Anti-wrinkle injections use a prescription-only medicine injected in tiny, precisely placed doses into specific facial muscles, temporarily reducing the muscle activity that creases the skin above it. Lines produced by expression — forehead lines from raising the brows, frown lines between them, crow’s feet from smiling — soften because the muscle making them is working less. With repeated treatment the static lines etched by years of that movement soften too. The same principle applied to other muscles lifts the brow, corrects a gummy smile, slims a wide jaw, smooths neck bands and reduces excessive sweating. The effect begins at 3–5 days, is complete at 14 days and lasts three to four months because it is a prescription medicine, UK rules require a face-to-face consultation with a prescriber before treatment. At Medisha Clinic that prescriber is Dr Nish Shah MD, who also performs the injections himself using The Medisha Method.

‘Botox’ is the brand name of one of several prescription-only medicines used for anti-wrinkle treatment. The generic ingredient is botulinum toxin type A. UK advertising rules prohibit clinics from promoting prescription medicines by name to the public, which is why reputable clinics — including Medisha — describe the treatment as anti-wrinkle or wrinkle-relaxing injections and discuss the specific product only at your consultation. The choice of product is a clinical decision Dr Nish makes with you after assessing your muscles and history. The technique, mapping and dosing matter far more to your result than the brand. Every product used at Medisha is UK-licensed and prescribed face-to-face by Dr Nish.

At Medisha Clinic anti-wrinkle treatment is priced per area — forehead, frown, crow’s feet, brow lift, masseter slimming, gummy smile, chin, neck bands and underarm sweating. With the plan and price confirmed at your face-to-face consultation, as UK rules for prescription treatments require. Once agreed the price is fixed and includes a 2-week review with any top-up. Consultation with Dr Nish is £50, fully redeemable against treatment, so if you go ahead it costs nothing. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street station.

Two reasons. One legal, one clinical. Legally, anti-wrinkle injections are a prescription-only medicine, and UK regulators require the prescriber to assess you in person before prescribing. Remote or ‘video’ prescribing for cosmetic toxin is not permitted, and a non-prescriber injecting on someone else’s prescription who has never met you is a warning sign. Clinically, the consultation is where the result is decided: your muscles are mapped in movement, their strength and asymmetry judged, and each one dosed individually. At Medisha the prescriber and the injector are the same medically trained doctor — Dr Nish Shah MD — so nothing is lost between the assessment and the needle.

Not at Medisha, because a still face is a dosing error, not the treatment’s nature. The frozen forehead, the dropped heavy brow and the ‘Spock’ eyebrow all come from fixed ‘per area’ doses applied without mapping. The Medisha Method doses each muscle to its own strength and to the result you want: the frown can be relaxed almost completely because nobody misses it, the forehead is dosed more lightly to keep the brow up and the expression alive, and the crow’s feet are softened without flattening the smile. Dr Nish reviews you at two weeks in movement and adjusts. The intended result is that you look rested and people cannot tell why, and if you prefer a lighter, more preventative effect, it is simply dosed that way.

The effect begins around day three to five, is complete at fourteen days, which is when your review is booked, and lasts three to four months for the forehead, frown and crow’s feet. Masseter slimming builds more slowly, over four to six weeks, and lasts four to six months. Underarm sweating treatment lasts six to nine months. Duration is slightly shorter in very strong muscles and in patients with a high metabolic rate or heavy training loads. With regular treatment every three to four months the muscles gradually weaken their habit, static lines soften cumulatively, and many patients find the interval lengthens over time.

The classic three are the forehead (horizontal lines), the frown (the ’11s’ between the brows) and the crow’s feet (lines fanning from the outer eye). Beyond those: a brow lift, by relaxing the muscles that pull the brow down. Bunny lines on the nose. A gummy smile, by relaxing the muscle that over-lifts the upper lip. A dimpled or over-active chin. Downturned mouth corners. Masseter slimming for a wide or square jaw and for clenching and grinding. Neck bands in the neck (the Nefertiti lift), and excessive underarm sweating (excessive sweating). Areas are commonly combined in one visit, and all are priced per area after consultation.

Yes — masseter injections are one of the most effective non-surgical treatments for a wide or square lower face when the width comes from muscle bulk rather than bone. The masseter is the large chewing muscle at the angle of the jaw. In people who clench or grind, or who have naturally strong masseters, it enlarges and squares the face. Relaxing it reduces its bulk over four to six weeks, slimming the lower face and, in most patients, relieving clenching, grinding and associated tension headaches. Results last four to six months. If your jaw is wide because of bone rather than muscle, or weak because of a lack of it, filler is the treatment instead — Dr Nish assesses which at consultation.

The injections use an ultra-fine needle and most patients describe a brief sting. No anaesthetic is needed and the treatment takes 15–20 minutes. There is no downtime: tiny bumps at the injection points settle within twenty minutes, occasional pinpoint bruising fades within days, and you can go straight back to work. Many patients come in a lunch break. For four hours afterwards stay upright, avoid rubbing or pressing the area, lying flat, strenuous exercise, saunas and tight hats. Use the treated muscles a few times in the first hour. A mild headache in the first day or two after forehead treatment is common and harmless.

Yes, and most complete facial plans use both. Anti-wrinkle injections treat the lines you make by movement. The upper face above all — while dermal filler restores the structure you have lost in the mid and lower face. The two do opposite jobs and can be done on the same day. Anti-wrinkle with Profhilo or Sunekos Performa treats expression lines and skin quality together. With a PDO thread lift it addresses lines and descent. Masseter slimming with jawline filler slims the width and sharpens the edge at once. Dr Nish performs all of these and will set out at consultation which your face actually needs.

Anti-wrinkle injections have decades of safety data and, correctly placed, a very low complication rate. Expected, temporary effects: tiny bumps for twenty minutes, occasional pinpoint bruising, a mild headache for a day or two after forehead treatment. Uncommon effects: mild asymmetry (corrected at the 2-week review, which is why it is included). A heavy brow or a drooping eyelid, which come from product reaching the wrong muscle and are avoided by accurate placement, correct depth and staying upright afterwards. They are temporary if they occur, and rarely a flu-like feeling for a day. Treatment is not given in pregnancy or breastfeeding or with certain neuromuscular conditions and medications, which is one purpose of the face-to-face consultation. Every treatment at Medisha is performed by a medically trained doctor who teaches facial anatomy to other doctors.

Because the product is the same everywhere and the result is decided entirely by who maps your muscles and chooses the dose. Dr Nish Shah MD is a medically trained doctor and prescriber, Senior International Clinical Trainer at Derma Medical where he teaches facial anatomy and injectable technique to other doctors, Brand Ambassador and Key Opinion Leader for dermal fillers, and has performed over 6,000 non-surgical rhinoplasties. He sees you face-to-face, prescribes, and injects you himself. No remote prescribing, no hand-off — using The Medisha Method: muscles mapped in movement, each dosed to its strength and asymmetry, injected precisely, and reviewed at two weeks with any top-up included. The intended result is softer lines with your expression intact. £50 consultation redeemable against treatment. 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street. Also Marylebone.