Aesthetic Injections
Specialist assessment and treatment with muscle relaxing injections, dermal fillers and polynucleotides
At Midland Skin we offer aesthetic injectable treatments for patients in Birmingham, Solihull, Coventry, Wolverhampton, Worcester and the Midlands. Every treatment starts with a face-to-face consultation with a consultant or aesthetics doctor, who assesses you and carries out your treatment personally.
Quick Facts about aesthetic injections
Best for
Lines, volume & skin quality
Treatment
Injectable treatments
Provider
Consultant or aesthetics doctor
Recovery
Minimal downtime
Lasts
Varies by treatment
Price
See below
What are aesthetic injections?
Aesthetic injections are treatments given through a fine needle to soften lines, restore lost volume or improve the quality of the skin itself. At Midland Skin we offer three: muscle relaxing injections, dermal fillers and polynucleotides.
They work in different ways and suit different problems. Some people are best served by one of them, some by a combination, and some by a treatment that is not an injection at all. Which is right for you is decided at your consultation, after you have been assessed.
Muscle relaxing injections
Muscle relaxing injections use a purified protein, botulinum toxin type A, to temporarily relax the small facial muscles that crease the skin when you frown, raise your eyebrows or squint. When those muscles relax, the lines they create soften. Botulinum toxin type A has been used in medicine for over 30 years; Botox is the best-known brand name.
It is a prescription-only medicine. In the UK it can only be prescribed after a face-to-face assessment by a qualified prescriber, which is why treatment at Midland Skin always follows a consultation.
The injections treat expression lines. They do not fill lines, tighten loose skin or improve skin texture. Where those are the main concern, your clinician will discuss other options.
Beyond facial lines, the same treatment is used for jaw clenching and teeth grinding, for excessive sweating of the underarms, palms, soles, forehead or scalp, and, at a low dose placed in the skin, for persistent facial flushing and redness. The evidence for flushing comes from small studies with varied methods, so it is offered selectively rather than routinely.
Muscles begin to relax within two to three days and the full effect takes around two weeks. For facial lines, movement usually starts to return after three to four months. Treatment for sweating tends to last longer, often six months or more for the underarms and less for the palms.
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Dermal fillers
Dermal fillers are gels based on hyaluronic acid, a substance that occurs naturally in the skin. Injected beneath the surface, they add volume and support where tissue has been lost or where a contour needs definition. Unlike muscle relaxing injections, the result is visible straight away.
Filler is used to restore volume in the cheeks, temples, jawline and chin, to soften deeper lines and folds such as those running from the nose to the mouth, and to improve the shape and definition of the lips.
How long it lasts depends on the product, the area treated and how much is used. Most facial fillers last somewhere between six and eighteen months before the effect gradually fades. Hyaluronic acid fillers can also be dissolved if needed, which is not true of every injectable material.
Tear trough filler, placed in the hollow beneath the eye, is not carried out on this service. It is one of the most technically demanding filler sites, and at Midland Skin it is managed by our oculoplastic team. If that is what you are looking for, say so when you book and we will direct you to the right clinic.
Polynucleotides
Polynucleotides are purified DNA fragments used to improve the quality of the skin itself rather than to add volume or relax muscle. They are injected into the skin in small amounts and are thought to work by stimulating the cells that produce collagen.
At Midland Skin polynucleotides are used for the skin around the eyes, where fine lines, crepiness and dullness are common and where thicker fillers are often unsuitable. Treatment is given as a course of sessions a few weeks apart, with maintenance afterwards. The result builds gradually over several weeks rather than appearing straight away.
The published evidence is promising but still limited. A 2024 systematic review of nine studies covering 219 patients found improvements in wrinkles, skin texture and elasticity, but the studies were small, used different products and injection protocols, and were rated low to moderate quality. We will be straightforward with you about what is well established and what is not.
Who are aesthetic injections suitable for?
Treatment may be considered for:
- Frown, forehead and eye lines – the expression lines that deepen when you frown, raise your eyebrows or smile
- Other expression lines – lines under the eyes, lines around the mouth, chin dimpling or neck bands
- Gummy smile – where too much gum shows when you smile
- Jaw clenching or teeth grinding – treating the masseter muscle can ease jaw tension and, with repeated treatment, slim a bulky jawline
- Excessive sweating – underarms, palms, soles, forehead or scalp
- Facial flushing and redness – a low-dose technique that may be considered for selected patients with persistent flushing
- Loss of facial volume – flattening of the cheeks, hollowing of the temples, or a jawline and chin that have lost definition
- Deeper lines and folds – including the lines running from the nose to the corners of the mouth
- Lip shape and definition – where the lips have thinned or lost their outline
- Skin quality around the eyes – fine lines, crepiness and dullness, where polynucleotides may suit better than filler
Injectable treatment is not suitable during pregnancy or breastfeeding, or where there is active infection or inflammation at the injection site. Muscle relaxing injections are not used in certain neuromuscular conditions. Polynucleotides are derived from purified salmon DNA and are not suitable if you have a fish allergy. By law, cosmetic injectable treatment is not available to anyone under 18.
Loose skin, sun damage and uneven pigmentation respond poorly to injections alone. If a different treatment is likely to suit you better, your clinician will say so at your consultation.
What to realistically expect
- Results appear at different speeds. Filler is visible immediately. Muscle relaxing injections take around two weeks to reach full effect. Polynucleotides build gradually across a course of sessions.
- All three treatments are temporary. Maintaining a result means repeating treatment, so the cost is ongoing rather than one-off. If you stop, the area returns to how it would otherwise have been; it does not end up worse than before.
- Dose and amount are decided after assessment. Stronger muscles need higher doses, and some areas need more than one millilitre of filler, which is why several items are priced at more than one level. Your clinician will recommend the smallest amount likely to achieve what you are after, and a conservative first treatment is usual.
- Injections do not fix everything. Sun damage, pigmentation, skin laxity and surface texture respond poorly to injectable treatment on its own. Where those are the main issue, another approach is likely to help more.
- No particular outcome can be promised. Results vary from person to person, lines present for many years may soften rather than disappear, and a specific cosmetic result cannot be guaranteed before treatment.
Risks and safety
Common to all three. Bruising, redness, swelling and tenderness at the injection points are common and usually settle within a few days. Filler and polynucleotides bruise more readily than muscle relaxing injections.
Muscle relaxing injections. A mild headache in the first few days is common. Less commonly there may be heaviness of the brow, a drooping eyelid (reported in fewer than 5% of treated patients in clinical trials) or slight asymmetry. Treatment of the masseter, of flushing, or of the palms can occasionally weaken nearby muscles, causing a temporary change in smile or reduced grip strength. Because the medicine itself is temporary, any unwanted effect also wears off, although this can take weeks to months.
Dermal fillers. Lumps, unevenness or prolonged swelling can occur and can usually be corrected. Delayed nodules and infection are uncommon. The serious risk is accidental injection into a blood vessel, which can interrupt the blood supply to the skin and, very rarely, to the eye. Published rates for vascular complications are well below 1% and vision loss is rarer still, but where it occurs it is often permanent. The risk is not the same across the face: in the reported cases, injections around the nose, forehead, glabella and temple account for most events. This is why the injector’s knowledge of facial anatomy matters more than the product used, and why tear trough filler is handled by our oculoplastic team rather than on this service.
Polynucleotides. Small raised bumps at the injection points, bruising and mild swelling are the usual effects and settle within a day or two. The product is derived from purified salmon DNA and is not used in anyone with a fish allergy.
Contact us straight away if after any injectable treatment you develop severe or increasing pain, blanching or dusky discolouration of the skin, or any change in your vision. These are uncommon, but they need to be assessed urgently rather than left to see whether they settle.
Treatment pathway
Initial assessment
You meet a consultant or aesthetics doctor who examines the areas that concern you and discusses what you are hoping to achieve, your medical history and your medications. Muscle relaxing injections are a prescription-only medicine and can only be prescribed after a face-to-face assessment.
Suitability and treatment plan
Your clinician advises which treatment, if any, is appropriate, and explains the areas to be treated, the amount likely to be needed, the cost, expected results, risks and aftercare. If another treatment or another part of the clinic would suit you better, that is discussed. Treatment is booked as a separate appointment, giving you time to consider.
Treatment appointment
Your clinician confirms the plan, takes your consent and carries out the injections personally. Most appointments take 20 to 30 minutes. Polynucleotides are given as a course, so more than one appointment is arranged.
Results, aftercare and repeat treatment
Filler results are visible immediately, muscle relaxing injections develop over about two weeks, and polynucleotides build across the course. There is no routine review appointment, but if you have any concern about your result or your recovery, contact the clinic and you will be seen. Returning patients can book treatment directly and are reassessed at each visit.
What happens during and after treatment?
- Before. No special preparation is needed. To reduce the chance of bruising, avoid alcohol and non-essential aspirin or ibuprofen for 24 hours beforehand. Please arrive without makeup on the areas being treated. If you get cold sores and are having lip filler, tell your clinician in advance.
- During. Muscle relaxing injections and polynucleotides do not usually need anaesthetic, and each injection causes a brief sting. Filler is generally injected using a product that contains local anaesthetic, and numbing cream can be applied first. Most appointments take 20 to 30 minutes.
- Immediately afterwards. Expect redness and small raised marks at the injection points. After muscle relaxing injections and polynucleotides these usually settle within about half an hour. After filler there is visible swelling, most noticeable in the lips, which peaks over the first day or two. You can drive yourself home.
- Aftercare. Avoid rubbing or massaging the treated area for the rest of the day. Avoid strenuous exercise, saunas, steam rooms and lying flat for about four hours after muscle relaxing injections, and for 24 hours after filler. Makeup can be applied after about four hours.
- Practical downtime. Most people return to normal activity the same day. If you are having treatment before an event, allow two weeks: lip filler in particular can look swollen for several days, and muscle relaxing injections need that long to settle into their final result.
Your treatment at Midland Skin: FAQs
Who will assess and treat me?
A consultant or aesthetics doctor carries out your consultation and performs your injections. You will meet your clinician before treatment, so you know exactly who is treating you.
Can I have treatment at my first appointment?
No. Your first appointment is a consultation, and treatment is booked as a separate appointment afterwards. Returning patients can book treatment directly.
Will it hurt?
Each injection causes a brief sting, similar to a small pinch. Muscle relaxing injections and polynucleotides do not usually need anaesthetic. Filler is generally injected using a product containing local anaesthetic, and numbing cream can be applied beforehand. Injections in the palms and soles are the most uncomfortable, and your clinician will discuss ways to make this more manageable.
Do I need to stop any medication?
Do not stop prescribed medication without advice. Tell your clinician about everything you take, particularly blood thinners, muscle relaxants and any recent antibiotics. Avoiding alcohol and non-essential aspirin or ibuprofen for 24 hours before treatment reduces bruising.
How much downtime should I allow?
Most people go back to normal activity the same day. Bruising is the main practical consideration and can take a few days to fade. If you have an event coming up, allow two weeks between treatment and the date.
How often will I need treatment?
Muscle relaxing injections are spaced at least three months apart, and most people who want to maintain a result have treatment two to three times a year. Polynucleotides are given as an initial course followed by maintenance sessions.
Fees
Aesthetic injectables Show pricing
Book ConsultationInitial aesthetic assessment
Up to 25 minutes
Botulinum toxin – One area
£310 higher dose
Botulinum toxin – Two areas
£380 higher dose
Botulinum toxin – Three areas
£495 higher dose
Filler per ml
Polynucleotides – Full face (4ml)
Polynucleotides – Eyes (2ml)
Amelia Cox
References used for this article
- Camargo CP, Xia J, Costa CS, Gemperli R, Tatini MDC, Bulsara MK, Riera R. Botulinum toxin type A for facial wrinkles. Cochrane Database Syst Rev. 2021;7(7):CD011301. doi:10.1002/14651858.CD011301.pub2.
- Galadari H, Galadari I, Smit R, Prygova I, Redaelli A. Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: a systematic review. J Am Acad Dermatol. 2021;85(5):1121–1129. doi:10.1016/j.jaad.2020.07.123.
- Yeh MC-H, Shih Y-C, Huang Y-C. Intradermal injection of botulinum toxin for erythema in rosacea: a scoping review and meta-analysis. Indian J Dermatol Venereol Leprol. 2025;91(4):448–454. doi:10.25259/IJDVL_274_2024.
- Lampridou S, Bassett S, Cavallini M, Christopoulos G. The effectiveness of polynucleotides in esthetic medicine: a systematic review. J Cosmet Dermatol. 2025;24(2):e16721. doi:10.1111/jocd.16721.
- Foster JA, Aakalu VK, Freitag SK, McCulley TJ, Tao JP, Vagefi MR, Yen MT, Kim SJ, Wladis EJ. Vision-threatening complications of soft tissue fillers: a report by the American Academy of Ophthalmology. Ophthalmology. 2025;132(8):935–944. doi:10.1016/j.ophtha.2025.01.020.
About the Author
This page has been written and/or medically reviewed by Dr Sajjad Rajpar, Consultant Dermatologist and Medical Director of Midland Skin, Birmingham.
Dr Rajpar is on the GMC Specialist Register in Dermatology and has over 20 years’ experience in clinical dermatology. He provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current dermatology practice.
Dr Sajjad Rajpar
Date last updated: 26th Sep 2026
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The content on this website is provided for general information only. It is not, and must not be treated as, medical advice, a diagnosis, or a recommendation for any particular treatment. We make reasonable efforts to keep information accurate and up to date, but medicine and technology change, and content may not reflect the most current evidence, guidance, product information, or individual practice. You should not rely on this website to make decisions about your health or treatment. Always seek personalised advice from an appropriately qualified healthcare professional. Any examples, images, testimonials, and outcome descriptions are illustrative only. Results vary between individuals and no outcome can be guaranteed.
