Are the injections painful?

No, neuromodulator injections are usually painless.

When will I see results?

The effects will begin to work after a few days, reaching maximum effect by 2 weeks.

How long do results last?

For most patients, the effect lasts three to four months, after which muscle tone gradually returns. With regular treatment, the muscle response often becomes more balanced, extending the duration of results.

What are dermal fillers?

The dermal fillers we use are made from hyaluronic acid - a substance that occurs naturally in the body. These types of fillers are biodegradable, which means that they will gradually be absorbed as the gel breaks down and water takes its place. When totally absorbed, the filler gel disappears unnoticed from the body.

Am I suitable for muscle-relaxing injections?

This treatment is not suitable if you are taking the following medications: antibiotics like gentamicin, tobramycin, clindamycin and lincomycin, or quinidine for heart rhythm problems. You should not have muscle-relaxing injections if you have a muscle-weakening disorder (myasthenia gravis, Lambert-Eaton syndrome, ALS/motor neuropathy), are pregnant, breastfeeding, or allergic to human albumin (not egg allergy). Avoid having alcohol in your system, as it can increase the likelihood of bruising and make the injections spread to muscles you don't want to treat.

Which treatments complement the effects of muscle-relaxing injections?

Hyaluronic acid-based dermal fillers can support the muscles on resorbing bone and help reduce lines and wrinkles due to muscle overactivity. Plexr Skin Tightening is a plasma-based solution that will vaporise excess skin by up to 30% with each treatment, leaving it appearing tighter and more contoured.

What does Dr Sabrina correct with these treatments?

Horizontal "worry" lines (frontalis over-activity) - lines that appear across the forehead and can sometimes remain visible. "11's" or vertical "frown" lines (corrugator over-activity) - small lines that deepen over time between the brows from concentrating or frowning. Laugh or smile lines (orbicularis over-activity) - crow's feet that appear around the eyes when smiling or laughing. Jelly rolls of the lower eyelid (orbicularis hypertrophy) - horizontal under-eye lines caused by blinking, squinting and unavoidable reflexes. Bunny lines (procerus over-activity) - tiny lines that appear when wrinkling the nose. Bobbly / golf-ball chin (mentalis over-activity) - a dimpling effect on the chin due to excessive flexing. Marionette lines (DAO over-activity) - lines on either side of the mouth that deepen over the years due to loss of facial volume. Square jaw / bruxism (masseter hypertrophy) - masseter muscles that are over-pronounced in the jaw. "Turkey neck" (platysmal bands) - when the thick muscle that runs from the ear to the collarbone pulls the lower face downwards over time, causing a sagging effect. Brow ptosis or asymmetric brows - when the brows start to drop or there is asymmetry. Blepharospasm / hemi-facial spasm - muscular spasms around the eyes or involuntary contractions on one side of the face.

How does the treatment differ for men and women?

Most women like to have a more rested appearance with high brows and no lines. They tend to require additional fillers to maintain their preferred brow position and microdroplet injections for their necks around the time they reach their mid-50s. Meanwhile, men usually prefer to retain a few horizontal forehead lines, instead focussing on treatment for their "11" vertical frown lines. They tend to require microdroplets for their brow and forehead by their mid-40s.

What are the potential side effects?

As with any drug, there are some possible side effects. However, the product only stays in the body for a maximum of 6 months, so any side effects associated with the injection will diminish after that time. Possible side effects can include: Bruising and/or erythema: redness of the skin at the site of injection. Feeling unwell: headache, respiratory infections, nausea and flu-like symptoms. Temporary ptosis or droopy eyelid: this typically reverses in 4-6 weeks as the toxin begins to wear off. It can be managed with Apraclonidine and Phenylephrine drops three times a day for a few weeks. The "Spock look": lateral brow peaking can be addressed with a small amount of further treatment at the apex of the peak. Droopy, flat brow or a lower resting eyebrow position: this can occur when the forehead is treated to eliminate horizontal forehead lines. The risk increases with age and can be minimised by microdroplets. Temporary lower facial paralysis: an effect of the chemical neuromodulator diffusing further than the treatment dose, which can be minimised by microdroplet.

Periorbital Wrinkle Management (Neuromodulators) in London

Consultation for the treatment of periorbital and facial muscle overactivity, by leading oculoplastic surgeon Dr Sabrina Shah-Desai and her team.

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Before & After Periorbital Wrinkle Management (Neuromodulators) before and after, a patient of Dr Sabrina Shah-Desai

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Periorbital Wrinkle Management (Neuromodulators)

At a Glance

Procedure Time: 15 minutes to an hour
Driving: After 24 hours
Anaesthesia: Topical
Hospital stay: None
Exercise: After 24 hours
Final results: Up to a year or more after a course of 4-6 treatments
Pre admission tests: None
Addresses: Periocular textural change, post-inflammatory pigmentation, and fine surface irregularities

Why choose this treatment

Advantages of Periorbital Wrinkle Management (Neuromodulators) Treatment

Specialist Doctor Treatment

Targeted and clinically guided.

Comfortable

Ultra-fine needles minimise sensation.

Effective

Achieves balanced muscle relaxation.

Safe & Accurate

Established medical use for over 20 years.

The Procedure

How Does the Microdroplet Technique Work?

Comfortable: no anaesthetic required. Effective: reduces functional skin folding and muscular strain. Clinically proven: clinically tested for more than 20 years.

The microdroplet technique delivers a series of small, controlled injections into superficial muscle-skin connections (septae). By reducing local muscle hyperactivity, it softens repetitive skin creasing and relieves tension around the eyes and forehead. This results in a smoother skin surface while maintaining full facial mobility.

Comfortable How Does the Microdroplet Technique Work?

Treatment Summary

Dr Sabrina and her team specialise in managing muscle overactivity that contributes to facial tension, eyelid strain, and dynamic skin creasing. They use chemical neuromodulation (muscle-relaxing injections) to reduce excessive muscle contraction in areas such as the brow, forehead, and around the eyes. This approach helps relieve discomfort, prevent skin irritation, and improve ocular surface comfort while maintaining natural expression.

Her team is among the few specialists offering the refined microdroplet injection technique, which allows precise targeting of superficial muscle fibres for subtle, functional improvement. The focus is on restoring muscle balance, not altering expression.

Real Patient Results

Before and After Treatment

See the Bonta Wrinkle Treatment before and after results below, achieved by Dr Sabrina. Disclaimer: your results may vary. Any specific claims or length of results vary for each patient and are not guaranteed.

4 cases

Individual results vary. All photographs are of real patients treated by Dr Sabrina Shah-Desai and are published with consent.

Meet the Expert: Dr Sabrina Shah-Desai

Dr Sabrina Shah-Desai is the founder and Medical Director of Perfect Eyes Clinic. With over two decades of surgical and non-surgical experience, she is considered one of the safest, most experienced oculoplastic surgeons in the UK.

Her extensive training, combined with her caring and empathetic nature, makes her a natural choice for patients seeking the very best care. Dr Sabrina appears consistently in Tatlermagazine as one of the UK's “Best Eye Surgeons” and “Top Doctors” since 2019.

Learn About Dr Sabrina

Royal College of Surgeons of England - register of Board-Certified Cosmetic SurgeonsBest Aesthetic Doctor - Safety in Beauty 2023Consultant Surgeon of the YearBest Surgical Result - Aesthetic Awards 2021Tatler Best Eye Surgeon 2019-2026

Transparent pricing

Treatment with Chemical Neuromodulator Cost in London

Prices are a guide; your doctor will calculate total costs during consultation. With Dr Shah-Desai.

1 Zone (Glabellar frown lines) - from £420
2 Zones (Glabellar frown & forehead lines) - from £480
3 Zones (Glabellar frown, forehead & smile lines) / Chemical Brow Lift - from £540
Masseter Hypertrophy - £500
Migraine / Blepharospasm - £600

Important: all cosmetic procedures incur 20% VAT. Fees are estimates and will be confirmed after medical consultation.

Book a medical consultation

Patient Questions About Periorbital Wrinkle Management (Neuromodulators)

Frequently Asked Questions

The questions patients ask most often, answered by the clinic. If yours isn’t here, ask us directly - we would be delighted to help.

No, neuromodulator injections are usually painless.
The effects will begin to work after a few days, reaching maximum effect by 2 weeks.
For most patients, the effect lasts three to four months, after which muscle tone gradually returns. With regular treatment, the muscle response often becomes more balanced, extending the duration of results.
The dermal fillers we use are made from hyaluronic acid - a substance that occurs naturally in the body. These types of fillers are biodegradable, which means that they will gradually be absorbed as the gel breaks down and water takes its place. When totally absorbed, the filler gel disappears unnoticed from the body.
This treatment is not suitable if you are taking the following medications: antibiotics like gentamicin, tobramycin, clindamycin and lincomycin, or quinidine for heart rhythm problems. You should not have muscle-relaxing injections if you have a muscle-weakening disorder (myasthenia gravis, Lambert-Eaton syndrome, ALS/motor neuropathy), are pregnant, breastfeeding, or allergic to human albumin (not egg allergy). Avoid having alcohol in your system, as it can increase the likelihood of bruising and make the injections spread to muscles you don't want to treat.
Hyaluronic acid-based dermal fillers can support the muscles on resorbing bone and help reduce lines and wrinkles due to muscle overactivity. Plexr Skin Tightening is a plasma-based solution that will vaporise excess skin by up to 30% with each treatment, leaving it appearing tighter and more contoured.
- Horizontal "worry" lines (frontalis over-activity) - lines that appear across the forehead and can sometimes remain visible.
- "11's" or vertical "frown" lines (corrugator over-activity) - small lines that deepen over time between the brows from concentrating or frowning.
- Laugh or smile lines (orbicularis over-activity) - crow's feet that appear around the eyes when smiling or laughing.
- Jelly rolls of the lower eyelid (orbicularis hypertrophy) - horizontal under-eye lines caused by blinking, squinting and unavoidable reflexes.
- Bunny lines (procerus over-activity) - tiny lines that appear when wrinkling the nose.
- Bobbly / golf-ball chin (mentalis over-activity) - a dimpling effect on the chin due to excessive flexing.
- Marionette lines (DAO over-activity) - lines on either side of the mouth that deepen over the years due to loss of facial volume.
- Square jaw / bruxism (masseter hypertrophy) - masseter muscles that are over-pronounced in the jaw.
- "Turkey neck" (platysmal bands) - when the thick muscle that runs from the ear to the collarbone pulls the lower face downwards over time, causing a sagging effect.
- Brow ptosis or asymmetric brows - when the brows start to drop or there is asymmetry.
- Blepharospasm / hemi-facial spasm - muscular spasms around the eyes or involuntary contractions on one side of the face.
Most women like to have a more rested appearance with high brows and no lines. They tend to require additional fillers to maintain their preferred brow position and microdroplet injections for their necks around the time they reach their mid-50s. Meanwhile, men usually prefer to retain a few horizontal forehead lines, instead focussing on treatment for their "11" vertical frown lines. They tend to require microdroplets for their brow and forehead by their mid-40s.
As with any drug, there are some possible side effects. However, the product only stays in the body for a maximum of 6 months, so any side effects associated with the injection will diminish after that time. Possible side effects can include:
- Bruising and/or erythema: redness of the skin at the site of injection.
- Feeling unwell: headache, respiratory infections, nausea and flu-like symptoms.
- Temporary ptosis or droopy eyelid: this typically reverses in 4-6 weeks as the toxin begins to wear off. It can be managed with Apraclonidine and Phenylephrine drops three times a day for a few weeks.
- The "Spock look": lateral brow peaking can be addressed with a small amount of further treatment at the apex of the peak.
- Droopy, flat brow or a lower resting eyebrow position: this can occur when the forehead is treated to eliminate horizontal forehead lines. The risk increases with age and can be minimised by microdroplets.
- Temporary lower facial paralysis: an effect of the chemical neuromodulator diffusing further than the treatment dose, which can be minimised by microdroplet.

Call or email us today, we would be delighted to answer your questions.

Ask a Question or Book an Appointment

Patient stories

Rated five stars by patients across the globe

4.8out of 5 from 240+ Google reviews

Desi Stevens

“Simply the best dermatologist for skin care and eye surgery. She is a safe and skilled doctor who is highly experienced and will meet your needs, her approach is a soft and natural aesthetic. She listens and communicates clearly, professionally and in a kind and personable manner. I have been looked after by Dr Sabrina for many years have always been extremely happy with her advice, procedures and results. Highly recommend, she is a talented Dr you can trust.”

Kealey Hessey

“Dr Sabrina is the magic eye fairy. Only 10 days after my lower lid bleph and midface lift and nearly all bruising and swelling has gone. After a lot of research, I knew after my initial consultation with Dr Sabrina she was the one I trusted. Such a warm & kind woman. I am so pleased I put my Trust in Dr Shah. Immensely happy with the results and will be back to get my upper eyes done in the future. Thank you to the whole team.”

Jo Kirby

“I had been recommended Dr Sabrina by a medical colleague & am extremely glad I made the journey from Southampton to the Perfect Eye Clinic in London to discuss blepharoplasty. The team were all so friendly & very professional and most importantly, Dr Sabrina informed me that I had a bilateral eye ptosis. This explained a number of issues I was experiencing. I will definitely be booking to have a correction of bilateral eye ptosis and upper blepharoplasty. Can't recommend enough.”

Shirley Ford

“I am so very happy with my experiences at Perfect Eyes. Dr Sabrina is an absolute Star. Extremely talented, very personable I just couldn't be happier with my results and her overall professionalism. But a big part of my review is how lovely the support staff are too. Namely Safiya and Lisa who greet you with such warmness and respect. I highly recommend this clinic as I have done so with many friends.”

Radhika Rajan

“Top notch surgeon. Dr.Sabrina Shah is the best. Very meticulous and focused. Very experienced and very skillful. Supported by a great team, Irvana at the office is efficient and directs empathy as well towards nervous patients like myself . All in all a great experience.”

Tina Stonely

“Dr Sabrina is so so kind and thorough in really assessing and understanding my needs and explaining in detail what works and the pros on cons of each treatment. I trust her implicitly and know she is the best physician in the UK and trainer to physicians for all aesthetic treatments. I cannot recommend her enough. You will not be disappointed choosing Sabrina.”

Tanya Del Federico

“Perfect Eyes provides an exceptional experience from start to finish. The team is warm, professional and highly knowledgeable, and every aspect of the consultation feels thorough and personalised. Sabrina combines outstanding surgical expertise with a genuine commitment to achieving natural, elegant results, taking the time to explain every option and ensure patients feel completely at ease. The care, attention to detail and standard of service are second to none. I would highly recommend Perfect Eyes to anyone looking for expert oculoplastic and aesthetic care.”

Minda Wang

“I am so happy with my experience. The results look natural, and I feel like a fresher version of myself since having my Biostimulation treatment with Doctor Sabrina. The whole experience was comfortable and professional, and I felt supported and well cared for throughout. I would definitely recommend this treatment to anyone looking for a natural-looking boost.”

Samantha Andrews

“Amazing. I’m so happy with the results. Sabrina is a master. She also has a wonderful bedside manner. I can’t recommend Sabrina and her team enough. Worth double the money. 👏🏻”

Hayley Pearson

“I was lucky enough to first meet Sabrina 9 years ago & have never used anyone else since. She has helped transform my appearance; with natural looking aesthetics. I currently live abroad, however remain dedicated to stay a patient of Sabrina. What’s 3,500 miles when you have found the best in the business!”