Botox - How to avoid that 'plastic fantastic' look

Heather Stephen

You can’t be too careful when someone is taking a needle to your face so Heather Stephen spoke to two eminent doctors who told us why they think Botox – in the right hands – is one of the safest procedures around.

Botox may be one of the most popular treatments in the UK with more than a million Brits spending in excess of £18 m a year on the wrinkle-smoothing jab and fillers. But horror stories about botched jobs and pictures of frozen-faced celebrities who have taken it a step too far can be off putting.

That ‘Stepford wife’ look with little to no visible sign of facial movement can be avoided according to Dr Leah Totton who has treated thousands of patients at the Dr Leah clinics she runs in London and Essex with Lord Sugar. She says these days practitioners are able to achieve very natural effects that won’t make people look plastic.

Botox, botox fears, skin

‘We are moving away from the “wax work” look of the 90s,’ she says. ‘People want to look fresh faced rather than frozen and this is something that can be achieved by altering the dose and way in which Botox is injected.

‘I recommend clients go for a sprinkling of Botox like actress Robin Wright to leave a few lines and reserve some movement which gives character to the face. It means people have to come in for treatment more often but with a lower dose you can achieve a more natural result.’

Dr Tatiana Lapa, medical aesthetician at the Studio Clinic, London, agrees: ‘The completely frozen look with no expression has largely gone out of fashion. And in recent years people have started asking for more subtle treatments to soften lines, lift brows and smooth the jawline.’


Starting young

Surprisingly, Dr Lapa is seeing a growing number of young patients asking for the treatment. ‘It might seem ridiculous to give people Botox in their 20s,’ she says. ‘But if you treat little lines just as they are starting to appear you will stop these fine lines turning into deep wrinkles.

‘Consider your skin to be a crisp cotton shirt. If you crinkle it a bit and smooth it out again it’s going to look pretty good. But if you screw it up in a ball and leave it like that you’re going to struggle to make it smooth again.

‘Botox is a very safe treatment and patient satisfaction is very high but, as with any procedure there can be complications such as redness, soreness, bruising and asymmetry,’ says Dr Lapa.

Dr Totton agrees there can be minor side effects but she says complications are rare and can be managed successfully if treatment is administered by a doctor.

‘Having Botox is not like having a manicure,’ she warns. ‘It is a prescription medication which always carries a risk of side effects.


Side effects

‘People can experience headaches and flu like symptoms up to five days after treatment and a very small number of people can experience drooping lids or brows but these will always wear off or can be corrected by treatment.

‘For instance, with lid ptosis where the lid droops, drops can be prescribed to re-open the eye and injections can be given to lift the brow until the side effect wears off which is typically within 6 weeks.’

So if you weigh up the risks and decide to go for Botox what is the best way to boost your chances of the best and safest results?

Dr Lapa says the best thing you can do is to choose your practitioner wisely. ‘You have to do your homework and should go for someone who has a medical or nursing qualification as they need to be able to recognise and manage any potential problems resulting from treatment,’ she says.

Dr Totton adds you should always ask how many procedures your practitioner has done and beware of special offers and deals as reputable clinics will never offer discounts.

‘You should always use a doctor or nurse prescriber with experience and you should always make sure you have a proper consultation beforehand to discuss what you want to achieve.’

And finally Dr Totton says you should never choose a clinic based on price. ‘Remember you get what you pay for. This is your face so choose a safe and established practitioner.’


Who shouldn’t have Botox?

According to Dr Lapa you shouldn’t have botox if you are:

  • pregnant, breast feeding or planning to, or trying to conceive in the next few months. Those who’ve had Botox should avoid trying to conceive until at least four month after treatment
  • have a chronic health condition like myasthenia gravis, motor neurone disease or lupus
  • are taking medication which could compromise your immune system such as chemotherapy, steroids or anti-rheumatic drugs as you could be more prone to infection
  • have previously had an allergic reaction to Botox.


Online help

  • – Find a doctor via this national accreditation scheme which gives patients information about the qualifications and experience of their practitioner.

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