How does Botox really work and how can I avoid the ‘frozen look’?

Written by: Mr Giovanni Ferrando
Edited by: Cameron Gibson-Watt

If you are thinking about getting Botox but concerned about looking unnatural, expressionless or ‘frozen-faced’, you shouldn’t worry. When done right and by an experienced professional, Botox can offer a subtlely rejuvenated and natural look, and can even help to prevent wrinkles forming in the future.

Mr Giovanni Ferrando is a highly experienced consultant plastic and reconstructive surgeon based privately in London and Genoa, Italy. As an expert in administering Botox, he explains what the substance is, how it works and what you should be looking out for when choosing a Botox provider to avoid undesirable results.



How does Botox work?

Botox - also known as botulinum toxin - is a neurotoxic protein that temporarily blocks impulses from the nerves to the muscles, resulting in a weaker, or paralysed muscle that can’t contract. The affected muscle appears more relaxed which consequently reduces the presence of wrinkles and in some cases, slightly raises the eyebrow. This effect gives the face a younger and more rested appearance; however, it isn’t permanent, and after five or six months the effect will disappear and the muscle will regain its strength.


Which area of the face should I get treated?

Botox can work in various areas of the face and body. However, it is typically used in the face and more specifically, the superior third of the face. This consists of the area above the eyes and the forehead and is where the ageing process is more prominent due to the over-contraction of the muscles which over time results in wrinkles. Relaxing the right muscles in this area using botox is one of the best anti-ageing treatments.


How can I avoid looking unnatural?

Avoiding an unnatural result depends on the ability and experience of the doctor or surgeon carrying out the procedure. Some types of Botox are stronger than others therefore, it is important to correctly calculate the dosage otherwise if the injected units are not well calculated, you can end up with an unnatural appearance, ‘Spock brows’, or how many describe it; the ‘frozen look’.


How often should I get Botox treatments?

You can repeat the treatment two or three times per year. I don’t recommend having it more often than that, however, it depends on the strength of the muscle and other individual variables.


Are there possible side-effects?

Side-effects from Botox are very uncommon. They depend mainly on the experience of the doctor or surgeon. If the professional doesn’t have sound knowledge of the substance and skill in administering it, the final result may not be as desirable as you’d hoped. It is very important that the specialist carrying out the procedure fully understands the anatomy of the head muscles and has sufficient experience to reach the best result.


What should I look for in a Botox provider?

In a nutshell, the specialist who performs the Botox procedure has to have expert knowledge of the facial anatomy and know how any single muscle will look once it has been injected and relaxed. It is only in this way we can move away from an excessive contraction of the muscles and wrinkles to a more youthful and harmonic appearance.


If you are interested in receiving Botox treatment, visit Mr Giovanni Ferrando’s Top Doctors profile and book a consultation to see him.

By Mr Giovanni Ferrando
Plastic surgery

Mr Giovanni Ferrando is a vastly experienced consultant plastic and reconstructive surgeon with private clinics in London and Italy. He is known for his innovative and pioneering work in designing and developing new techniques to be used in cosmetic and aesthetic surgery, and has a very keen attention to detail, always striving to achieve natural-looking results. He specialises in all kinds of aesthetic surgery, with special interest in rhinoplasty, blepharoplasty, facelift, breast augmentation, Botox injections on other less invasive aesthetic medicine treatments. 

When performing surgery on a patient, Mr Ferrando prefers to take time to study the proportions of the patient's face, and also gets to know the patient well to make a decision on what the best nose for the patient would be. He personally draws a portrait of the patient to see the desired results, and to use the same hand to craft the drawing that will perform the surgery. This part of the process is important to Mr Ferrando in ensuring the best results are achieved. 

Alongside his clinical practice, Mr Ferrando devotes time to giving talks about his profession, and is a regular contributor to the Aesthetic Plastic Surgery Journal, and is currently writing a book on rhinoplasty. 

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