Expression Lines & Facial Movement in Brighton & Hove
You may notice it in photographs first — an expression that reads as tired or severe when that is not how you feel.
Most people who come to me are not looking for a different face. They want the one they have to read the way they actually feel.
Sometimes that change is difficult to name. A line may hold your attention more than it used to, or one expression may seem stronger than you remember. Noticing that is enough to begin.
What may change — and what happens next.
What may improve
If muscle contraction is part of what creates a line — or an expression that looks tenser than you feel — reducing that activity may soften it. A line already visible at rest may also soften, but the change is less predictable.
What the result can look like
Any change stays recognisably yours. Even so, no two faces respond identically.
If you are not sure
If you are not sure whether movement is what you are seeing, or you are not certain you want anything done at all, that is exactly what a first assessment is for.
The consultation, and what happens next
A consultation stays a consultation.
No procedure takes place during it. Its purpose is to give you time, full information and room to feel comfortable, without any pressure to go ahead. A treatment appointment is a separate booking, and the required assessment, consent and any prescription decision still come before it. Throughout, I stay in contact with you and explain step by step what will happen and what may be visible afterwards.
- Consultation
- Information and decision only; no treatment takes place during that appointment
- Treatment appointment
- Usually 45–55 minutes, depending on the plan, including preparation, treatment and aftercare.
- Immediately afterwards
- Short-lived redness or small marks may be visible; you are told step by step what to expect
- Review
- When clinically useful, a review usually takes place at 10–14 days.
You do not have to arrive knowing what you want — most people do not.
The decision is not simply whether a line can be softened. It is whether movement is meaningfully contributing to what you see, whether the likely change fits what you want, and whether treatment is the right step for you now. The answer may be treatment, another route, more time to think, or no treatment at all.
Full clinical guide
Understanding · Why this page reads as it doesDeciding · The consultationSafety & care · Alternatives · Questions & evidence
The real detail, when you are ready for it.
01Why expression lines form
A single drop of water seems insignificant. Falling in the same place over years, it can wear a hollow into stone.
Expression works in a similar way. Each frown, smile or squint folds the skin for a moment, and the same fold, repeated over years, begins to leave a line behind. Skin is not stone — it repairs itself, and for a long time it keeps up. Then, gradually, it stops keeping up completely: the line that once appeared only when you moved starts to stay once your face is at rest.
Where movement is what creates a line, reducing that muscle activity means the skin folds less strongly and less often — which is why softening movement can help a line made by expression, and sometimes a line already visible at rest.
Not every line is made by movement. Skin quality and changing support play a part too; the next section explains how I tell the difference.
02Dynamic versus static lines
One kind of line appears only when you move and vanishes the moment you stop; another remains after your face is still. Most lines are some of both — shaped by movement, and by skin, volume and support over time.
Most real lines sit somewhere along this spectrum rather than at either end — part movement, part skin, part support. Placing your particular line accurately on that spectrum is much of what the consultation is for, because it decides whether reducing movement would help a little, a lot, or not at all.
03Muscle balance across the face
Across the face, muscles that lift and muscles that pull down act against one another, and what you see is the balance between them. If that balance shifts — with age, or through treatment that ignores it — the expression can change in a way nobody intended. The brow is the clearest example: one muscle lifts it while others pull it down, so reducing one without accounting for its partners can create the very heaviness someone hoped to avoid.[6]
It is also why the number of areas is the wrong starting point. What matters is how your particular face moves as a whole, which expressions you want to keep, and how any change in one muscle would affect the rest. A considered plan preserves the movements that make your face yours.
04Why there is no medicine name, brand, price or before-and-after on this page
If your lines are driven by movement, the option sometimes considered is a prescription muscle-relaxing medicine. UK law does not allow a prescription-only medicine to be advertised to the public, and a prescription decision belongs to your assessment rather than to marketing.[2][1][3] This page does not use product pricing or show before-and-after images. It explains your concern, how I assess the face, and how the decision is made. If a prescription option is appropriate, I will explain it by name during your consultation, together with its benefits, limits, risks and alternatives.
05Searching online for help with expression lines
Most people arrive having searched for a product name. That is the normal way in, and a sensible one — it is the word everybody knows. What a search cannot tell you is what is actually creating your line: whether it is movement, whether your forehead is quietly holding your brow up, or whether the change is really in the skin or the structure. So before anyone talks about a product, I look at your face at rest and moving, work out what the change is made of, and explain which approach is most appropriate — including when none is.
06What treatment may — and may not — change
This approach acts on muscle contraction. Where contraction is part of what creates a line, or of an expression that sits tenser than you intend, reducing that activity can soften it while leaving you a face that still moves.[7]
It reduces selected muscle activity for a period. It does not remove the muscle, permanently change the nerve, or stop the ageing process. Nor does it act on the skin itself or on the support beneath it — so where skin quality, lost volume or structural change is the main cause, another route is more likely to help, and I will tell you which. I would far rather you left knowing exactly what this can and cannot do than discover it afterwards.
07When treatment is not the right answer
There are good reasons to decide against treatment, at least for now: a line that is mostly static and would barely respond; a concern better answered by skin, volume or surgical routes; a wish to keep full, expressive movement; uncertainty, or simply wanting time to think. There are also clinical reasons treatment may be declined — discussed under suitability below.
Being told “not this” or “not yet” can feel like a door closing. It usually is not. More often it means I have found something more useful to do first.
08Natural asymmetry and compensation
Faces are not mirror images. One brow may sit higher, one eye may open more fully, one side of the mouth may move first, and one muscle group may be stronger than its partner.
Some of that difference is structural. Some is habitual. Some develops because one area works harder to compensate for another. Previous surgery, dental change, injury, facial-nerve problems and earlier aesthetic treatment can also alter the pattern.
Assessment records the starting point rather than pretending it is symmetrical. A plan may aim to reduce a particular imbalance, but complete symmetry cannot be promised, and changing one movement may make another difference more noticeable.
09The consultation — what is assessed
I will not consider treatment before I have properly assessed your face. The assessment is where the decision is actually made, not a step to get past. In practice it covers:
- Movement — how your face moves through frowning, brow-raising, smiling and squinting, and how it looks fully at rest.
- Muscle balance — how the lifting and depressing muscles interact, how strongly each pulls and in which direction, and what a change in one would do to the others.
- Baseline, brow and eyelid position — existing brow height and symmetry, any hooding or lid heaviness, any asymmetry already present and how one side compensates for another, recorded as a baseline.
Your history, whether treatment is suitable, the alternatives, what a good outcome would mean to you and consent are each covered in the sections that follow.
With your consent, standardised photographs may be taken to record the starting point. They are clinical documentation, not a promise of outcome.
10Who may not be suitable
Treatment with a muscle-relaxing option is not appropriate for everyone. It is generally not offered in pregnancy or breastfeeding; where there is an allergy to a component; with certain neuromuscular conditions; where there is active infection or skin disease at the site; and it is unlawful in England for anyone under 18 outside limited medical circumstances.[8] Some medicines and health conditions also affect whether, or how, treatment can be considered.[4]
This is not an exhaustive list. I assess whether this is right for you — your face, your history, your medicines — not for a category you happen to fall into.
11Consent & realistic objectives
Consent is a conversation, not a signature. If a prescription option is appropriate, it is discussed by name in person, with what it may realistically achieve for your face, what it cannot do, how long any effect and any recovery tend to last, the risks and how they are managed, and the alternatives — including doing nothing. You are given time, and you can change your mind at any point before treatment. I decide whether treatment is clinically appropriate; you decide whether it is right for you.[9]
Before I treat anything, you and I agree how much change you actually want — and how much you do not. Where expectations cannot be met by reducing movement, that is said plainly — because a treatment that meets a hope it was never going to meet is not a success.
12Planning a result that still feels like you
Treatment planning begins with the result you would actually like to see. Some patients want a strong frown to become much less visible. Others want only a small change while retaining almost all movement. Some are more concerned by balance than by the depth of an individual line.
Meaningful improvement may be possible. A movement-led line may become less visible; an established line at rest may soften but remain. Existing asymmetry may also improve, although complete symmetry cannot be promised.
The intended degree of movement is something we discuss and plan. The exact biological response remains individual, and the same plan does not behave identically in every face.
What “natural” means here
People use “natural” to mean very different things, so I will say what it means to me. For me, a natural result still looks and moves like your face — movement is how you look like yourself. We agree how much movement to preserve before treatment, and I plan around the balance between the muscles rather than chasing every line.
13Safety & red flags
Where treatment is given, short-lived effects can occur: discomfort, redness, swelling or a small bruise where an injection is given, and sometimes a passing headache. These usually settle on their own, and they are discussed in person before any decision.
Contact the clinic if you notice asymmetry, an unwanted change in expression, local weakness, or heaviness or drooping of a brow or eyelid. A temporary imbalance — for example a slightly uneven brow or a heavier-feeling lid — is uncommon and usually settles, or can be reviewed once the effect has developed.[5]
Seek prompt advice. Spreading redness, increasing pain, signs of infection, difficulty swallowing or breathing, or marked weakness beyond the treated area are not expected and need prompt medical attention. Your written aftercare gives the route to contact the clinic; anything affecting breathing or swallowing needs emergency medical help.[10]
14Choosing who provides care
A prescription muscle-relaxing option requires a proper assessment, a prescriber who takes responsibility for the decision, knowledge of facial anatomy and movement, and a willingness to say when not to treat. It is reasonable to ask who is assessing you, whether they can prescribe, how they handle unwanted effects, and whether they will decline treatment that is not in your interest. At odNOVA, your assessment and care are delivered personally by Piotr Wójtowicz.
15If a procedure is agreed
The exact process depends on the plan prescribed for you, but the principles are consistent.
The appointment time is not all spent injecting. It includes checking what has changed since consultation, confirming the plan, preparing the skin, allowing topical anaesthetic to work where appropriate, carrying out the procedure without rushing and explaining aftercare. The injection stage itself is commonly much shorter, but the appointment is not organised around the shortest possible needle time.
A treatment appointment is usually 45–55 minutes, including preparation, treatment and aftercare. That time is used to assess how your face moves, agree how much expression you want to preserve and adapt the plan to you rather than follow a fixed template. A topical numbing option is available when appropriate, and the reasons for each decision are explained before any treatment is carried out.
01Before
Complete the medical information accurately and report any change in your health, medicines, skin or previous response. Do not conceal medication or stop it independently in order to obtain treatment. Arrive without heavy makeup where possible and follow the instructions provided for your appointment.
02During
The plan is confirmed against the face in front of me, not copied from a fixed template. The area is prepared and the agreed medicine is administered according to the prescribed plan. You can ask to pause or stop at any point.
03After
You receive written advice specific to the treatment performed. Avoid rubbing or manipulating the treated area unless specifically advised otherwise. At odNOVA, the usual advice is to avoid vigorous exercise, alcohol and facial massage for the first 24 hours, unless your individual instructions say otherwise. Generic internet rules do not override the aftercare given for your own treatment.
04Review
Movement usually begins to soften within about 3–7 days, although it can take up to 10 days to begin. When a review is clinically useful, I compare movement and balance against the baseline, discuss how the result feels to you, and use that information when considering any future treatment.
16Alternatives — cause-led
When movement is not the main cause, another route is usually more direct:
- Static lines & sun damage — retinoids and medical skincare, peels and resurfacing, microneedling or laser.
- Skin quality, dryness or crepiness — skin boosters, polynucleotides, PRP/PRF or a considered skincare plan.
- Volume loss or deep folds — structural support only where appropriate, with dermal fillers or collagen biostimulators.
- Loose or descended skin — energy-based devices or a surgical opinion.
- Pigmentation or a skin lesion — a dermatology-led pathway or referral.
- Drooping lids or excess eyelid skin — oculoplastic or surgical assessment.
- Mild, accepted lines — no treatment, and good skin care.
Often the best plan addresses the skin and the cause first, and reconsiders movement later — if at all.
17Questions, answered
Understanding the concern
Why does one line disappear when I stop the expression and another stays?
A line that softens at rest is being driven by movement; a line that stays is more established in the skin, from years of folding plus ageing and sun damage. Movement can help the first far more than the second — which is why placing your line on that spectrum is the whole point of assessing it.
Why can treating the forehead affect my brow?
Because the muscles that lift and lower the brow work as a balance. Reducing one without accounting for its partners can let the brow sit lower or feel heavier. It is why a considered plan looks at the whole face, not one line.
Will I look frozen or expressionless?
The intention is to preserve the amount of movement agreed with you, not to remove expression. Even with careful planning, the exact response cannot be guaranteed. Anatomy and muscle balance matter, and changing one area can affect another.
Why this page reads as it does
Why does this page not name a medicine, a price or show before-and-afters?
Because the option sometimes used is a prescription-only medicine, and a prescription medicine cannot lawfully be advertised to the public in the UK. So this page explains the concern and the clinical decision; if a prescription option is right for you, it is named and explained in full at your consultation.
So what exactly are you offering?
A consultation about expression lines and facial movement. If assessment shows movement is the cause and treatment is appropriate, a prescription muscle-relaxing option may be considered — only then, and only in person.
The consultation & deciding
What happens at the consultation?
Your face is assessed in movement and at rest, and your history and objectives are discussed. What is examined is set out in full in the guide. Only then is any decision about treatment made.
I had treatment elsewhere — can you just repeat it?
Not by default. Your health, medicines, movement and preferences may have changed, and prescription options are not interchangeable. The current face and current information are assessed before any new decision. Bring what you know — when, where and what — and how it behaved.
Can jaw tension or teeth grinding be assessed here?
It can be discussed, but clenching and grinding have dental, behavioural, sleep-related and medical causes as well as muscular ones. A cosmetic consultation is not a substitute for dental or medical assessment, particularly where there is pain, tooth damage, an altered bite, locking or restricted movement.
What if I decide not to go ahead?
That is entirely acceptable. You can change your mind at any point before treatment, and no treatment is a legitimate outcome.
What may change
Can complete symmetry be achieved?
Meaningful improvement in balance may be possible, but complete symmetry cannot be promised. Some asymmetry is normal and may come from bone, soft tissue, muscle strength, habit, previous treatment or nerve function. The starting point is recorded so that the plan responds to the difference already present rather than pretending both sides are identical.
Can the result still look natural?
That is the intention, but “natural” means different things to different people. For one patient it means keeping almost all visible movement; for another it means a clearer change in one expression while preserving the character of the face overall. The consultation establishes what natural, subtle and refreshed mean to you so the plan can be built around that preference.
What if the line is visible when my face is relaxed?
That suggests a static component. It does not automatically rule out a movement-focused approach. The line may soften, but an established surface line can remain. Whether a skin-quality treatment belongs in the plan depends on assessment.
How long does the effect last?
Effects are temporary and vary between people. For the cosmetic facial options used in this pathway, the expected effect is commonly around three to four months, but individual response, the area, muscle strength and the prescribed plan all matter. Repeat treatment is considered only after reassessment and not sooner than the interval appropriate to the medicine used.
Cause, safety & suitability
What if the concern is skin quality rather than movement?
Then the route should follow the cause — texture, photodamage, scarring and pigmentation each point somewhere different. The alternatives section sets out which.
What if the concern is volume or structural support?
Reducing movement does not restore lost support. A structural assessment may be more useful, and that does not automatically mean a filler or another procedure.
Is treatment considered during pregnancy or breastfeeding?
Elective prescription treatment is postponed during pregnancy and breastfeeding at odNOVA because current product information does not provide adequate evidence to recommend use in these circumstances.
What risks should I understand?
Possible effects include injection-site discomfort, redness, swelling, bruising and headache, and less commonly asymmetry, unwanted change in expression, local weakness or brow or eyelid heaviness. Safety & red flags sets these out in full, including when to contact the clinic. Anything affecting breathing or swallowing needs emergency medical help. The risks relevant to your own plan are discussed before consent.
Does consultation guarantee treatment?
No. Consultation establishes whether treatment is appropriate and whether the likely benefit justifies the uncertainty and risk. It may equally lead to a referral or to no treatment.
18References
View 10 sources
The wording on this page is narrower than the range of claims commonly made about anti-wrinkle treatment. The sources below are used for the claims they can support; they do not turn general information into an individual recommendation. Evidence checked 19 July 2026.
- Advertising and public information: Committee of Advertising Practice. CAP Code, Section 12: Medicines, medical devices, health-related products and beauty products. Available at: asa.org.uk/type/non_broadcast/code_section/12.html (Accessed: 19 July 2026).
- Clinic websites and prescription-only medicines: Medicines and Healthcare products Regulatory Agency. Blue Guide: advertising and promoting medicines, including Appendix 6. Available at: gov.uk/government/publications/blue-guide-advertising-and-promoting-medicines (Accessed: 19 July 2026).
- Advertising of prescription-only medicines: ASA/CAP. Healthcare: Prescription-only Medicines (websites). Available at: asa.org.uk/advice-online/health-prescription-only-medicines-websites.html (Accessed: 2 August 2026).
- Current licensed information, contraindications, warnings, interactions and adverse effects: Electronic Medicines Compendium. Current UK licensed product information for relevant prescription medicines. Product units, indications, contraindications and safety information are not interchangeable. Available at: medicines.org.uk — current licensed product information (Accessed: 2 August 2026).
- Upper-face adverse events — systematic review and meta-analysis. Cavallini M, et al. (2022), Aesthetic Surgery Journal. PMCID: PMC9005453. Available at: pmc.ncbi.nlm.nih.gov/articles/PMC9005453/ (Accessed: 2 August 2026).
- Forehead and glabellar functional anatomy. de Almeida ART, et al. (2013), Dermatologic Surgery. PMID: 23846022. Available at: pubmed.ncbi.nlm.nih.gov/23846022/ (Accessed: 2 August 2026).
- Upper facial expression-line evidence and variation: Qian W, et al. (2022) systematic review and meta-analysis of randomised controlled trials. Available at: pubmed.ncbi.nlm.nih.gov/36099476/ (Accessed: 19 July 2026).
- Under-18 law in England: GOV.UK. Guidance on the under-18 law for specified cosmetic injections in England. Available at: gov.uk/government/publications/botulinum-toxin-and-cosmetic-fillers-for-under-18s (Accessed: 2 August 2026).
- Consent: General Pharmaceutical Council. In practice: guidance on consent. Available at: pharmacyregulation.org — guidance on consent (PDF) (Accessed: 19 July 2026).
- Urgent symptoms: NHS. Botulism. Available at: nhs.uk/conditions/botulism/ (Accessed: 19 July 2026).
Evidence varies by medicine, indication, treatment area and study design. This page provides general information and does not constitute a diagnosis, prescription, individual recommendation or guarantee of outcome. Suitability is established in consultation.
19Fees
This page provides general information about the concern and consultation. It is not individual medical advice or a recommendation. Any prescription option is considered only after a face-to-face assessment; consultation does not guarantee treatment.
Written and clinically reviewed by
MPharm · Pharmacist Independent Prescriber · MSc Cosmetic & Aesthetic Medicine · PGDip Dermatology in Clinical Practice · JCCP registered
Bring what you have noticed
Feeling tired of a line you keep noticing is a good enough reason to come and ask.
