Frequently Asked Questions

Botulinum Toxin is a neurotoxic protein that can be used for medical and cosmetic purposes. It works by weakening or paralysing certain muscles or by blocking certain nerves.

There are several product brands under the different Botulinum Toxin A subtypes including Azzalure®, Dysport®, Bocouture®, Xeomin®, Botox® and Vistabel®. All botulinum toxins are prescription only medicines and can only be prescribed by registered prescribers.

Botulinum toxin has been proven to be safe for human use at the low doses used in Aesthetics. However, all treatments have side effects that can occur. Swelling, redness, bleeding and bruising are common with botulinum toxin treatments and are considered part of the normal recovery process rather than true side effects. The side effects that can occur are as follows:

• Headache: Some people describe a headache or feeling of forehead “heaviness” in the days after treatment. This is treatable with simple painkillers and usually resolves by one week.
• Asymmetry: We aim to deliver toxin in a symmetrical manner but sometimes one side of our face has stronger muscles or the toxin spreads in an unexpected direction. This can lead to asymmetrical results affecting the brow, smile or facial expression depending on the area injected. This is managed either by waiting for the toxin to wear off or by injecting toxin in specific areas to address the asymmetry if suitable.
• Drooping of the brow or eyelid: Sometimes the toxin can spread towards the brow or eye causing drooping to occur. This normally resolves by itself over 6-8 weeks. Occasionally small doses of botulinum toxin may be used to lift the brow and for eyelid droop an eyedrop can be prescribed.
• Over or under-treatment: The response to botulinum toxin can vary and for this reason we cannot guarantee the results you will see. Whilst we aim to give you the results you desire sometimes you may see more or less paralysis of the muscle. Under-treatment can be easily rectified with a top up, but over-treatment normally requires waiting until the toxin has worn off.
• Unexpected response: Sometimes botulinum toxin can cause unexpected effects on surrounding muscles. Rest assured that if this happens it is almost always temporary and will resolve as the toxin wears off.

Botulinum toxin can be used for many medical purposes such as migraines, muscle spasm and bladder overactivity. Most brands of botulinum toxin are only licensed for use in frown lines but have been proven to be safe and effective in many other “offlabel” uses including:

• Upper face: Traditionally known as the “3 Areas of Botox” this encompasses treatment of horizontal forehead lines, frown lines and crow’s feet.
• Brow lift: These are injections targeted just under the brow to lift the brow, open up the eyes and reduce dark shadows.
• Bunny lines: Lines on the nose that appear on wrinkling the nose like a bunny can be treated with an injection into the nasalis muscle.
• Gummy smile: When we smile, our upper lip rests around the level of the top of the upper teeth. If our muscles are overactive, then this can lift the lip too high and expose more of the upper gum. Botulinum toxin can be used to lower the upper lip.
• DAO: The depressor anguli oris (DAO) muscle is responsible for bringing down the corners of our mouth. Paralysing this muscle provides a lift to the corners.
• Mentalis: The muscle of the chin, botulinum toxin in this area smooths out the chin and prevents it from puckering on facial expression. This is otherwise known as chin dimpling or orange peel skin.
• Masseter/Jawline slimming: Botulinum toxin into the masseter muscle treats jaw clenching and grinding (bruxism) and over time can slim the jaw.
• Neck: Paralysing the platysma muscle of the neck can get rid of neck “bands” visible on straining and provide a slight lift to the neck. It cannot address neck “bands” that remain visible on relaxing the neck muscles.
• Hyperhidrosis: Botulinum toxin administered into the skin of the armpits, hands and feet reduce sweating.

At Elem, we offer all botulinum toxin treatments above.

Botulinum toxin (commonly known as Botox) cannot be reversed once it has been injected. However, its effects are temporary and typically wear off over 3 to 6 months as the nerve signals gradually return to normal. If you experience any concerns after treatment, it’s best to consult your provider to discuss options for managing side effects or adjusting future treatments.

All patients must undergo a face-to-face consultation with our prescriber prior to receiving botulinum toxin treatment. This is because botulinum toxin is a prescription only medicine, meaning you cannot get it without a valid prescription. This consultation is essential to assess your medical suitability, discuss your treatment options and ensure you provide informed consent. Please note that treatment cannot proceed without this in-person assessment. Your prescription will be valid for six months from the date of your consultation. The price of the consultation will be deducted off your treatment.

The term “Dermal Fillers” is used to describe a sterile gel that is injected under the skin to provide volume, lift and/or contouring. Dermal fillers are usually cross-linked to give a more structural effect. Most dermal fillers are made of hyaluronic acid which is a naturally occurring sugar found in your own skin. This makes them safe to inject (as the body doesn’t reject them) and reversible (with a product called hyaluronidase).

Dermal fillers are injected into the body at various depths and provide structural changes that are visible instantly. There are thin dermal fillers, which are suitable for rejuvenation of sensitive areas such as under the eyes or in the lips. There are also thicker dermal fillers that can be used to enhance the cheeks or correct irregularities in the nose. 

Dermal fillers do not require a prescription but should only be administered by a trained medical professional.

Most dermal filler and skin booster treatments are carried out with no problems. However, all treatments have side effects that can occur. Swelling, redness, bleeding and bruising are common with these treatments and are considered part of the normal recovery process rather than true side effects. The side effects that can occur are as follows:

• Lumpiness: Most filler treatments shouldn’t leave lumps and your practitioner may massage after the treatment to ensure everything is smooth. If you can feel something that they haven’t identified, then please highlight this as it is easier to treat the earlier it is picked up. If picked up later then they can be treated with heat and massage, needle puncture and/or dissolving. Some treatments, such as corner of the mouth filler, require a lump to be left to provide a lifting effect. In these cases, lumps should be felt but not seen. Skin boosters are injected in small “lumps” under the skin which spread after a few days.
• Asymmetry: No face is completely symmetrical, and it is impossible to make a face completely symmetrical, but we do aim to deliver dermal fillers in a symmetrical manner. Unfortunately, sometimes the swelling will be more on one side of our face, or the filler can spread in an unexpected direction, which can lead to asymmetrical results. If minor asymmetry, then this will be left to wear off naturally but if it’s more significant we can dissolve or add filler as required. There may be an additional cost associated with this.
• Over or under-treatment: The response to dermal filler and skin boosters can vary and for this reason we cannot guarantee the results you will see. Whilst we aim to give you the results you desire sometimes you may see more or less of a response. If there’s more filler than expected then this can be dissolved, if you want more filler then this can be provided. Normally these adjustments come at a cost so please ensure you are happy with the volumes used during your treatment.
• Bacterial Infection: All treatments are provided in very clean environments, but infection can still occur. Bacterial infection is more likely if you touch the injected areas or apply makeup within 24 hours of treatment and you may be more prone to infection if you have other medical conditions such as diabetes or take medications such as steroids. Bacterial infection can be treated with antibiotics in the early stages but may require debridement and drainage of any abscesses if it progresses.
• Herpes outbreak: Please mention to your practitioner if you have a history of cold sores as this will increase your risk of having a herpes outbreak. In some circumstances you will be asked to take a medication before and after treatment to prevent an outbreak from occurring. If an outbreak does occur this will be treated with the same medication.
• Vascular occlusion: If filler is injected into or around a blood vessel then this can reduce the blood supply to the skin. This is extremely rare and presents with pain and signs of poor blood supply in the affected area. You should always be comfortable and pain-free at the end of your appointment so please inform your practitioner if this is not the case. If you are found to have a vascular occlusion you will have emergency doses of hyaluronidase administered and given some mediation to help the blood flow. If vascular occlusion remains undetected it can lead to a small part of the skin scabbing over (avascular necrosis) and this may leave a scar when healed.
• Blindness: There have been reported cases of blindness in the literature due to injection of filler into a vessel near the eye. This is incredibly rare.

Dermal fillers can be used for a variety of purposes. As our knowledge and confidence using these products grows, so do the clinical applications. Currently dermal fillers can be used to:

• enhance, define, shape, and rejuvenate the lips
• fill deep lines around the mouth such as nasolabial, marionette and barcode lines
• contour and enhance the temples, cheeks, nose, chin, and jawline
• rejuvenate and soften the hollows under the eyes (tear troughs)
• restore volume in the hands to reduct the appearance of veins and tendons

At Elem, we offer the following dermal filler treatments:

• Lip Filler
• Cheek Filler
• Chin Filler
• Nasolabial Folds
• Marionnette Lines

Hyaluronidase is an enzyme that can be used to dissolve hyaluronic acid fillers and skin boosters. It can be used to treat lumps, asymmetry, or overcorrection in a non-urgent setting, but it can also be used in an emergency setting to treat vascular occlusion.

“Skin Boosters” are dermal fillers with less, or no, cross linking. This leads to enhancement of the skin’s own collagen and elastin without the structural changes associated with dermal fillers. Most skin boosters are made of hyaluronic acid which is a naturally occurring sugar found in your own skin. This makes them safe to inject (as the body doesn’t reject them) and reversible (with a product called hyaluronidase). 

Skin boosters are placed just under the skin to attract water and boost your body’s own collagen and elastin. 

Skin boosters do not require a prescription but should only be administered by a trained medical professional.

Dermal fillers and skin boosters improve the tone, texture, and hydration of the skin. Skin boosters can be used anywhere but are particularly good at treating:

• The face, in particular barcode lines around the lips
• The neck and the décolletage area on the chest
• The hands and arms

Vitamin injections deliver essential nutrients directly into the bloodstream or muscle tissue via an intramuscular or subcutaneous injection. This bypasses the digestive system, allowing for more efficient absorption and utilisation of the vitamins by the body. This method ensures that a higher concentration of the nutrient is available, providing quicker and more effective results compared to oral supplements.

Vitamin B12 is an essential water-soluble vitamin that plays a vital role in energy production, red blood cell formation, and neurological function. Many individuals experience benefits such as increased energy, improved mood, and enhanced mental clarity after receiving B12 injections. These injections are particularly helpful for individuals with B12 deficiencies, which can lead to fatigue, weakness, and other health issues.

Vitamin C, also known as ascorbic acid, is a powerful antioxidant that supports the immune system, promotes collagen production, and aids in the repair and regeneration of tissues. Vitamin C injections can help improve skin, nail, and hair health, reduce fatigue, and boost overall wellness, particularly in individuals who may not get enough Vitamin C through their diet.

Biotin, or Vitamin B7, is a B-complex vitamin that is essential for maintaining healthy hair, skin, and nails. It also supports metabolic functions by helping the body convert food into energy. Biotin injections are often used to address hair thinning, brittle nails, and dull skin, promoting overall aesthetic and wellness benefits.

You will be asked to complete a medical history and consent form prior to your appointment. You will also be asked permission to share your photos. This is not compulsory but since aesthetics is such a visual specialty, we rely on using photos to advertise our work. Once the paperwork is complete you will be settled in to wait for your practitioner to become available.

At Elem, we never want you to feel rushed. We schedule extra time to ensure that we can offer a thorough consultation and deliver your treatment at a pace that feels comfortable for you. We always endeavour to run on time, but there may be times where we overrun, so please accept our apologies if this is the case.

When it is your time, you will be brought into the treatment area. You will get settled onto a treatment couch and your medical history will be checked. You will then have the opportunity to discuss any specific concerns you have with your practitioner, and, with them, you will formulate a treatment plan. Once the treatment plan is agreed your skin will be cleaned using a cleansing solution. Please inform us if you have any allergies prior to this point. Your skin may be marked with a non-permanent skin pencil and the injections will be performed. 

If you are feeling nervous at the start of your appointment, just let us know. We will take extra care to make sure you feel at ease and talk through any concerns or worries that you may have.

A little pain with injectable treatments is not uncommon and depends on several factors including hormones, tiredness, stress, and distraction and varies from treatment to treatment and person to person.

For dermal filler and skin booster treatments, we use a strong numbing cream for the area being treated. We also use dermal fillers that contain lidocaine, a local anaesthetic, which will progressively numb the area throughout the treatment. Skin boosters do not have local anaesthetic and can therefore feel a little more painful.

For botulinum toxin treatments, we use ultra-fine needles to minimise discomfort. You can request to have numbing cream applied before the treatment, however people do not usually feel that this is necessary.

We understand that every individual has unique goals and concerns. That’s why we offer a variety of injectable treatments tailored to different needs – whether you’re looking to soften lines, restore volume, or enhance facial contours. During your consultation, our experienced practitioners will assess your features, discuss your goals, and recommend the most suitable treatment plan to achieve natural, beautiful results.

We understand that every individual has unique goals and concerns. That’s why we offer a variety of injectable treatments tailored to different needs – whether you’re looking to soften lines, restore volume, or enhance facial contours. During your consultation, our experienced practitioners will assess your features, discuss your goals, and recommend the most suitable treatment plan to achieve natural, beautiful results.

• Stay hydrated
• Avoid alcohol and caffeine for 24 hours before
• Avoid blood thinning medication such as Ibuprofen and Aspirin for 24 hours before
• Avoid oral/topical antibiotics or antibiotic eye/ear drops 2 weeks before
• Schedule your appointment at least 2 weeks before any special event you may be attending

Please come to your appointment with a clean face, free of any makeup and skin care products.