Botulinum Toxin (Botox®)
Botulinum toxin type A (Botox®, Azzalure®, Bocouture®) temporarily relaxes targeted facial muscles, reducing dynamic lines. Treatment areas include forehead lines, glabellar furrows (frown lines), crow's feet, brow elevation, upper lip lines, chin dimpling, jaw (masseter) slimming and hyperhidrosis (excessive sweating). Effects last 3–4 months on average. All injections are performed personally by Mr Naparus — not delegated to non-medical practitioners.
Botulinum toxin is a prescription-only medicine. By law it must be prescribed and administered by an appropriately qualified medical professional. Mr Naparus is a fully qualified Consultant Surgeon.
Functional & Therapeutic Uses
Beyond cosmetic treatment, botulinum toxin has an established role in facial reanimation and functional correction. Mr Naparus uses it in the management of facial palsy — including synkinesis and contralateral treatment to improve symmetry between the affected and unaffected sides of the face — and in correcting facial asymmetry more broadly. Botox® is also a licensed, evidence-based treatment for chronic migraine, delivered via a standardised injection protocol across the head and neck.
Aims & Philosophy
The goal is always natural enhancement — refreshed, not altered. Mr Naparus takes a conservative approach, preferring to under-treat and review rather than over-treat. Results should be invisible to others as treatments.
Who Is a Good Candidate?
Not everyone who asks for Botox is a good candidate, or needs it — Mr Naparus is happy to advise against treatment where it would not achieve a natural or worthwhile result, including in patients where the underlying concern is better addressed with skin quality treatment, volume restoration, or no treatment at all.
Indications: Dynamic facial lines (frown lines, forehead lines, crow's feet) that bother the patient at rest or on animation; functional indications such as migraine, hyperhidrosis or synkinesis (see Facial Palsy & Reanimation and Migraine Surgery).
Contraindications
- Pregnancy and breastfeeding
- Active skin infection at treatment site
- Known allergy to product components
- Autoimmune neuromuscular disorders
- Anticoagulant medication (increased bruising — manageable but discuss)
Risks & Complications
Bruising / Swelling
Common (20–40%); temporary. Resolves within 1–2 weeks.
Asymmetry
Usually temporary; reviewed at 2 weeks and adjusted if needed.
Ptosis
<1%; temporary upper eyelid droop if toxin migrates; resolves within weeks.
Headache
Mild and self-limiting; occurs in a small proportion of patients within 24–48 hours.
Infection
Rare (<0.1%). Aseptic technique used throughout.
After Treatment
- Avoid strenuous exercise, saunas and alcohol for 24 hours post-treatment
- Do not rub or massage treated areas for 24 hours
- Botox review at 2 weeks for assessment and top-up if required
- Avoid dental procedures within 2 weeks of jaw botox
- Return to work/normal activities: immediately (some swelling/bruising)