The best Botox doctors in the UK
These innovators don’t just smooth wrinkles. Olivia Falcon talks to the experts about new alternatives that can even treat hay fever and hair loss
In the beginning there was Botox. Botulinum toxin type A, to give it its proper name, is an injectable neurotoxin that inhibits the release of neurotransmitters that cause muscles to contract, smoothing frown and expression lines in the skin. Its advent in the 1990s was undoubtedly the aesthetic industry’s Big Bang moment, launching thousands of cosmetic clinics and the billion-pound industry that is still booming today.
Pre Botox the options where limited; we had beauty salons and their underwhelming facials or plastic surgeons’ clinics offering overwhelming surgical solutions. Not only has Botox helped with a raft of medical issues, from treating cerebral palsy to hyperhidrosis (a condition that causes excessive sweating) and migraines, but it is used for cosmetic concerns such as “relaxing” wrinkles, smoothing brows, crow’s feet, bunny lines (those unsightly crinkles around the nose) and glabellar or “11″ lines that hang between the brows, making one look angry and older. It can also be used to improve skin texture if injected very superficially.
With more than 75 million units of botulinum toxin injected every year in the UK, Botox has become synonymous with facial rejuvenation. Building on the global success of the brand, competitors such as Dysport, Xeomin, Bocouture and Azzalure have followed, and more recently other neurotoxins have emerged promising faster and longer-lasting results. But perhaps even more important than the brand is the practitioner. Here the UK’s top experts reveal their predictions for what will be keeping our brows smooth in the future.
Sharon Bennett
As chairwoman of the British Association of Cosmetic Nurses, Bennett has busy clinics in Yorkshire and London, and a loyal following of women of a certain age who covet her highly effective treatments. “Wrinkle-relaxing injections have become so much more clever in the past five years,” she reports. “As practitioners we used to have little choice in the toxin we used and we followed facial ‘templates’ to smooth lines. I have now moved on to being far more creative and I will often use two different toxins in different parts of the face, a technique I call Twin Tox (from £250), to help get the result I want. For example, some toxins such as Azzalure have a wider field of spread, so I may use it for upper foreheads, and then I will use Nuceiva, which is more targeted, for the lower forehead, to smooth wrinkles and lift eyebrows without dropping the brow.” harrogateaesthetics.co.uk
David Eccleston
Eccleston, who owns the MediZen clinic in Manchester, has 27 years of experience and has used six different toxin brands in that time. But for the past six months he has been busy converting patients to Nuceiva (from £235), which was launched in the UK in September last year but has been storming clinics Stateside since 2019 (where it is known as Jeuveau). Nuceiva uses a process called Hi-Pure that removes the fragment particles that are a by-product of the manufacturing process. “The purity of Nuceiva means it stays where you inject it and has a quicker onset, so patients see a difference in 24 hours. The effects last about a week or two longer than other brands,” Eccleston says. “The feedback from my patients is that Nuceiva feels softer and more natural, and patients’ friends give them compliments but don’t spot they have had treatment. No one is asking to go back to the brand they had before.” medizen.co.uk
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Professor Syed Haq
Haq, who has clinics in London and Northern Ireland, offers Letybo (from £300), otherwise known as letibotulinum toxin type A. This is a newly registered toxin in Europe and the first brand to be specifically tested in clinical trials on older patients (up to 75 years) as well as in a large male cohort. In the three studies, 1,200 patients were treated with Letybo repeatedly every 19 weeks for up to two years, in 27 centres in the US and Europe. “As we live longer, it’s very important that we are able to provide treatments that have been tested in the older patient population and show clear efficacy and safety. Older patients have weaker, thinner muscles, so one has to adjust the dose of toxin to account for this. Similarly with male patients a higher dose may be needed as the male face has more muscle bulk. With Letybo the clinicians have found the same dose works well on people of all ages and sexes, and this universal dosing will make it easier for practitioners to provide consistently good results with greater certainty.” amaesthetics.clinic
Dr Suha Kersh
The medical director of 23md clinics in Chelsea and Beirut is expanding her empire with a new outpost opening in Dubai this month. Kersh is very experienced in injecting the lower face and works with an array of toxin brands (Botox, Dysport and Bocouture, from £400). “I love working with the jawline and lips — relaxing barcode lines on the upper lip and fixing the downward pull of the mouth which becomes more noticeable as we get older. I also use toxins on the décolletage with other modalities such as Morpheus8 [micro-needling with radiofrequency energy] to relax skin and tighten the chest as it really reduces lines.” Kersh is also offering Microtox, a technique that uses a super-diluted formulation, administered only into the skin’s upper layer in tiny amounts, for a more natural look. Microtox is also a good solution for oily or acne-prone skin as it relaxes tiny strands of muscle that allow the sebaceous glands to work; this restricts the production of excess sebum that can lead to acne and oiliness and even drastically reduces the appearance of a sweaty forehead. 23md.co.uk
Dr Marco Nicoloso
Nicoloso trained on Harley Street and with the surgeon Mauricio de Maio. A purist, he is loyal to the Botox brand and a devotee of the Baby Botox technique (from £665), which involves smaller doses: “I like very natural results and in terms of treatment I think Botox is fantastic to open the eyebrows, which in turn freshens up a face. I usually focus on giving a bit of a lift to the brows but I preserve the movement in the forehead to ensure a natural, rested look. Too much Botox on crow’s feet changes the way you smile and looks unnatural.” Nicoloso is also the man to see for Botoxing armpits to help with excessive sweating (hyperhidrosis). ouronyx.com
Dr Tapan Patel
Patel is the recipient of the Aesthetic Awards’ Outstanding Achievement in Medical Aesthetics, has been injecting toxins for 23 years, presides over Phi Clinic on Harley Street and is on the medical faculty for Allergan, the maker of Botox. Loyal to the brand, he cites Botox (from £595) as having the most research, with clinical papers and medical indications behind it. “There are very few treatments I offer in my clinic that I can guarantee will work, but Botox always delivers.” He’s known for his light-handed Baby Botox treatments, and his approach has always been to start with a smaller dose and build up slowly, recalling patients two weeks later if needed. “While Botox is licensed for treating mainly the upper face, it can be very artistically used to balance muscle activity in other areas. I can stop teeth grinding or balance smile asymmetry by treating the muscles around the nose that pull up the middle of the lip. Botox is close to the perfect product. I’m reluctant to change something that is serving me so well.” phiclinic.com
Dr Emma Ravichandran
Co-founder of the multi award-winning chain of Clinetix clinics in Scotland, Ravichandran favours Bocouture (from £175), a purified toxin free from complexing proteins. Evidence from existing independent research supports the idea that injecting Bocouture is less likely to cause antibody formation leading to immunity, which can lead to future wrinkle-relaxing treatments being ineffective. “I prefer to choose a toxin without any unnecessary proteins in the formula,” explains Ravichandran. “I think this could be very useful for younger patients who are looking to start toxin treatment early for preventative reasons and who will be using them for decades to come.” Ravichandran is also carrying out in-clinic research studies on Bocouture, injecting it superficially into the dermis rather than facial muscles to reduce oil production, which may help with conditions such as acne, rosacea and open pores. The results so far are very promising. “I also love the low environmental impact,” Ravichandran adds. “Every other toxin available in the UK has to be refrigerated and is frequently transported with non-recyclable cool packs and packaging, but Bocouture can be transported and kept at room temperature, significantly reducing its carbon footprint.” clinetix.co.uk
Dr Sophie Shotter
Crowned Medical Aesthetic Practitioner of the Year at the 2023 Aesthetic Awards, Shotter — who exclusively uses Botox in her Kent and London clinics — is leading the way in innovative toxin applications. “While there are now a few different licensed products available, I think the key to good results is the combination of a great injector using a top-quality product. For me Botox gives a very predictable result, which I can tailor to a patient’s needs. I use Botox regularly in many areas: to treat jaw grinding, to relax the strong platysma muscle in the neck, to lift downturned mouth corners and conceal a gummy smile, to relax lip lines and tension in the chin, to raise the tails of the eyebrow, and even to increase hair growth by releasing the muscles in the scalp, which increases blood flow to the area, helping more nutrients get to the hair. Most recently I have tried a technique called Haytox, which has been very popular in Australia. A few injections are administered to the nose; it works by blocking the nerve signals in the nasal passage which trigger the onset of hay-fever symptoms — the results of this treatment last about six months and having tried it myself I have found the results amazing.” Looking to the future, Shotter is also excited about the advanced stage studies into botulinum E, which are ongoing. “This will represent an entirely new form of toxin, which will fill a different niche in my treatment practice,” she says, “as the results both set in and wear off quicker than other brands out there.” Perfect for beginners who want to dabble. illuminateskinclinic.co.uk
Dr Munir Somji
Averaging 5,000 injectable treatments per year, Somji, who has three Dr MediSpa clinics in London and Essex, is excited about Juvapen, a robotic pen that precisely injects toxin using superfine needles. “Juvapen consistently releases botulinum toxin in microdoses with a lower force than a human hand,” he explains. “If you are injecting at high pressures, toxin will spread through the skin tissues and can cause problems like droopy eyelids or heavy-set brows, but Juvapen limits the spread of toxins beyond the target site.” Somji favours Azzalure (£350), a toxin brand which he says gives a softer look than its competitors. He also uses a hand-held ultrasound tool to help him inject around facial ligaments rather than into muscles for a less frozen look. He is one of the first practitioners to offer Alluzience (£400), the sister brand of Azzalure, which lands at his clinic this spring. “I conducted consumer trials for Alluzience, which lasts on average a month longer than Botox. Rather than waiting a number of days for the wrinkle-smoothing effects, 20 per cent of patients in my study saw a difference within one day. It’s about £50 more expensive than competitor brands but I think offers a more precise treatment.” It will also prove very useful in areas where toxins wear away quickly, such as in lip flips (a procedure where minute drops of toxin are injected into the vermilion border to encourage more lip show). drmedispa.com
Dr Wassim Taktouk
As founder of LAAM (the London Academy of Aesthetic Medicine), where he teaches advanced injection techniques, Taktouk is one of the capital’s most popular cosmetic doctors. He is eagerly awaiting the launch of Daxxify (£295), or “Daxi” as it’s known, a new American toxin that has just been approved by the Food and Drug Administration and is slated to launch in UK later this year. “Botox has a very high safety profile and is still very popular, but Daxi’s point of difference is that it will last twice as long [six months rather than three], and even though it will cost about 50 per cent more per treatment, it will reduce the spend for the patients long term as they will only need two treatments per year, rather than four. This will also cut my waiting list in half [which is at present around three months], meaning I can take on new patients.” drwassimtaktouk.com
