Aesthetic medicine · HappyDERM, ul. Barlickiego 31/1u, Wrocław
Botox in Wrocław: botulinum toxin for expression lines
Frown line, horizontal forehead lines, crow’s feet. One area 600–650 PLN, three areas 1300 PLN, Alluzience 1500 PLN. The treatment is performed by a dermatologist, Małgorzata Micał-Strąk, MD, PhD, using Azzalure, Bocouture, Letybo or Alluzience. The effect appears after 3–7 days, is complete after two weeks and lasts 3–5 months. We also use Botox to treat bruxism, excessive sweating and migraine.
Follow-up after 14 days. At that point we assess symmetry and add a few units if needed. We do not do this earlier, because the effect is still developing.
What Botox is and how it works
“Botox” is the popular name for treatment with botulinum toxin type A. Botox is the brand of one of the products; Azzalure, Bocouture, Letybo and the ready-to-use solution Alluzience are also registered in Poland, and these are the ones we use. The toxin blocks the signal from the nerve to the muscle for several months, so the muscle that wrinkles the forehead or draws the brows together works less strongly. The skin above it stops folding in the same place a hundred times a day and the line smooths out. There is no filling and no “freezing” of the face if the dose is chosen sensibly.
Expression lines
They appear when you wrinkle your forehead, narrow your eyes or draw your brows together, and disappear when the face is at rest. They are the target for the toxin, and this is where it works best.
Static lines
After years of expression, a furrow remains even at rest. The toxin makes it shallower because it stops being deepened, but it does not erase it. After 2–3 cycles we sometimes complement a deep frown line with a little hyaluronic acid.
Not a filler
The toxin does not add volume. It has no effect on nasolabial folds, hollow cheeks or thin lips. Those are treated with hyaluronic acid, as described on the page on aesthetic medicine.
Which areas we treat with the toxin
Frown line (650 PLN)
Vertical lines between the eyebrows. The most common area and the most rewarding: the effect is clear and the risk small. We inject at 5–7 points and match the dose to muscle strength; in men it is usually higher.
Horizontal forehead lines (600 PLN)
Care is needed here, because the frontalis muscle lifts the eyebrows. If it is weakened too much, the brows drop and the eyelids feel heavy. That is why the doses are smaller and the lower band of the forehead is often left alone.
Crow’s feet (650 PLN)
Radiating lines at the outer corners of the eyes, visible when smiling. We inject superficially, 2–4 points per side. The result: the eyes look rested while the smile remains.
Other areas (from 400 PLN)
“Bunny lines” on the nose, a gummy smile, drooping mouth corners, a dimpled chin, lifting the tip of the nose, neck bands. Some of these uses go beyond the product’s registered indications, which we discuss before the treatment.
Qualification: we look at movement, not at the line
We ask the patient to wrinkle the forehead, draw the brows together, smile broadly and close the eyes tightly. We look at which muscle is strong and which is weak, where the asymmetry lies and whether the forehead is holding up drooping brows. Two people with the same line receive different points and different doses. Before the treatment we also check:
- the position of the brows and eyelids and natural asymmetry (everyone has it),
- earlier treatments: when, which product, how long the effect lasted and whether anything was concerning,
- medicines, especially blood thinners, aminoglycoside antibiotics and muscle relaxants,
- neuromuscular diseases (myasthenia) and swallowing disorders,
- pregnancy, breastfeeding, a planned vaccination or dental procedure,
- infection or cold sores at the injection site,
- what the patient expects and what limitation of expression they would not accept,
- whether there is an event within 2 weeks at which the patient needs to look their best.
What the treatment looks like and when the effect is visible
The treatment itself takes 10–15 minutes and the whole visit with the consultation about half an hour. At a first visit we perform Botox straight away if there are no contraindications.
1. Plan and photographs
Assessment of expression, marking the points with a pencil, photographs at rest and in motion. Without these photographs the result cannot be assessed reliably at the follow-up.
2. Injection
Disinfection, a few to a dozen or so pricks with a fine insulin needle. It feels like small pinches. No anaesthetic is needed. You can return to work straight away.
3. The first days
After 3–4 days the muscles begin to weaken; after a week most of the effect is visible. Possible: a small bruise, a headache for a day, a feeling of “heaviness” in the forehead for a few days.
4. Follow-up after 14 days
We assess symmetry and the strength of the effect. If one side works more strongly, we add a few units. Only now is the result assessed, not after three days.
For the first 4 hours
Please do not lie down, bend the head low, massage or press the injection sites, so that the product does not spread to neighbouring muscles. For 24 hours avoid saunas, sunbeds, alcohol and intensive training. Make-up may be applied from the next day.
How long the effect lasts
Usually 3–5 months, sometimes shorter for crow’s feet, because the orbicularis oculi muscle works constantly. After the first treatments the effect may be shorter; with later ones the muscles “learn” not to work and the intervals grow longer. Very physically active people metabolise the toxin faster.
How often Botox should be repeated
We perform the next treatment when the muscles return to work and the line begins to show again, usually after 4–6 months. Never earlier than after 3 months, as stated in the product information and because injecting too often favours the formation of antibodies, after which the toxin stops working. There is no point in “topping up” the dose after 6 weeks when the effect begins to fade; it is better to wait.
The first year
Usually 2–3 treatments. We establish the dose that gives an effect without a mask-like look and learn how long it lasts in your case.
Later years
Two treatments a year are often enough. The muscles weaken, static lines become shallower and doses may be smaller.
Records
The product name, batch number, units and points. If you change clinics, ask for these details. “I had Botox” is not enough.
A break
You can stop at any time. The muscles return to their pre-treatment state, not a worse one. Lines do not “take revenge” for a break.
Natural expression: where the “mask effect” comes from and how we avoid it
Less first, then a top-up
We give a dose that weakens the muscle by two thirds rather than switching it off. If after 14 days there is too much movement, we add more. It does not work the other way round: too much toxin means 3 months of waiting.
Asymmetry
Every face is asymmetrical. The toxin can even out brows that lift unevenly, but it can also reveal asymmetry that stronger movement had been masking. We point it out in the mirror before the treatment.
“Spock” brows
When the centre of the forehead is weakened but the sides are not, the brows lift at the outer ends like Spock’s. This is easily corrected at the follow-up with a few units at the sides, which is why the follow-up is not optional but part of the treatment.
When Botox is not a good idea
Drooping brows and heavy eyelids
If the forehead is working all the time because it holds up drooping brows, weakening it will make things worse: the eyelids will drop and the eyes will look tired. In such cases we treat only the frown line and crow’s feet, or leave the forehead untreated.
The problem is volume, not expression
Hollow temples, nasolabial folds, jowls, lax skin on the neck. The toxin will not help here; hyaluronic acid, a stimulator or a laser is needed. We say so plainly rather than charge for a treatment without effect.
Unrealistic expectations
“I want my forehead as smooth as glass and I want it to last a year.” That is neither possible nor advisable. If after the conversation we still do not agree on the goal, it is better not to start.
Contraindications, side effects, warning signs
Botulinum toxin is a prescription medicine. It is given by a doctor who knows the anatomy, can recognise a complication and knows what to do about it. We never perform the treatment in pregnancy, in myasthenia and other neuromuscular diseases, in allergy to the product’s ingredients or with an infection at the injection site. Breastfeeding, blood-thinning medicines and aminoglycoside antibiotics are situations to be discussed, not an automatic refusal.
- common and harmless: a bruise, redness, slight swelling, a headache on the first day, a feeling of heaviness in the forehead for a few days,
- less common and temporary: a drooping eyelid or brow (2–6 weeks), an asymmetric smile, dry eye, uneven brow elevation,
- very rare, requiring urgent help: difficulty swallowing, speaking or breathing, generalised muscle weakness, visual disturbances, an allergic reaction with shortness of breath.
How much Botox costs in Wrocław
HappyDERM price list
- horizontal forehead lines: 600 PLN,
- frown line: 650 PLN,
- crow’s feet: 650 PLN,
- Botox lift, 3 areas: 1300 PLN,
- Alluzience, 3 areas: 1500 PLN,
- nose, chin, mouth corners, gummy smile: from 400 PLN.
How we charge
The price covers one area, regardless of the number of units, which we match to muscle strength. The rules for the follow-up and any top-up are discussed at the visit, before the treatment. A consultation without a treatment is charged as a medical appointment (280–350 PLN). The full price list: HappyDERM price list.
Botox: what patients ask
Does Botox hurt?
A few pricks with a very fine needle, like a vaccination but shallower. No anaesthetic. The frown line is felt most, crow’s feet least. The whole thing takes a few minutes.
When will I see the effect and how long does it last?
The first changes after 3–4 days, the full effect after 10–14 days. It lasts 3–5 months; after a first treatment and in very physically active people it may be shorter.
Will my face look “frozen”?
Not if the dose is matched to your muscles. We keep movement and only reduce it. If after the follow-up you decide you would like a stronger effect, we add more. That is safer than the other way round.
From what age does it make sense?
When expression lines begin to remain at rest, in many people around the age of 30. Preventive treatment in twenty-year-olds without lines is pointless. More in the guide on baby Botox.
Will the lines be deeper after stopping?
No. The muscles return to work and the face looks as it would have without treatments, and often slightly better, because the line was not being deepened for months.
Can I have Botox during pregnancy or while breastfeeding?
Not during pregnancy. For breastfeeding the data are limited and depend on the product; we usually suggest waiting. The treatment is aesthetic, so there is no reason to take a risk.
What this information is based on
- Summaries of product characteristics (Polish Register of Medicinal Products) Azzalure, Bocouture, Letybo: indications, intervals of at least 3 months, warnings, side effects.
- American Academy of Dermatology, botulinum toxin: procedure, effects, safety.
- Carruthers J. et al., Dermatologic Surgery 2017: the effect of successive toxin cycles on glabellar lines at rest (study sponsored by the manufacturer).
Prices come from the HappyDERM price list and are indicative until the medical assessment. The product, dose, injection points and the date of the next treatment are decided by the doctor. Results vary between individuals.
Book a consultation and treatment at one visit
Please call 573 290 488 or write via the form. Tell us which areas you are interested in and whether you have been treated with the toxin before. Wrocław, ul. Barlickiego 31/1u.
Botox Wrocław – price
- Horizontal forehead lines – 600 PLN
- Frown line – 650 PLN
- Lines around the eyes (crow’s feet) – 650 PLN
- Botox lift – 3 areas – 1300 PLN
- Alluzience ABO Liquid – 3 areas – 1500 PLN
We confirm the final price at the consultation, after assessing the scope of the treatment. The full list is available in the HappyDERM price list.