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Botulinum Toxin works by weakening the action of the muscles being treated, which has the effect of softening lines and wrinkles making the skin look smoother. This treatment is also an effective way to improve migraines and is successfully used to manage spasm of muscles around the eyelids (blepharospasm) and the face (hemifacial spasm) and can also be used to “lift” parts of the face.

Sometimes other treatments are used in combination with or instead of Botulinum Toxin to achieve the best results. For deep lines or folds, fillers can be used to improve loss in tissue volume and Plexr (plasma treatment) helps to tighten loose skin. There are a number of common areas and conditions where Botulinum Toxin can be used effectively whilst still maintaining facial movement for a natural, refreshed look.

Frown Lines and Worry Lines

Horizontal forehead “worry” lines and the vertical “11” frown lines between the eyebrows can make a person look tired, old and angry. If left untreated, the lines become deeper and can lead to headaches. Fortunately, this area can be treated with Botulinum Toxin, combined with fillers if there are deeper lines to give an open, relaxed appearance.

Crow’s Feet

Laughter lines or “crow’s feet” are the fine wrinkles at the outer edges of the eyes that appear over time when a person smiles. To start with they may only be visible on active smiling but can eventually increase in number and remain as permanent fine lines even when not smiling.

Bunny lines

Bunny lines are the fine lines that appear when you scrunch up your nose when you smile or laugh. Botulinum Toxin can be used to discretely treat this area whilst maintaining facial movement.

Asymmetrical brows or Brow ptosis

Uneven or droopy brows can be corrected to help lift and correct asymmetrical brows and smooth the surrounding skin. Depending on the result required, the higher brow can be dropped down or the lower side can be raised. This results in a more youthful look by opening up the area between the brows.


If you would like to discuss your treatment options, make an enquiry or call us on 0203 369 2020

Make an enquiry

Blepharospasm and Hemifacial Spasm

Abnormal contraction or twitching of the muscles around the eyelids and face can be socially embarrassing and also interfere with daily activities like driving and using computer screens. Treating the affected muscles with Botulinum Toxin can temporarily prevent them from twitching and restore normal function.


Botulinum Toxin has been used for a number of years as an effective treatment for chronic migraine. This treatment avoids having to use regular painkillers and anti-sickness medications and has had a major impact in improving the quality of life for migraine sufferers.

Gummy Smile

The upper lip should rest just above the top of the upper row of teeth to give the correct gum tissue to teeth ratio for the “perfect smile”. By reducing the action of the muscle that raises the upper lip, Botulinum Toxin can successfully be used to treat a gummy smile resulting in a more natural and attractive smile shape.


Teeth grinding at night (bruxism) can lead to jaw pain and teeth that become damaged, worn or sensitive. There are a number of different treatments available, including Botulinum Toxin, which can be used to reduce the activity of the muscle that moves the jaw and thereby stop the wear and tear on teeth caused by grinding.

Golf Ball Chin

When the muscles of the chin pull to hard, it can result in an “orange peel” appearance or a dimpled appearance like a golf ball, which becomes more prominent when talking and chewing. These small irregularities can be softened and relaxed with Botulinum Toxin to give a more youthful contour.

Consultation & Treatment


Initially you will have a consultation with Miss Sarangapani, during which the procedure will be fully explained to you. There will also be a detailed discussion on expected results, risks and benefits of Botulinum Toxin treatment and the care that will be required before and after the procedure.
We will take photographs to document the “before and after” treatment effects. A detailed medical history will also be taken and if you have any medication that you take, we would ask that you bring this with you.

We will also ask you if you have any allergies, have had previous surgery and about your smoking habits. You will have the opportunity to ask any questions and we will also discuss whether any other non-surgical treatments, like hyaluronic acid filler or Plexr will help to achieve the best results.



Botulinum Toxin treatment usually only causes minimal discomfort, but the area being treated can be numbed with local anaesthetic cream beforehand if needed. The effects of the treatment are not immediate but will start to work within a few days and reach a maximal effect by 2 weeks. In most cases, Botulinum Toxin treatment lasts for 3 to 4 months, but over time and with repeated courses of treatment, the effects can last 6 months or longer.

With any drug treatment, there can be side effects. These are usually minimal and settle quickly. In rare cases if there are any side effects that don’t immediately settle, as Botulinum Toxin only stays in the body for around 3 months, it will resolve as the effects of the drug wear off.


Our Cosmetic Treatment Reviews

Treatment Precautions & After Care

On the day of the treatment (before and after)

  • Do not consume alcohol, take aspirin containing drugs or Vitamin E
  • Do not go to the gym or take part in strenuous exercise

6 hours following treatment

  • Stay upright and do not bend over/ lie down
  • Do not use face creams or make-up

7 days following treatment

  • Do not rub or massage the treated area
  • Do not have any facial treatments or a scalp massage
  • Do not expose the treated area to intense heat e.g. sauna, sunbathing or extreme cold


How much does Botulinum Toxin Treatment cost?


1 area £300
2 areas £375
3 areas £450

What makes our treatment unique?


Holistic approach

OCL Vision’s oculoplastic surgeon, Miss Susan Sarangapani, offers both surgical and non-surgical cosmetic treatments, sometimes combining both as appropriate. This holistic approach allows her to personalise care for each patient and deliver optimal results.


Natural-looking results

Susan Sarangapani specialises in natural-looking results with strong attention to detail, alongside an empathetic consultative approach to ensure she understands exactly what every patient is looking for.


Convenient consultation and treatment

Susan Sarangapani is part of OCL Vision, a group of expert eye surgeons offering consultation, treatment and surgery onsite in one place. Choose from our central London location (close to Harley Street) or Elstree, Hertfordshire.


Expert, highly-trained surgeon

Susan Sarangapani is an expert in her field and has undertaken a fellowship at the internationally renowned Craniofacial Unit of Chelsea and Westminster Hospital, ensuring extensive training in facial and eyelid reconstruction surgery.

Ask the surgeon

Miss Susan Sarangapani blepharoplasty surgeon

Is botulinum toxin safe? Botulinum toxin injections are usually relatively safe when performed by an experienced doctor. Possible side effects and complications include: swelling or bruising at the injection site, pain, headaches or flu-like symptoms. Symptoms like eyelid or mouth droop or double vision are rare. Should you experience any side effects, they are temporary and will resolve. It is better to avoid taking painkillers like Ibuprofen, Neurofen or Aspirin on the day of treatment as this can lead to bruising after the injection.

Susan Sarangapani

Oculoplastic surgeon at OCL Vision
Meet Susan Sarangapani

More anti-wrinkle injection FAQs

Find out the answers to some more of the most frequently asked questions about anti-wrinkle injections, from our expert surgeon Susan Sarangapani.

How long do anti-wrinkle injections last?

Generally, they last 3-4 months. There are some patients for whom anti-wrinkle injections last longer, (4-6 months), or shorter, around 2 months. It is also common when having injections for the first time, to find that it may not last a long time initially but may last longer after the second treatment. After repeated treatments over a number of years, it can last even longer than 6 months for some patients.

What does botulinum toxin feel like when it starts to work?

Immediately after botulinum toxin injections, you may feel a slight stinging sensation or notice a small bump at the injection site, a bit like an insect bite. These bumps will fade quickly and should NOT be massaged. Some patients feel a heaviness or tightness in the muscles when they first have anti-wrinkle injections – this usually wears off as you get used to the treatment and is usually not noticeable in subsequent treatments.

Is botulinum toxin haram?

The word haram translated from Arabic means forbidden and some Muslim patients may feel that the teachings of Islam are focused on developing inner beauty and not to prioritise the outward physical appearance. Permanent physical changes, such as cosmetic enhancements and interventions may be seen as altering and changing the creation of Allah but temporary changes which alter your physical appearance, such as henna tattoos and jewellery, are permitted.

Respecting our Muslim patients, it is better that they make their own decision regarding botulinum toxin treatment based on their own beliefs.

Does botulinum toxin make you look older after it wears off?

No – once the effects of botulinum toxin wear off, your face will NOT look older. Anti-wrinkle injections help you get rid of some of the unwanted wrinkles around the eyes and face, but after they wear off, these wrinkles begin to reappear again. Wrinkles do not become worse after botulinum toxin treatment, they just return to how they were before the treatment.

Can you drink alcohol after anti-wrinkle injections?

We recommend that patients do not drink alcohol on the day of treatment and for 24 hours afterwards, as this will increase the risk of bruising, swelling and headaches.

Can you exercise after anti-wrinkle injections?

Exercise should be avoided for at least 24 hours following anti-wrinkle injections to reduce the risk of the botulinum toxin moving to other areas of the face and causing unwanted side effects. Strenuous exercise, heavy lifting or bending forwards also raises the blood pressure which increases the risk of bruising or swelling.

Can you have anti-wrinkle injections when pregnant?

Whilst it is unlikely that botulinum toxin will affect your pregnancy or the baby, no research has been carried out on botulinum toxin treatment during pregnancy. Obstetricians therefore advise NOT to have this procedure or other injectables when pregnant or breast feeding.

How long does botulinum toxin take to work?

Botulinum toxin usually begins to take effect anywhere from 3 to 7 days after treatment, though it can take up to a full 14 days after treatment for the full results to become apparent.

Do anti-wrinkle injections hurt?

The needles used for anti-wrinkle injections are very small and most patients feel no pain when they are injected at our clinic.

What is "baby botox"?

“Baby botox” or “micro-botox” is a new trend in injectable treatment. It aims to add volume to your face, smoothing out wrinkles and fine lines, just like traditional botulinum toxin, but using less of the botulinum toxin product.

Can anti-wrinkle injections cause headaches?

Some people may experience a mild headache following a botulinum toxin injection which can last a few hours to a few days. According to a 2001 study, about 1% of patients may experience severe headaches that can last for two weeks to one month before slowly disappearing.

susan's picture facing the camera

Meet Susan Sarangapani

Miss Susan Sarangapani specialises in Oculoplastics; she uses both surgical and non-surgical treatments to achieve outstanding natural-looking results in eyelid and facial restoration treatment. Susan offers personalised care and takes an empathetic approach when providing consultation.

Susan can be seen at our clinic in New Cavendish Street in Central London, as well as the Spire Bushey Clinic and Spire Harpenden Clinic.

Meet Susan

If you would like to discuss your treatment options, make an enquiry or call us on 0203 369 2020

Make an enquiry

Last updated on January 9th, 2024 by Ms Susan Sarangapani