Thinking outside the Botox

Could a new toxin-free anti‑wrinkle procedure be the way to a stress‑free face? Our undercover columnist puts Frotox to the test

Patient receiving the Iovera treatment
Patient receiving the Iovera treatment

Everything might indeed have its moment in the spotlight, but then – inexorably – it loses its lustre. Could Botox be about to fall from its pre-eminent position as the go-to treatment for every woman over the age of 30 determined to brave the world with a stress-free face? With short procedure times, improved patient comfort and results within a week, it’s a tough act to follow – except in one crucial area. It involves injecting our dairy-free, gluten-free, organically fed, natural-remedy-loving bodies with a toxin – botulinum, to be precise.           

In the interests of research, I put myself forward for a prodecure called Iovera, which, instead of injecting a toxin, uses localised cold therapy that is claimed to reduce lines and wrinkles by numbing muscles. It’s the latest in a series of cold-based therapies that I have tested and written about for – from CoolSculpting my fat cells to blasting my cellulite with nitrogen gas in a cryosauna. Using a sub-zero treatment on my face feels like the logical next step.

Dr Suha Kersh, my new anti-ageing secret weapon, ushers me into her sparsely furnished room. She is the resident cosmetologist at KX, a state-of-the-art fitness club to its members and a leading anti-ageing spa for members and non-members alike.

After a quick examination of my worry lines, Dr Kersh explains that Iovera is administered by a visiting practitioner. She hastens to add that there are insufficient clinical trials for her to recommend it outright, but if I’m searching for the latest Botox alternative and my forehead is my biggest concern, then this could be what I’m looking for.

Harley Street’s Dr Yannis Alexandrides (most well known for the Y-lift facelift) is Iovera’s leading practitioner in the UK and a much sought-after cosmetic guru. He consults at KX as well as at his own practice, and clients can choose to have their treatments at either address. When I arrive for my Harley Street appointment, Dr Alexandrides reveals a sleek device with three little needles at the tip. These needles, he explains, puncture the skin near the nerve that controls the frontalis – the muscle that raises the eyebrow.

“The procedure involves rapidly injecting liquid nitrous oxide down the tiny needle shafts. The body’s natural response to the cold is to temporarily relax the muscles,” he says. He explains that the cold therapy targets peripheral nerve tissue, which then undergoes a period of dormancy. The results are supposed to last for around four months before muscle function returns to normal. Unlike Botox, which tends to paralyse large areas, “Frotox” (as it is colloquially known – cryoneuromodulation is the medical term) is more precise, so the results can look more natural. And while Botox normally takes about a week to kick in, this procedure works instantly.

The hand-held device and charging dock
The hand-held device and charging dock

Dr Alexandrides starts with a pre-procedure, which involves tracking the nerve that causes me to frown by moving a small probe from a Transcutaneous Electrical Nerve Stimulation (TENS) device across the nerve pathway.

He asks me to tell him where I can feel the strongest pulse, or to put it more simply, when he has hit a nerve. As he moves it millimetre by millimetre, I feel twinges, until – ouch – he hits the spot.

An anaesthetic cream is applied topically to numb the skin, and I wait about half an hour for it to take effect. Face numbed, I’m ready for action. Dr Alexandrides holds the device firmly against the targeted area for about eight seconds, and I feel a strong surge of pressure against my temple. It’s not much more painful than Botox or fillers, but I am very grateful for the numbing cream.

After tackling my left side, he asks me to try and raise my eyebrows. They move as normal. He moves to the right and repeats the process on each side several more times. Despite feeling like a bit of a guinea pig, by the end, we get there: both eyebrows are frozen. I am very pleasantly surprised (although I can’t show it).

I can barely move each eyebrow more than a millimetre, but the small lines between them are less affected by the treatment so some mobility remains, which means I still have a natural expression.

The bottom line:


Following the Iovera, my frown lines have become considerably less pronounced. If I compare the results of Frotox and Botox, I would have to say – line for line – that it’s pretty close. However, Botox wins by a whisker. In the right hands it can really correct, sculpt and improve facial features like little else – yet.  

In terms of ease, Frotox took about a hour – a lot longer than the average Botox treatment, where I can pop in for a 10-minute fix.

With regards to pain and discomfort, its pretty much of a muchness – no matter how you dress it up, both remain an uncomfortable procedure.

That said, the idea of stunning the nerves with cold as opposed to blasting them with toxins means that I am very excited by Iovera. Long term, I would much prefer not to have poison injected into my body, so it’s something I will seriously consider over the coming years.

Iovera – or Frotox – is a great option for anyone who wants to show a little less of their life adventures on their face. However, be aware that it’s not an all-over-face solution – currently, it is only used for the forehead.

Spa Junkie pays for all her own travel, accommodation and therapies.