Anti Wrinkle Injections

If you are considering a botulinum toxin treatment, please read the following information carefully before you book an appointment, as it contains important information to enable you to ask informed questions prior to any treatment.

What are anti Wrinkle Injections?

Anti wrinkle injections are procedures involving botulinum toxin. Botulinum Toxin is a naturally, occurring neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine causing temporary relaxation of muscle action which can result in an improvement in appearance of lines and facial expression. Botulinum toxin can only treat lines of expression (dynamic lines). Lines that are present when the muscle is not contracted, and the face is relaxed (static lines) generally do not improve with anti wrinkle injections and may benefit from alternative treatments. There are 3 main brands of Botulinium toxin that are currently available in the U.K. These include Botox by Allergan, Bocouture by Merz and Azzalure by Galderma. All 3 brands are available at Pin Aesthetics however we mainly use Azzalure as this is the most popular requested brand by patients. All 3 brands contain Botulinum toxin type A but are mixed with different proteins so their composition differs slightly and one brand may be more suitable for certain patient groups than others. This will be discussed at your consultation.

Botulinum toxin is a prescription only medicine (POM) that must be prescribed by a medical practitioner such as a nurse, doctor, dentist, midwife or pharmacist, with a prescribing qualification. If you are considering treatment you must have a face to face consultation, medical assessment and discussion of possible alternative treatment options, before the procedure. The actual treatment, however may be performed by a non-prescribing nurse, midwife or other healthcare practitioner according to the assessment conducted by the prescriber, and providing you agree to this. Pin aesthetics is a nurse led clinic run by Sophie Dyson Registered adult nurse and Independent nurse prescriber. Sophie is registered with the Nursing and Midwifery Council (NMC) and member of (BACN)British association of cosmetic nurses and (ACE) The aesthetics complications expert group. NMC registration status and qualifications can be checked by visiting NMC website and entering the name of the nurse.

What areas can be treated?

Botulinum toxin has been licensed for the temporary improvement in moderate to severe lateral canthal lines (crows feet) at the outer corners of the eyes) Glabellar lines (frown between the eyebrows) and horizontal forehead lines. There are other areas which are less commonly treated with botulinum toxin. Although this is ‘off label’ (not specifically licensed for this treatment), these are well established and have evidence to support their use. The most requested areas to treat are the upper face and usually classed as 3 areas (lateral canthal lines, Glabellar and forehead). There is a wide variation of doses required between individuals and the results may vary significantly from patient to patient . Every face is individual and some patients may need more and some less to achieve the same results. This is why at Pin Aesthetics we take an holistic approach to the face and charge for the dosage required and not per area, as not one shoe fits all!.

Areas that can be treated:

Glabellar lines (frown lines) Platysmal bands (turkey neck)

Lateral canthal lines (crows feet) Jawline (Nefertiti lift)

Horizontal forehead lines Slimming of the jaw muscles

Gummy smile Chin dimpling

Bunny lines Brow lifting

Barcode lip/lines Hyperhidrosis (excessive sweating)

How does it work ?

Facial expressions occur when the brain sends signals to the facial muscles causing them to contract in response to voluntary control, automated or emotional response. Botulinum toxin blocks the transmission of the chemical signal from the nerve reaching the target muscle. Without this signal, the muscle is unable to contract and remains in a resting state, therefore facial expressions are relaxed. It is not always possible or desirable to stop all movement as a completely frozen look may not be aesthetically pleasing. It is important to discuss your expectations with your practitioner prior to any treatment.

The effects of botulinum toxin are not instant, and most people will start to see the results after about 4 days, having full effect around day 10. Most practitioners will offer a follow up appointment at 2 weeks if any adjustments are required. Additional botulinum toxin may be administered at this time if needed. This is only usually required for the first few treatments until individual patterning and dosage is established. If you are continually needing extra amounts at 2-3 weeks then it may be that your dosage needs to be increased and this will reflect in the price. At Pin Aesthetics we do not routinely offer top up appointments as standard. It is the patients responsibility to request an adjustment if it is required. Please note that adjustments are free of charge if there are asymmetries however if extra dosages are continually requested then this will incur an added charge and the dosage and price will increase at the next appointment. PLEASE NOTE THAT CUT OFF FOR ADJUSTMENTS IS 3 WEEKS. More toxin can not be added after this time due to the risk of asymmetries when the toxin wears off at different rates. If it is past 3 weeks then the next time anymore can be added is at the 12 week point when ready for full re-treatment.

Over approximately 3 to 4 months, the nerve terminal recovers and movement in the treated area restarts. You can expect to start seeing some muscle activity return from around week 6-8 and may have full movement by week 12. Some patients get longer, as much as 6 months, before muscle contraction has completely returned, but the average time scale is around 3 months. Treatment can be repeated at this time to maintain desired results. It is not recommended to repeat treatments at intervals of less than 3 months as this can potentially create antibodies to the toxin and it will no longer work. Static lines that are present at rest, may soften once the botulinum toxin has taken effect and with repeated treatments may continue to improve as the skin recovers and is no longer being creased by constant muscle action. There are no known long term side effects from having repeated treatments, although there may be some muscle wasting (atrophy) with repeated treatments.

Is it painful?

Botulinum toxin is injected using a fine needle, similar to the size used on an insulin pen. It is not generally painful and most people will only experience minor discomfort. Some describe the sensation like plucking an eyebrow. Very rarely, for those who cannot tolerate the procedure, a topical numbing cream or ice may be applied to treatment area to reduce sensation.

Is it safe?

Millions of botulinum toxin treatments have been performed worldwide and it has excellent safety profile. However, as a medical aesthetic procedure, there are certain risks and side-effects which should be discussed with you during your initial consultation.

Side-effects may be more likely due to the following factors:

Patient factors: Poor condition of the skin, loss of elasticity, heaviness of the forehead, certain autoimmune or chronic medical conditions.

Practitioner factors: Training, years of experience, number of procedures performed.

Premise factors: suitability of premises.

We do not recommend that treatments are carried out in a non-clinical environment. Pin aesthetics does not offer mobile treatments

Possible side-effects include:

Injection site pain Abnormal appearance of the brows(Mephisto or Spock brow.

Bleeding and /or bruising at the injection site Blepharitis (inflammation of the eyelids).

Redness, itching, irritation at the injection site Eye pain or visible disturbance.

Swelling, including under eye puffiness Paraesthesia (abnormal sensation)

Headache, which may last several days. Muscle twitching

Nausea and/ hot flushes Flu like symptoms

Poor cosmetic results Anxiety symptoms

uneven effect on one side Rarely, muscle or joint pains

Drooping or heaviness of the brow or eyelid

If you experience any unexpected side effects after treatment, it is important to contact your practitioner as soon as possible, who may offer advice or corrective treatment.

What does the treatment involve?

Prior to treatment, you should complete a medical history with your prescribing practitioner, you should also receive all of the relevant information that you need to make an informed decision about whether to go ahead with treatment or not, as well as possible side-effects specific to your treatment and costs involved. It is usual to have a consultation and then rebook treatment for a later date, giving you the opportunity to have a cooling off period to consider all the information provided.

Do not feel pressured or coerced into having treatment at the same time as your consultation.

Before treatment you should be given the opportunity to have further questions answered and sign a consent form, either printed or electronically produced. The practitioner will examine the treatment area to determine the most appropriate injection sites and dosage for optimum results.

Treatment usually takes about 10-15 minutes to perform and you can resume your normal activities afterwards. Photographs should be taken prior to having the procedure to compare with the outcome at a follow up appointment. Any photographs taken taken will form part of your medical record and should not be used for any other purpose without your explicit permission.

Botulinum toxin injections are undertaken on a treatment couch. Firstly, the treatment area will be cleaned and disinfected. The practitioner will examine the muscles, plan the treatment, mark out the area, take photos and then inject the required dose into the target muscles. You can expect between 3-6 injections per treatment area. immediately after treatment, you may have small, raised bumps on the skin where the botulinum toxin has been injected, but these should resolve within less than an hour.

If you have never had botulinum toxin treatments before, it is generally recommended to have one area treated initially.

Am I suitable for treatment?

Treatment results are often more successful when the skin is in good condition, with good elasticity, where facial expressions are not excessive and there are no or only minimal static lines in the area to be treated.

You may not be suitable if the following apply:

Botulinum toxin is only recommended to those aged between 25 and 65, although it may be used off license for people outside this age range.

Botulinum toxin cannot be given to pregnant or breast feeding women and is not recommended if you are actively trying to conceive.

Patients with certain neurological disorders such as (myasthenia gravis)

You are currently taking certain medicines including antibiotics, such as clindamycin).

You have previously experienced adverse reactions to botulinum toxin treatment.

Treatment is not recommended if you are suffering from any skin infection in or near the treatment area, including cold sores.

You are unwell, including coughs and colds, on the day of treatment.

You are taking any medicines which effect bleeding such as aspirin, warfarin.

It is important to be honest about your medical history, previous surgery, previous or planned dental treatment and any medication taken, so that you can have a safe and effective treatment.

Pre treatment advice

Avoid taking anti inflammatories (such as aspirin, ibuprofen, naproxen) for 3 days prior to treatment (unless this has been prescribed by your doctor) as this increases the risk of bruising.

Alcohol, fish oils, St Johns Wort, Gingko Biloba, garlic, coffee and vitamin E should be avoided for 3 days prior to treatment to lessen the risk of bruising.

If you are prone to bruising, taking arnica orally for a few days prior to treatment may lessen the risk.

If you are unwell on the day of your appointment, contact the clinic to reschedule.

Ensure you inform the clinic if there are any changes to your medical history or medication has been taken before receiving any treatment.

Do not plan to have treatment within 2 weeks of an important social event or holiday as this may not allow enough time for side effects, such as bruising to settle, or to have a review appointment.

After treatment most people can resume their normal daily activities. Immediately after treatment, there may be some redness, minor swelling at the injection sites and pin prick marks, which should settle in time. If you develop any bruising, which may be apparent at the time of treatment or may develop over the following days, it is usually minor and can be covered with make up. Occasionally, more significant bruising can occur, which can last several days. Rarely, you may develop a headache after treatment which can last a few days. simple analgesia such as paracetamol can be taken for this if needed.

Many practitioners advise the following:

Do not apply make up for 12 hours after the treatment to reduce the risk of infection.

Try to avoid touching or rubbing the treated area until the following day as you may effect the results of the treatment.

Avoid extreme of hot or cold and vigorous exercise on the day of treatment.

Contact your practitioner if you experience any unwanted side effects.

If you are not happy with your treatment outcomes, you should attempt to resolve this with your treating practitioner in the first instance. If you need to see a different practitioner, you are entitled to receive a copy of your treatment record outlining the product used, areas injected and dosage, as well as photographs that were taken, to have your concerns addressed safely. However, remedial treatment may not always be possible. Sometimes it may be necessary to allow time for the treatment to wear off.

Example questions from Medical Form which you will complete at Consultation

Are you currently taking or have you ever taken any of the following medications?

Laxatives / Vitamin E? 

St John’s Wort?

Hormones/contraceptive pill? 

Steroids/gold injections? 

Aspirin/pain killers? 

Gentamicin/Neomycin ?



Do you drink alcohol? How many units per week? 

Are you pregnant or breastfeeding? 

Do you suffer from any allergies? If ‘Yes’, please give details? 

Have you suffered from any of the following? 

Auto-immune disease? 


Facial cold sores?

Herpes infections (shingles, chicken pox, cold sores, genital herpes sores?

Increased scar formation?

Increased light sensitivity?

Acne, psoriasis or any other skin condition or infection in the area(s) you wish to have treated?

Inability to swallow or dysphagia?

High/low blood pressure?

Heart disease, Angina, cardiac infarction?

Stomach ulcer/colitis Yes  NoHIV/hepatitis?

Venereal disease/STD?

Phlebitis (inflammation of your veins)?

Myasthenia gravis, Lambert-Eaton syndrome, amyotrophie lateral sclerosis, multiple sclerosis?


Bell’s palsy or a stroke?

Pigment disorders?

Thyroid problems?



Emotional or neurological disorders, e.g, seizures (epilepsy), paralyses, depression

M.E. (Myalgic Encephalomyelitis?


Skin disease (e.g. acne)?



Amyotrophic lateral sclerosis?

Thyroid problems?

HIV, hepatitis, rheumatoid arthritis or other auto immune diseases?

Nose bleeds, bruises (e.g, after light touch) or coagulation disorders or bleeding disorders?

Metal stents in the area of treatment?

Open wounds or lesions to face?

Do you or anyone in your family suffer from hereditary disease? if yes please specify:

Have you ever been admitted to hospital? . If ‘Yes’, please give details:

Have you had any previous surgery (non-cosmetic)? If ‘Yes’, please give details: 

Have you previously had any cosmetic surgery, including eye/eyelid or facial surgery? If ‘Yes’, please give details and dates: 

Have you previously had any cosmetic injection treatments? If ‘Yes’, what was treated and when? 

Have you had any sunbed treatment, dermabrasion, skin peels or laser skin resurfacing in the last 6 weeks? 

Are you currently undergoing any dental treatment? If ‘Yes’, please give details and dates: 

Do you have any phobias that may affect treatment? e.g. needles or blood If ‘Yes’, please give details: 

Are you particularly prone to fainting, bruising, keloid scarring or bleeding? Do you have any other medical/health conditions we should be aware of? 

After care leaflet


  • Pin Aesthetics does not require a deposit.  
  • please  give a minimum of 24 hours cancellation notice if possible.  
  • In order to change the date/time of your appointment please follow the link and instructions that can be found in your confirmation e-mail.


  • If you are going to be late or cannot make your appointment due to unforeseen circumstances, please contact us as soon as possible.
  • If you arrive more than 15 minutes late we do reserve the right to cancel your appointment. We are a very busy clinic, if you are 15 minutes late for your appointment it is highly likely that we will NOT be able to see you.
  • No shows will not be given another appointment unless a valid reason is given


  • All clients must be over the age of 18 
  • Children are strictly not allowed in the clinic
  • No food/drinks are allowed in the clinic due to hygiene reasons.


  • You MUST come ALONE to your appointment
  • Please only arrive to your appointment for your scheduled time slot – no earlier or later. we do have a waiting room but please bear in mind that if I am busy with a patient I will not be able to answer the door.
  • Please wear a mask – this is legal requirement 
  • Hand sanitiser will be provided upon your arrival
  • If you have any COVID-19 symptoms please rearrange your appointment

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