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Wrinkle Injections

Author: Dr Naomi / 30 Oct 2015

The reason we use the term wrinkle injections, is because in Australia we are not allowed to name the products that we are using for cosmetic injectables. We will just call them treatment B, treatment D.

Antiwrinkle injections or neuromodulators or muscle relaxing injections can be used in many parts of the face and body

Select from the sidebar the Antiwrinkle Injection you would like to learn more about.

TREATMENT WITH WRINKLE INJECTIONS

The consultation for antiwrinkle injections
History-taking  is very important with the treatment of antiwrinkle injections. The following should be explored:
Has the patient had treatment before?
Were they happy every time?
Did the antiwrinkle injections last well?
Which area came back first?
How is the patient’s metabolism? Do they exercise? Are they very muscular? Do they have trouble putting on or losing weight?
What areas of the face / body  are bothering the patient
Have they every had any complications, eg eyelid droop or eyebrow droop or strange smile etc
Does the patient want a more “natural look”, with some lines left, or do they want the maximal effect possible?

The examination

The doctor will examine the face. In particular, she will look at many features, such as:

  • What area of the face is most aged
  • What area of the face could be improved in terms of making it more beautiful or more young appearing.
  • Where the lines are.
  • Any assymmetries
  • Looking at the profile

Choosing the dose of toxin
The doctor will assess the face and decide on the best dose after taking a history and examining the patient.
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, then a higher dose may be suggested.
If a patient has a history of complications with muscle relaxing injections, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.

Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Most patients do not bother with numbing cream because it takes so long to work and because the treatment isn’t very painful anyway. 

Ice is always used to decrease pain and to reduce the risk of bruising. 

Very rarel patients will use Penthrox for crow’s feet treatments. 

Nitrous oxide (happy gas) is available for patients to used. 

We have yet to try the “Ouchless needle”, but we are able to order it if requested to do so.

What happens during the injectables treatment itself?
The face will be cleaned with alcohol.
Ice will be applied to the area briefly before treatment
The doctor will inject using a very fine needle. Then pressure with gauze will be applied.
The procedure itself takes less than 5 minutes.

How do I look afterwards?
Sometimes there is nothing to see. Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.
Most people could come during their lunch break during work and go back without their coworkers noticing anything

Side effects /risks with muscle relaxing injections
The treatment is very low risk
Headache happens in around 10% of new users.
Bruising occurs in a significant number of cases.

Swelling in the injection area can occur. When it is just the fluid from the injection, this resolves within about 45 minutes
Asymmetry: Sometimes one side is better treated than the other, this is usually because the patient is asymmetrical to start with.
Infection is a very rare complication, but always a possibility when the needle goes into the skin.
Eyelid droop and eyebrow droop are uncommon side effects

Instructions for care afterward
No makeup for 4 hours
No massage that day
No heavy exercise that day
No lying down for 4 hours
Lots of facial movement suggested for a few hours
Lay off the acid face products for 24 hours

What to expect after antiwrinkle injection treatment?
The effect of the B or D will not start to occur for 2-8 days.
The maximal effect of the drug will be at 3-4 weeks, so a review should be booked in at 3 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required)
What if I get assymmetry at some time before the 3 week point? Do I call the doctor?
No. No need to call the doctor. Sometimes assymetry will occur because one side just comes on quicker than the other. Usually it will right itself by the time of the review appointment. If it doesn’t, then it can be treated at the review appointment. There is no point in coming in early for treatment of assymetry. In other areas, treating assymetry too early could lead to droop or further assymetry

How long will the treatment last?
The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
Typically this is what happens:
At 3-4 weeks, there is a maximal effect
at 8 weeks, movement starts to return
at 12 weeks, 50% of movement should be back
at 16 weeks 80% of movement should be back.
For most patients, this is very close to what occurs.

When should I have my next treatment with antiwrinkle injections?
Patients should be retreated when the movement is between 50%-80% back ie sometime from 3-4 months.

Some patients come back every 8 weeks as they do not even like to start to move

Pricing for antiwrinkle injections

Comparing these doses, the D should have a greater longevity than the B. 

The onset of action is quicker with D

Costs for B and D when treating more areas (link)

#photos of antiwrinkle injections

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