common Side Effects Associated with the Injections Include:

• Pain or stinging sensation when the injection is performed.
• Localised swelling, redness, tenderness
• Bleeding at the sites of injection
• Bruising
• Numbness or itching of the area following injection.
• Headache *upper face only

​The above usually resolve spontaneously within hours or days but may persist for longer.

​Asymmetry of expression – Perfect symmetry may not be achievable; that caused by the treatment can often be corrected at your review appointment.

​Common side effects associated with treatment with botulinum toxin to the upper face.
1%-10% risk

• Eyelid ptosis (a drooping or heaviness of the eyelid, one or both), brow ptosis (heaviness and or lowering of the brow).

​Uncommon Side effects
0.1-1% risk

• Swelling/ puffiness around the eyes
• Altered skin sensation, muscle twitching or spasm in the treated area.
• Eye pain, dry eyes, tearing, sensitivity to light, blurred vision, strabismus.
• Itching or dry skin
• Muscles not targeted may be affected, specifically, the muscles which lift the eyelid (frown treatment) and those which lift the corners of the mouth (crow’s feet treatment).

​Lower Face

• Asymmetry of expression or function of the lips either in eating, drinking, smiling, or speaking
• Asymmetry of the chin muscle

​Neck

• Aching
• Loss of muscle strength- to lift the head from a lying position.
• Altered voice.
• Difficulty swallowing

​Armpits

• Aching
• Heaviness or weakness of the arms
• Infection

​Other side effects reported (rare)

• Infection
• Nausea
• Anxiety
• Dry mouth
• Flu-like symptoms
• Muscle spasm

​This list is not exhaustive, you may ask for a copy of the patient information leaflet in the pack or check the Summary of Product Characteristics online.

Adolescents, patients that are pregnant breastfeeding or planning to fall pregnant, and patients who are feeling unwell with common cold/flu/covid at the time of treatment. It is important to disclose any prior complications experienced with botulinum toxins at your consultation.

Dr Jonathan Hopkirk

The cost varies based on the number of areas being treated and the total dose required to achieve desired results, hence why a consultation is most important for costs to be established prior to making a treatment commitment. Costs can vary from $300 – $800 depending on the above variables.

It is important you tell your clinician about any medicines or dietary supplements you are taking; some medicines can adversely affect the way the toxin works or increase your risk of bruising.

If you are taking supplements such as Vitamin A, C or E, Gingko Biloba, Garlic, fish oils, St. John’s Wort or some pain-killing medicines such as aspirin or ibuprofen, then these can increase your risk of bruising and it may be advisable to stop taking them a few days before your treatment.  It is also advisable that you do not drink alcohol the night before your treatment, for the same reason.

It is not advisable to have treatment if you are feeling at all unwell.

Make-up will need to be removed prior to the injections and you will be advised not to reapply it for 12 hours to reduce the risk of infection or irritation at the injection sites.

Be aware of the necessary aftercare advice and that your schedule allows for you to follow it.