Anti-Wrinkle Injections

One of the obvious signs of ageing are wrinkles in the facial skin. These can be both Static and dynamic. Static wrinkles are present all of the time (permanent) and dynamic wrinkles are those that occur first, in younger people, appearing during facial expression as a result of the underlying muscles contracting. The more commonly we display emotion then the quicker these lines are likely to become deeper and ultimately static.

Anti-wrinkle injections work by temporarily paralysing the underlying muscles thereby delaying lines and wrinkles forming, and for those lines already formed, helping prevent them getting any deeper. Anti-wrinkle injections do NOT rid you of permanent wrinkles.

Anti-Wrinkle Injections

  1. Those that are starting to form fine lines
  2. Those that have lines and wish to prevent them worsening
  3. Those that wish to try to avoid forming lines altogether
  4. Those looking to boost self-confidence and esteem
  1. Pregnant females
  2. Females breast feeding
  3. Anyone that has a neuromuscular disease/disorder (e.g. Myasthenia Gravis, Multiple Sclerosis, Motor neurone disease)
  4. People taking the following medications:
    – Calcium channel blockers
    – Aminoglycoside antibiotics (Streptomycin, Tobamycin, gentamycin)
    – Penicillamine
  5. People with an allergy to human albumin or Botox®/Bocouture®
  1. Botulinum Toxin injections (e.g. Bocouture® & Botox®)
  2. Laser resurfacing (Erbium & CO2)
  3. Chemical Peel/Bensipeel (see separate information section)
  4. Dermabrasion
  5. IPL

The whole process starts with a detailed consultation and assessment of your skin in clinic followed by a discussion about what, if any, elements of your skin are damaged and, where applicable, the options that exist to try to improve things.

Botulinum toxin injections are performed in the clinic room, usually taking 15 minutes to inject three areas of the face – this is the most common request, to treat the crows feet, in-between the eyes and the forehead wrinkles. As the finest needles are used it is relatively painless, but if requested, topical local anaesthetic or an ice pack can be used to prepare the sites of injection.

You will not notice any effect initially and usually start to notice a weakening of the muscles around the 3rd day with full effect often taking up to 10 days to be reached.

The duration of effect is usually around 3 months, sometimes sooner.

  • Platysmal bands in the neck
  • Square jaw reduction – results from very strong muscles of mastication (chewing)
  • 8-point facelift
  • chemical brow lift
  • migraine treatment
  • reduction in sweating (see separate section)

Whilst all the above methods will in some way help to improve specific elements of their skin, most are not long lasting as they do NOT treat the underlying cause and thus resign you to a recurrence of the problem sometime in the not-to-distant future and thus more expense to undergo further repeats of treatment – they only treat the symptom and not the underlying cause. Topical skin treatments are therefore, in my opinion, the key to restoring the skins health, treating underlying causes that can then be augmented by one or more of the other treatment methods mentioned.

  • Avoid drinking Green tea 10 days before your injections
  • If safe to do so, stop any Aspirin, Ibuprofen, Diclofenac or other NSAID’s 10 days before your injections
  • Avoid vitamin E supplements for 2 days before injections
  • Avoid drinking alcohol for at least 1 day before injections (this includes the night before)
  • Make-up will be removed prior to treatment so bring any you wish to re-apply with you
  • Keep your head up for four hours after your injections:
    • Do NOT stoop/bend over
    • Do NOT strain
    • Do NOT massage the injected areas
    • Do NOT sleep or lay in a reclined position
    • Try to exercise your muscles of facial expression as much as you can
    • Do NOT take any of the medications listed earlier, including aminoglycaside antibiotics
  • Do not exercise for the remainder of the day
  • The following day you can resume your normal activities

Sometimes you can feel a little sore around the site(s) of injection – this usually settles very quickly.

Occasionally you can bleed very briefly from the site(s) of injection. Applying simple pressure and keeping your head up for 10 minutes should settle this.

Swelling &/or bruising
It is not uncommon to have a little swelling and redness at the site(s) of injection – these usually settle within half-an-hour of injection. Bruising is uncommon but should it occur can be covered up with make-up until it resolves

No change/improvement
Very rarely some people can be resistant to Botulinum Toxin A so no change is noted. It has also been noted that with repeated injections of the A toxin that resistance can develop. In these groups using the Botulinum B toxin would then be recommended.

If desired effect has not been achieved by two weeks after injection, then you may need to return for a top-up.

Eyelid and/or Brow ptosis (droop)
Should any of the Botulinum toxin track down and effect the muscle that lifts the eyelid, it can result in the drooping of the upper eyelid. This usually settles after a few weeks but should it be a problem then see the Doctor about getting eye drops that can lessen this.

Allergic reaction
Allergy to the toxin is very rare indeed, however some have been allergic to other ingredients such as the human albumin

Facial asymmetry
Despite best efforts to inject the toxin symmetrically to both sides of the face, very occasionally the toxin can have more effect on one side than the other resulting in asymmetry. Should this occur then return to the Doctor for a top up to the less affected side.

Should this occur after injection it usually only lasts a few hours and can be relieved by taking Paracetamol if you are able.

Respiratory compromise
This can occur as a result of a true anaphylactic reaction to one of the constituent products.