Anti-Wrinkle Injections

What are Anti-wrinkle Injections?

Anti-wrinkle injections are the single most popular cosmetic treatment performed at Skin Integrity.   Due to restrictions from the TGA, the actual name of the anti-wrinkle injection cannot be used here.  This is because it is a prescription medication and it is illegal to advertise prescription medication directly to the public.  If you would like further information, including the names and prices of the medications used, you can become a registered user of our site and access more information.

Anti-wrinkle Injections involve the injection of a small amount of a purified protein into specific muscles of the face.  The medication causes these muscles to relax creating a softening of the wrinkles above them.  This results in a fresher, rejuvenated appearance in the treated areas.  

Anti-wrinkle injections are most useful in the upper face, specifically frown lines, horizontal forehead lines and wrinkles radiating out from the side of the eyes (crows feet). 

Frown Lines (Glabella) 

This is the most popular treatment area.  When people frown they are activating a series of muscles that pull the inner eyebrow downwards and inwards.  By relaxing these muscles many people look more relaxed, approachable and less intense or scornful.  This treatment is particularly useful for people who think or are told the look cranky when they don't necessarily feel that way.  Anti-wrinkle injections in this area can help your external appearance match your inner self. 

One of the great things about treating this area is that it creates alook of serenity that goes beyond simple wrinkle reduction.  Even young children instinctively shy away from faces with frowns.  This instinct carries on through life.  I have witnessed first hand the gain in confidence some people achieve when they have this treatment. There is even research that suggests that this treatment could be useful for mild depression.

 

Crows Feet

Crows feet are the lines that radiate out from the eyes when we smile or squint.  They do not refer to the lines in the lower eyelid.  The skin in this area is quite thin and this exacerbates the formation of these wrinkles which eventually can extend down into the cheek area.  Anti-wrinkle injections can soften or eliminate these lines and restore a more youthful appearance.

With anti-wrinkle injections in this area the target muscle is a circular muscle around the eye called orbicularis oculi. There is another muscle called zygomaticus that also contracts during smile and is responsible for lifting the cheeks and corner of the mouth.  If this muscle is inadvertently injected the smile can appear lopsided.  It is therefore important to choose an experienced injector with a good understanding of facial anatomy.

Interestingly, when people smile naturally they tend to mainly contract orbicularis oculi.  When they pose for a photo or smile on demand they tend to contract zygomaticus.  Therefore, these injections often work best when the client is smiling naturally rather than posing for a photo or in the mirror!

 

 

Forehead Lines

Many people have very animated faces and lift their eyelids repeatedly when talking.  Sometimes this can be distracting and it ultimately leads to the formation of horizontal forehead lines.  These can be effectively treated with anti-wrinkle injections.

It is important to realise that the forehead muscle, known as frontalis, is responsible for holding up the eyebrows,  Therefore, if it is over treated it can lead to the eyebrows becoming heavy or dropping.  This is particularly the case in men who tend to have lower brows naturally.  In addition, an over treated forehead can give an unnatural, frozen appearance.  It is sometimes better to undertreat this area and review it in 2 weeks and provide more injections if necessary.

Interestingly, many headache or migraine sufferers report improvement in their symptoms when this area is treated.

 

What other areas can be treated?

Eyebrow lift:

• Eyebrow lift: By injecting certain areas of the muscle that pulls down the eyebrow, lifting of the eyebrow can be achieved.  Different eyebrow shapes can be created, including an arched brow or a flared brow.
• Lower eyelid: Small amounts of anti-wrinkle injections can be used in suitable candidates to treat fine wrinkling and also open up the eye when smiling.
• Bunny lines or scrunch lines on the side of the nose.
• Gummy smile: By injecting the muscle that elevates the central lip when smiling, a gummy smile can be effectively treated.
• Masseter muscle:  This muscle lies near the angle of the jaw and injecting it can slim down a square jaw as well as offering relief for teeth grinding and sometimes also tinnitus (ringing in the ears)
• Lifting of the corner of the mouth (often used in conjunction with dermal fillers)
• Nefertiti lift:  By relaxing the muscles along the lower jaw and neck bands a subtle lifting effect to the lower face can be achieved.
• Treatment of a dimpled or popply chin.
• Treatment of excessive perspiration in the armpits (hyperhidrosis).  Excessive perspiration can be socially debilitating. Anti-wrinkle injections are now considered the optimum treatment for this condition with results typically lasting 9 to 12 months.

 

Am I a Good Candidate for Anti-wrinkle injections?

Anti-wrinkle injections work best on wrinkles caused by facial expression.  These wrinkles are called dynamic wrinkles.  If you frown and your lines become deeper then you should be a suitable candidate for treatment in the frown area.  Similarly, if you raise your eyebrows and the horizontal lines deepen or if you smile and the crows feet become more prominent you will achieve a benefit from this therapy. 

Patients that receive the greatest benefit are those that don't already have wrinkles, or have minor wrinkling only, when their face is relaxed.  The wrinkles only appear when a particular facial expression is made.  In these patients, apart from the initial cosmetic benefit, anti-wrinkle injections are also an effective preventative strategy.  As a result, it is now quite common for patients to start treatment in their 20s and the majority of ideal candidates are in their 30s or 40s.

As we age, the dynamic wrinkles are present even when the face is relaxed.  This is due to repeated muscle contraction and is exacerbated by thinning of the skin and breakdown of collagen and elastin in the skin.  Environmental factors such as smoking and sun exposure also accelerate skin ageing.  The skin becomes looser and more crepey.  This usually becomes apparent in the late 40s or 50s. These patients are still suitable candidates for anti-wrinkle injections but they may not achieve the dramatic results of younger clients.  Having said this, patients will often find that results will improve over time after several treatment sessions.  Often these clients will require other therapies such as dermal fillers, microdermabrasion, skin needling or laser resurfacing to achieve optimum results.

In our 60s and 70s skin thinning and collagen breakdown continues.  Wrinkles become more prominent and this is also exacerbated by volume loss in the mid and lower face.  At this stage the results of anti-wrinkle injections can be disappointing as the major problem is now skin deterioration rather than excessive muscle activity.  Unfortunately, relaxing the underlying muscle will not tighten the overlying skin.  Other treatments in this type of patient are more effective, particularly dermal fillers or surgery.

The best candidates are people that are physically fit with no history of neuromuscular diseases such as multiple sclerosis. Women that are pregnant or breast feeding should not receive anti-wrinkle injections. People with facial scars, marked facial asymmetry or drooping eyelids may not be good candidates. You should inform Dr Wassall of any medications, vitamins or herbal supplements that you are taking.

The level of improvement in the appearance of wrinkles varies between patients. People with deeper dynamic wrinkles can still expect improvement but not to the same degree as someone with finer wrinkles. It is important to discuss your concerns and expectations with Dr Wassall. He can advise you on the expected level of improvement but sometimes another form of treatment may be recommended.

 

How long do anti-wrinkle injections last?

Results from anti-wrinkle injections begin around 3 to 5 days after treatment and the full effect is seen after 10 to 14 days.  The results generally last 3 to 4 months at their maximum effect before gradually wearing off. However, many factors determine treatment duration.  Younger patients generally have a longer duration and higher treatment doses tend to last longer.  Patients that are very physically active often report a shorter duration of action.  Interestingly, the same patient may receive different durations from two identical treatments.  

As a rule of thumb, most patients will initially require treatment 3 to 4 times per year to maintain their results.  Over time with repeated treatments, patients often only require treatment 2 to 3 times per year.  However, there is no compulsion to have regular treatment.  Many patients elect to have treatments for special occasions such as weddings or school reunions.

 

What does treatment involve?

Treatments with anti-wrinkle injections involve having a number of small injections in the treated areas. The process takes only a few minutes.  The needles used are very fine, and only a small volume is injected. The discomfort is usually minimal and most patients comment that it is less painful than they expected.  Ice, anaesthetic cream or numbing cream can be used to reduce discomfort further.

 

Are Anti-wrinkle Injections safe?

Anti-wrinkle injections are extracted from bacteria and refined into a medication that has been used safely and effectively in millions of patients for over 25 years. It has been used safely in young children for the treatment of cerebral palsy. There have been no long-term side-effects recorded from cosmetic usage. 

• The most common short-term side-effects are:
• Tenderness or bruising at injection site. The risk is higher in people on blood thinning medication eg. aspirin.
• Slight temporary drooping of eyelid or eyebrow lasting 1-6 weeks. This occurs in less than 1% of cases.
• Double vision (very rare).
• Temporary headache.
• Temporary tearing or eye irritation.
• Minor facial asymmetry which can generally be corrected with further injections.