Subtle, natural-looking treatment planning led by Consultant Plastic Surgeons in South Kensington. We assess facial movement, anatomy, goals and suitability before discussing any prescription treatment.
Expression lines are influenced by facial movement, anatomy, skin quality and age. The same pattern of lines can require a different approach from one person to another. At Santi, the consultation is therefore the most important part of the process.
We assess how the face moves at rest and during expression, discuss what you would like to change — and what you would prefer to preserve — and explain realistic options, benefits, risks and alternatives.
Consultant Plastic Surgeon Mr Yazan Ajam discusses when treatment may be appropriate and some of the considerations that should come before deciding to proceed.
Santi’s aesthetics programme is led by Consultant Plastic Surgeons with extensive surgical training, academic experience and a detailed understanding of facial anatomy.
Mr Saeed has worked in plastic surgery since 2005 and trained on the Pan-Thames specialist rotation, with appointments across leading UK centres. His interests include non-surgical facial rejuvenation, laser and light technologies and reconstructive surgery.
Meet Mr Mobin Saeed →Mr Ajam specialises in facial aesthetics and reconstructive surgery, with a conservative approach focused on facial balance, natural movement and subtle, proportionate results.
Meet Mr Yazan Ajam →The sections below make it easy to get a quick answer. The detailed educational material continues further down this page for anyone who wants to understand the treatment in more depth.
What to expect, who it suits and how we approach subtle, natural-looking line softening.
Read the consultation guide →An educational overview of botulinum toxin, how it works, safety and what to expect.
Read the overview →What is normal afterwards, simple do’s and don’ts, the two-week review and ways to support longevity.
Read the aftercare guide →A practical timeline covering early aftercare, red flags, when to contact us and combining treatments.
Read post-treatment care →A gentler, conservative approach using precise placement and lower dosing where appropriate.
Explore Baby Botox →Practical information about consultation-led treatment at our South Kensington clinic.
Read the London guide →Jaw clenching, teeth grinding and selected lower-face contour concerns — assessed function first.
Explore masseter treatment →A dedicated function-first guide to clenching, grinding, dental collaboration and review.
Read the bruxism guide →Clinical assessment for recurrent migraine or frequent headaches, with triggers and next-step planning.
Explore migraine consultation →Clinician-reviewed guides, trigger checklists, consultation preparation and a downloadable diary.
Open the resource hub →Hyperhidrosis assessment and practical management information, including underarm sweating.
Explore hyperhidrosis →An anatomy-led guide to selected neck concerns, movement and conservative staged options.
Read the neck-lines guide →Advanced assessment of upper trapezius activity, shoulder contour and tension.
Explore TrapTox →Non-surgical neck and jawline refinement discussed through an anatomy-led consultation.
Explore the Nefertiti guide →A clearer look at onset, peak effect, duration and how results change over time.
Read the longevity guide →Different tools for different concerns — movement, volume and when each approach may be more appropriate.
Compare treatment approaches →We review medical history, facial movement, anatomy, previous treatments and what you want to achieve.
If a prescription option is clinically suitable, your clinician explains the plan, consent, risks, alternatives and expected outcome.
Where appropriate, you can return after approximately two weeks so the result can be assessed once the treatment has had time to take effect.
Facial movement is interconnected. Rather than treating a line in isolation, we assess the muscles acting across the forehead, brow, eyes, lower face and neck and consider how changing one area may influence another.
The diagram is educational and does not indicate injection points, doses or suitability. Any prescription treatment requires individual face-to-face assessment.
| Main concern | Usually discussed first | Why |
|---|---|---|
| Expression lines caused by muscle movement | Anti-wrinkle consultation | Targets dynamic muscular movement where clinically appropriate. |
| Loss of facial volume or contour | Dermal fillers | Volume and structural change require a different treatment strategy. |
| Dryness, crepiness and skin quality | Skin boosters | These focus more on hydration and skin quality than muscle movement. |
| Texture, pigmentation or sun damage | Laser / skin treatments | Surface and pigment concerns are often better approached through skin-focused treatment. |
Consultant Plastic Surgeons and clinicians providing care at Santi London.
Meet the clinical team →Objective skin measurements to help guide a broader plan for hydration, pigmentation, texture and skin quality.
Explore Skin Lab →For hydration and skin-quality concerns that are different from dynamic muscle movement.
Explore skin boosters →The remainder of this page is deliberately more detailed. It is for patients who want to understand mechanism, timing, advanced uses, safety, aftercare and emerging developments before coming in for consultation.
Botulinum toxin is a prescription-only medicine used in a range of medical and aesthetic settings. In aesthetic practice it may be considered to reduce the activity of selected muscles whose repeated contraction contributes to dynamic lines. It does not fill the skin or replace lost volume.
Botulinum toxin temporarily reduces signalling between nerves and selected muscles. The clinical effect depends on the treatment area, anatomy, dose and placement. Treatment planning therefore requires an understanding of how neighbouring muscles work together rather than simply targeting an individual line.
Changes usually develop gradually rather than immediately. Many patients begin to notice an effect over the first one to two weeks. Timing varies according to area, dose, muscle activity and individual response.
Duration varies between patients and treatment areas. Effects typically soften gradually over several months as normal neuromuscular activity returns. Muscle strength, metabolism, dose and treatment history all influence longevity.
That is not the aim of Santi's treatment philosophy. We favour a conservative, balanced approach designed to soften selected movement while retaining natural expression. The degree of movement preserved is discussed during consultation.
Age alone is not a reason to have treatment. What matters is facial movement, the presence of persistent dynamic lines, anatomy, patient goals and whether intervention is clinically justified. Consultation should come before any decision to treat.
Botulinum toxin is also discussed in relation to larger muscle groups such as the masseter, platysma and upper trapezius. These areas require particularly careful dosing because treatment can affect chewing, neck function or shoulder mechanics if performed inappropriately.
So-called “TrapTox” refers to treatment of the upper trapezius. Depending on the patient, the discussion may involve muscle over-activity, tension or shoulder contour. Athletes and patients whose work relies heavily on shoulder strength should disclose this during consultation.
Botulinum toxin has established medical applications, including selected cases of chronic migraine and hyperhidrosis. These require diagnosis, assessment and an appropriate medical treatment pathway. A cosmetic consultation should not be used as a substitute for medical assessment.
Short-lived redness, tenderness, small injection marks and bruising may occur. Less commonly, temporary asymmetry, heaviness or unwanted weakness of nearby muscles can occur. Rare complications are also possible. Your clinician discusses risks, alternatives and what to do if you are concerned before treatment.
Suitability is determined individually. Relevant factors may include pregnancy or breastfeeding, active infection in the proposed treatment area, certain neuromuscular conditions, previous reactions, medication and other aspects of medical history.
Evidence that zinc supplementation reliably extends treatment duration is limited and inconclusive. Technique, dose, anatomy, muscle activity and individual variation remain much more important determinants of outcome.
New botulinum-toxin formulations and neuromodulators continue to appear in research and international markets. Availability, licensing, indications and evidence vary. Brand selection is a clinical decision and, where relevant, is discussed privately during consultation rather than advertised.
Botulinum toxin is a prescription-only medicine in the UK. Any prescription treatment can only be considered after an appropriate face-to-face consultation confirms suitability.
Our approach is deliberately conservative and aims to preserve natural movement. The balance between softening lines and retaining expression is discussed during consultation.
The consultation is the important part. Where treatment is appropriate, the procedure itself is often relatively brief, commonly around 15–30 minutes depending on the areas being addressed.
The effect develops gradually. Many patients begin to notice change within one to two weeks, although timing varies.
Duration varies by treatment area, anatomy, muscle activity, dose and individual metabolism. The effect softens gradually over several months.
Yes. Santi offers a complimentary review at approximately two weeks where clinically appropriate, allowing the clinician to assess the result once the treatment has had time to take effect.
Sometimes, but they address different problems. Treatment can be staged or combined where clinically appropriate after assessment.
Selected patients may be assessed for treatment of the masseter muscles. Bruxism can also have dental and behavioural causes, so a function-first assessment is important.
Botulinum toxin is used medically for selected cases of hyperhidrosis. Assessment is required to confirm the diagnosis, severity and suitability.
Botulinum toxin has a recognised role in selected chronic migraine pathways. Migraine treatment requires appropriate medical assessment and is distinct from cosmetic treatment.
Bring a list of relevant medication, tell us about previous injectable treatment and consider which facial movements or concerns bother you most. Photographs of previous results can also be helpful.
Meet an experienced clinician, discuss your goals and facial movement, and receive a clear explanation of suitable options, risks, alternatives and aftercare. There is no pressure to proceed on the day.
This page is educational and does not advertise prescription-only medicines. Any prescription treatment can only be offered following a face-to-face assessment by an appropriate prescriber.
