Wrinkle-relaxing Treatments

Background

Wrinkle-relaxing injections are used to temporarily relax muscle and soften the appearance of ‘dynamic’ facial lines, most commonly in the forehead, glabella (between the brows) and crow’s feet (around the eyes). Dynamic lines are those that come and go with movement of the facial muscles. The result is a smoother, younger-looking appearance by weakening the muscles that cause frown lines and wrinkles. This treatment may involve a prescription drug and is indicated only following a face-to-face consultation with a trained Clinician. Results can be enhanced with multiple sessions in certain cases, and each course is effective for approximately 3 months. This treatment is not suitable for deeply engrained, permanent lines. As an aesthetic treatment, it is the most popular injectable procedure worldwide, but also has a multitude of medical uses.

A further specialist use for these injections is to reduce the appearance of creases in the neck, called platysmal bands. Used very superficially in the skin, the same injections can be used to reduce sweating - a highly effective treatment for hyperhidrosis (excessive sweating).

The drug commomly used is Botulinum toxin Type A, a purified protein produced by the Clostridium botulinum bacterium. The protein blocks the neurotransmitter Acetylcholine at the level of the neuromuscular junction (where the nerves meet the muscles), causing the muscles to remain in a relaxed state. Regardless of the product used, the prescription must be issued following a face-to-face consultation and the Practitioner trained in appropriate injection and complication management.

Contraindications

These treatments are generally safe in the right hands. However the main contraindications are a known allergy or resistance to the products used, pregnancy, breastfeeding, neurological or neuromuscular disorders, broken or inflamed skin in the treatment areas or Body Dismorphic Disorder (BDD).

Side Effects & Complications

In most cases, only mild and short-lived localised swelling, redness and/or bruising is observed. Uncommon side effects include muscle twitching, headache, itching, dry skin, flu syndrome and fever. Rare side effects that have been reported include rash, hives, serious allergic reaction and hair loss. The rate of serious complications is very low provided the Practitioner’s technique is sound, and it is well documented that non-healthcare professional practitioners have higher complication rates. There is a small risk of an asymetric result when treating either the face or neck, heavy brow (‘brow ptosis’) when treating the upper face or heavy eyelid (‘lid ptosis’) again when treating the upper face - these are mainly technique dependent so having a qualified, vigilant Practitioner is essential.

Procedure

Following a thorough consultation to establish 1) an appropriate indication and 2) no barriers to treatment, you have the opportunity to leave things as they are to consider matters further (a ‘cooling off’ period), or to proceed with treatment on the day following fully informed written consent. This means that following thorough discussion, you consent to the treatment with full understanding of the benefits and risks.

Basline photography is taken with your permission. The product used is mixed with saline and drawn up into a small syringe. The skin in the treatment area is cleaned then disinfected and the product is injected with a very fine gauge needle. Several injections are usually required per treatment area. The procedure causes minimal pain and lasts around 10 minutes. You may notice tiny puncture marks and/or very slight oozing due to the highly vascular nature of the head and neck.

Prior to departing, a follow-up appointment is arranged and you receive aftercare instructions and clinic contacts in case of any concerns/emergency.

Aftercare

Following wrinkle-relaxing treatment we would advise that you:

• Avoid rubbing the treated areas or applying any cosmetic products in the first 24hrs, to avoid migration of the product and weakening of muscles that were not the target of treatment. This is particularly important around the eyes.

• Avoid excess alcohol, strenuous exercise and/or extensive sun exposure for 24 hours following treatment - these situations encourage vasodilatation which can promote bruising.

• Take Paracetamol for any discomfort and avoid the use of Aspirin, Ibuprofen or other anti-inflammatory drugs as these may promote bruising. Overt pain is unusual so make sure you contact your Aesthetic Practitioner with any concerns.

• Do not be alarmed by any odd sensation, weakness or asymetry in the treated areas soon after your appointment. The effects can kick in within the first few days, however the maximal effect is often experienced around day 10-14 following treatment. The final result should therefore only be judged then and follow-up is aligned with this, in case any adjustment to treatment in necessary.

• Contact your Aesthetic Practitioner with any concerns without delay.