Botulinum Toxin in Marylebone, London

Cosmetic use typically lasts 3 to 4 months. With consistent treatment every 3 to 4 months, many patients find the interval stretches to 5 or 6 months as the treated muscles atrophy slightly from reduced use. Medical uses tend to last longer: masseter treatment for bruxism lasts 4 to 6 months, hyperhidrosis 4 to 9 months, and migraine treatment is repeated quarterly per the PREEMPT protocol.

Not at this clinic. Dr Oli's technique uses personalised dosing prioritising natural movement — the goal is a refreshed, well-rested appearance, not a treated look. Most patients describe the result as "only noticeable to you and the people you tell". Lower starting doses are used in first-time patients because adding more product is straightforward and removing it requires waiting for the effect to wear off.

NICE recommends botulinum toxin for chronic migraine — defined as ≥15 headache days a month, ≥8 of those with migraine features, lasting at least 3 months, and unresponsive to 3 oral preventatives. The PREEMPT injection protocol delivers the toxin to 31 sites every 12 weeks. Treatment is best delivered as shared care with your neurologist; Dr Oli can coordinate or take over a stable PREEMPT regimen.

Masseter (jaw muscle) treatment uses higher doses of botulinum toxin per side than upper-face treatments. Two main goals: reduce bruxism (nocturnal grinding/clenching) and visibly slim a square or overdeveloped jawline. Onset is around 2 weeks for symptom relief; visible jawline change builds over 6 to 12 weeks as the muscle atrophies with reduced activity. Effect typically lasts 4 to 6 months; repeat treatments tend to last longer as the muscle remains less active.

A 30-gauge ultrafine needle is used, and most patients describe each injection as a small pinch lasting 1 to 2 seconds. Topical numbing cream is available on request. The injections themselves take around 2 minutes for a typical three-area cosmetic treatment, slightly longer for medical indications such as hyperhidrosis (multiple sites per area) or PREEMPT migraine (31 sites).

Common, mild and short-lived: pinpoint bleeds at injection sites, a small bruise (5–10% of treatments, resolves in 5 days), and mild headache for 24 hours. Uncommon: temporary asymmetry corrected at the 2-week review. Rare: ptosis (drooping eyelid or brow) lasting 2 to 6 weeks — minimised by careful technique and avoiding the lateral brow region in forehead treatment.