Botulinum Treatment (Botox)

When we change facial expressions we move or relax our facial muscles. These muscles can cause the appearance of dynamic lines or wrinkles. When a very small dose of Botulinum toxin is injected into a specific facial muscle it blocks the signal from the nerve to the muscle, to stop its movement. This very small muscle paralysis helps to make the muscle-causing dynamic lines on the face to soften or even disappear.  The most effective dynamic lines to disappear are those between the eyes (glabella lines) and those around the outer eyes (crows feet lines) as well as the forehead wrinkles.   The treatment helps to soften the neck muscles to reduce the banding caused by those muscles or other areas of the face caused by muscle activity. This inhibition is not permanent and requires maintenance treatments to sustain the result. 

Botox can be also used very effectively to treat hyperhidrosis (excessive sweating).  Titus Adams can perform a starch-Iodine test first beforehand, in order to determine which exact areas of the body are particularly affected by sweating, and direct Botox treatment accordingly.

Titus Adams will assess your facial lines and discuss your expectations of the outcome of treatment and whether this is the best treatment for you. Before and after photographs may be taken to assess the results. You will be asked to sign a consent form before treatment starts.

Following the cleaning of the skin, a very fine needle and syringe is used to inject Botulinum toxin into the muscle beneath it, in more than one site. 

Most patients find that the injections cause only a little discomfort.  Sometimes, for more extensive areas or sensitive sites during hyperhidrosis treatment, numbing local anaesthetic cream can be applied for 45 minutes before the injection starts.  

Following this treatment, any red raised areas at the injection sites tend to fade within hours of the injection and can be covered with make-up.

The affected muscle begins to weaken by 72 hours after treatment, and peaks at 7 to 14 days. Minor reactions may include brief pain or a mild headache.  

Bruising may occur, but can be minimised by avoiding Aspirin, Ibuprofen and other anti-inflammatory medications, avoiding excessive alcohol intake, and strenuous exercise for 24 hours.

Treatment usually lasts between 3 to 4 months and can be repeated.  Then treatments need to be individualised as patients respond differently. 

Generally, Botulinum toxin injections are not recommended if you are pregnant and/or breast feeding or have a neuromuscular wasting conditions such as Multiple Sclerosis or Myasthenia Gravis.


Read the full Botulinum Treatment fact sheet for more information.

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“Recommendation after recommendation has put Adams firmly on the Cotswolds map (he has clinics in Berkshire and Oxfordshire). It’s partly down to his nature (he’s a wonderful conversationalist and has charisma in spades), but also his manner, which is thoughtful and careful. His forte? Womanly tummies, with curves in the right places. New mummies in particular love the way he recontours the waistline and creates the illusion of a lightly toned abdomen.”

“Titus Adams makes light work of postpartum tummies, slimming the silhouette and nipping in waists by pulling the underlying muscles tight, like a corset. ‘Though it’s best to leave some fat behind,’ he says. ‘It allows fluid to drain from the body, rather than building up in the tissues’. The fat he does take, however, is useful if there’s need to plump a deflated cleavage. And, because he’s chatty and approachable, smoothing over even the most awkward of questions (like ‘how do you wear your undergarments?’ – crucial, as it ensures the best positioning of scars), you feel at ease. You trust him.”

“Adams listens carefully & closely. And his results are truly top notch whether he is tidying things up after some impressive weight loss or putting you back together after the last baby. The key phrase is ‘preservation of tissues’, to retain a natural appearance.”