Most lines on the forehead and around the eyes are caused by creasing of the skin that occurs after years of smiling, frowning and screwing up our faces in the sun. These are called dynamic expression lines and can be reduced or eliminated by the injection of small amounts of a muscle relaxing protein into the area. This has the effect of partially relaxing the muscle for a period of about 3 months with the treated muscles recovering fully over the following weeks to months.
Initial treatments usually last about 3-4 months with the peak effect occurring 4-6 weeks after treatment and the movement slowly returning after this. Subsequent treatments tend to produce slightly better results that last longer, up to about 6 months particularly in the glabella or central frown area.
Wrinkle relaxing injections are mainly used to reduce dynamic expression lines in the upper part of the face; particularly the vertical frown lines between the eyebrows, the horizontal lines on the forehead and the smile lines or crows feet around the eyes. The lateral part of the eyebrow can also be raised by relaxing the muscle around the eye that pulls the eyebrow down which can improve the appearance of heavy or hooded upper eyelids. The small lines on the upper lip, around the corners of the mouth and on the chin can also be reduced or temporarily removed with a few painless injections.
The same protein can also be injected in tiny droplets into the skin under the arms to control excessive sweating for 6-9 months.
Expression lines that are not visible in the relaxed face will almost completely disappear whilst fixed creases will gradually improve with time since they are not being continually creased with every smile and frown. These lines can then be further improved if necessary with the use of dermal fillers.
Wrinkle injections can also be used to prevent the formation of new lines on the forehead or around the eyes that can be anticipated from looking at parents or older siblings with similar facial structure.
Eyebrow shaping and lifting can also be achieved by the careful administration of small amounts of the medication around the eye and on the forehead. This is often desirable in women where lateral flaring of the brow can be very rejuvenating.
The same medication used as a muscle relaxant cosmetically can also be used to reduce sweating in areas such as the armpits forehead and hands. In this application the medication is diluted and injected over the affected area reducing sweating substantially for 6-9 months.
A consultation is necessary to plan treatment and to make sure there are no medical reasons not to proceed with the injections.
Prior to the procedure the skin is cleaned with alcohol. Ice can then be used to numb the skin and reduce any discomfort from the needle pricks. Tiny droplets of the medication are then injected into the muscles to be relaxed via a tiny micro-fine needle with little to no discomfort. Pressure is then applied to the injection sites to minimise the chance of bruising.
Pain and Discomfort
There is little to no discomfort associated with wrinkle relaxing injections and what sensation there is can usually be lessened or completely removed with ice, local anaesthetic cream or laughing gas if necessary.
Following the treatment patients are advised not to rub the treated areas, do any vigorous exercise or lie down for about 4 hours. Patients are advised to move the treated muscles (ie frown and smile) for several hours afterwards to help increase the absorption of the medication into the muscles. It takes about 2-3 days for the medication to start to work and about 1-2 weeks for it to have its full effect.
There is little to no downtime after wrinkle relaxing injections and patients are usually able to return to work immediately. Any small marks or lumps at the injection sites usually subside over 1-2 hours. A small bruise occasionally results following the procedure but can usually be easily covered with makeup.
A small bruise may occur at one of the injection sites particularly under the eyes where the skin is loose. This is usually minor and resolves rapidly over a few days. A rare complication of treatment is a droopy eyelid or dropped eyebrow. This is due to too much medication being injected too low above the eyebrow. This can be avoided by skilled and accurate administration of the medication.
The cost varies depending on the units of medication used. This varies depending on the individual patient, age, sun damage and the desired result. The cost can be discussed and determined at the initial consultation.