Brow & Eyelid


Botulinum toxin is commercially available as Botox® or Dysport® or Azzalure® but are commonly referred to as ‘botox injections’ whichever product is actually used. This can reduce appearance-related anxiety / improve confidence in social or work public-facing situations for dynamic smile wrinkles / frown lines / raise the eyebrow position slightly.

Clients can be nervous about the cost implications of this treatment. If you wish to attend for botulinum toxin injections with Mr Blackburn 2022 indicative prices at Spire Cheshire are: 1 zone £324, 2 zones £399, 3 zones £489. Same day injection (as, if and when appropriate) reduces the consultation price to £54. A consultation fee only applies to the first consultation for ongoing botulinum toxin treatments (for the time taken discussing your aims, the treatment options, recording your medical history, medical photographs, information sheets and consent form completion). After this has been completed on the first visit, repeat injection treatments usually occur at longer intervals ~3-4months). There is no additional consultation fees for the subsequent visits. There is no requirement for your to reattend at 3-4 month intervals – some clients like to have this treatment effective for the lighter, summer months.


Excessive sweating is not a topic often discussed – even with our nearest and dearest – because of embarrassment and out of respect for the individual’s sensibility. Hyperhidrosis or excessive sweating is a major problem to many people and it may be associated with an unpleasant body odour because the excess sweat remains on the skin for a long time and forms a breeding ground for bacteria which create the malodour. It may be severe enough to overcome conservative measures such as antiperspirant applications. Sufferers may also feel embarrassed by the social awareness of visible sweat e.g. on the forehead, or damp clothes or palpable sweat on the palms when shaking hands – making them appear much more nervous or anxious than normal. As such, this can affect self-confidence, others’ perception of their professional demeanour for career progression etc. Equally, achieving a successful treatment can have a positive effect on both the condition and a client’s social confidence.

Focal hyperhidrosis is the term given to excessive sweating in specific areas of the body e.g. the forehead, palms, armpits etc. Other more invasive treatments exist – such as endoscopic thoracic sympathectomy for axillary hyperhidrosis.


Botox as a Treatment

Botox has been found to be effective in the management of reducing dynamic facial wrinkles (see below in Botox Frequently Asked Questions) and for excess sweating. It is a protein which occurs in nature and acts by blocking certain nerve impulses and it is effective in blocking those which would stimulate both muscle contraction and sweat production in the skin. Other functions of sensory nerves which allow your skin to feel touch etc are not affected.

The Botox takes effect after about 2-14 days and lasts about 3-4 months in relaxing muscles and 3-6 months to reduce excess sweating. Sometimes clients can find it lasts up to 9-12 months after treatment for excessive sweating. A treatment for crows feet wrinkles costs £214 and for hyperhidrosis costs £439 at 2017 prices.


Possible Complications

No severe complications have been reported in the literature. In the case of using Botox for wrinkle reduction, rarely, the solution can migrate and cause a weakness of nearby muscles, such as drooping of the upper eyelid. Such a side effect is temporary and would usually on last for a few weeks at most. Ask your practitioner if they have ever had such a complication in their practice.

It is important to say that in some cases of using Botox for the management of excess sweating, although rare, the treatment may have no effect whatsoever, even after repeat injections. Unfortunately, this is impossible to predict before treatment is given.


1 Zone

Same day injection reduces the consultation price to £54.


2 Zones

Same day injection reduces the consultation price to £54.


3 Zones

Same day injection reduces the consultation price to £54.


A consultation fee £230 only applies to the first consultation for ongoing botulinum toxin treatments (to discuss your aims, the treatment options, your medical history, medical photographs, information sheets and consent form completion). After this consultation has been completed on the first visit; injection can be performed and then repeat treatments usually occur at longer intervals ~3-4months). There are no additional consultation fees for the subsequent visits. There is no ‘requirement’ for your to reattend at 3-4 month intervals – it is up to you. Some clients like to have this treatment to be effective just for the lighter, summer months.

Botox – Frequently Asked Questions

Wrinkles form with ageing and can be related to sun radiation damage, gravity and repeated muscle contraction from muscles of facial expression. This treatment is a simple procedure that can reduce or eliminate unwanted wrinkles in the upper part of the face including frown lines between the eyebrows, “crows feet” / “laughter lines” around the eyes and horizontal forehead lines and also neck – e.g. platysmal bands (prominent muscle bands / webs in the neck). There is no chance of scarring with botox injections. It is safe and you can resume all your activities immediately after treatment – except you should avoid vigorous exercise for 12 hours. This treatment is not surgery – surgical procedures may be the most definitive solution for some unwanted wrinkles.

Botulinum toxin type A (botox) is one of several naturally occurring protein toxins produced by a bacteria called Clostridium botulinum which is widely found in nature in forest soils and shellfish. Botox is precisely manufactured to be used in safe doses to soften wrinkles in the skin by weakening the action of the muscles which cause the wrinkles. It was first used in 1973 to relax overactive muscles which caused ‘crossed eyes’ (strabismus) and facial twitches (or ‘tics’) then gained wider use for other muscular conditions and for use as a cosmetic agent. Although used globally for cosmetic purposes for since 1990, it is still not officially registered for such use at the moment. Botox is manufactured pharmaceutically in the United States of America – an animal source of protein is used in the process.

When the solution is injected in precise doses directly into a specific part of a muscle, it stops the electrical signals from the brain reaching muscle by blocking the chemical transmitter acetylcholine from crossing between the end of the nerve and the muscle. As the muscle function is lessened, the overlying skin relaxes and any wrinkles caused by those muscle contractions are softened and may disappear. Some deep or long-standing wrinkles may have ‘memory’ and still be visible (like creases in a straightened out shirt) – in these circumstances, the best result may be gained with additional dermal filler injections to plump out such wrinkles. Since the protein in the solution is only attracted to muscles, it has no effect on the brain or central nervous system of the body. It is temporary because the blocked nerve sprouts a new ending which connects to and re-innervates the muscle within 3-4 months and this process has been shown to readily recur again and again after any repeated injections.

It is a safe and simple procedure when delivered by an appropriately trained practitioner. A tiny and precise amount of solution is injected with a very fine needle into several locations in the face precisely and individually mapped to the muscle action related to the wrinkles being treated. These injections are associated with so little pain that it specialist practitioners routinely would use no local anaesthesia – the needles are a similar diameter to acupuncture needles. You may well develop slight bruising at the injection sites and require cover make-up although every effort is made to reduce this risk to a minimum. There may be a pinky-red flushing of the skin for an hour or so as a reaction to the needle itself. Certainly, within a couple of hours, many clients have no visible signs of having had a treatment.

This kind of treatment is a temporary solution to unwanted dynamic wrinkles because the injections only last about 3 or 4 months. This has the benefit of allowing the first treatment to be as subtle as a client wishes if there is a preference for having a trial treatment first. You will need 3 to 4 treatments per year to maintain best results and it is common for treatments to be offered in packages of 3 over 9-12 month time periods.

You cannot be breast-feeding or pregnant when receiving Botox treatment. Those taking certain muscle relaxants and antibiotics such as aminoglycosides (e.g. gentamicin) or with bleeding disorders should not have the injections. Mr Blackburn will not treat patients under the age of 27 on ethical grounds. Those with infection or inflammation at the proposed treatment site should not have Botox injections at that site. Clients who take aspirin, clopidogrel, dipyridamole, warfarin and non-steroidal analgesics such as ibuprofen are at increased risk of bruising. Clients with certain neuromuscular disorders such as myasthenia gravis are not eligible for treatment – you should ensure you inform the consulting practitioner of your full medical history.

Botox has no effect on the fine lines on the upper and lower eyelids within the oval eye socket or those facial fine lines related to sun damage rather than muscle contraction. Any such unwanted fine lines are better treated with chemical peels or laser resurfacing treatments to achieve a widespread tightening of the skin. Many of us have asymmetric faces when studied closely and botox injections cannot be expected to correct or mask such underlying asymmetry effectively.

You must inform any medical practitioner who may prescribe you medication that you have had the injection treatment for up to 3 months after the treatment. After treatment, you should not exercise vigorously or have a hot bath for 12 hours and should not massage the area for 72 hours. You can gently perform the wrinkling muscular action several times during the day once you have had the injection e.g. frowning if frown lines have been treated.

No-one ‘needs’ cosmetic treatments, however, many thousands of these types of treatments are safely performed each year and it has emerged as a reliable and exciting treatment for improving the visible effects of ageing. Many patients report an enhancement to their quality of life – with greater confidence / enjoyment of social interactions; and reducing appearance-related anxiety in social, work and personal relationship interactions. Of course, the best long-term holistic approach for healthy youthful skin includes not smoking, protection from sun-radiation, keeping well hydrated, a healthy diet, exercise and plenty of sleep.

NEWS: a BBC report on 9th July 2012 revealed: The General Medical Council (GMC) have published new rules here (click on ethical guidance section) to stop doctors remotely prescribing injectable cosmetic medicines such as Botulinum toxin if they have not seen the patient face to face. Nurses are legally allowed to inject the drug under a doctor’s supervision but risk being struck off for doing this remotely, unless in an emergency. The BBC went undercover to join a particular doctor’s practice who allegedly took phone calls from nurses around the country authorising injections and taking a fee for it (sometimes after the injection had taken place). You can see the report on

Mr Blackburn supports the independent and voluntary body Independent Health Advisory Services position on this. It is important to have a framework of standards and code of best practice for non-invasive cosmetic treatments. Mr Blackburn is medical director at the skn clinic in Manchester – registered with the Treatments You Can Trust scheme.

    • Call Mr. Blackburn on 01925 215 008 or email

    • Consultation with Mr. Blackburn
      30 minutes: £230. Written information about procedure and aftercare, letter to patient / GP.

    • Preoperative assessment with nurse and doctor support. Cosmetic Surgery with ward care, removal of stitches + postoperative review consultations with Mr. Blackburn all included in the cost of surgery.