What causes wrinkles?
As we age, the supportive components of our skin which maintains the skin texture and plumpness, such as elastic fibers, collagen fibers, and hyaluronic acid become damaged. As a result, our skin becomes thinner, and less elastic and starts to sag which causes wrinkles.  Extensive sun exposure and smoking will hasten the aging process. Wrinkles begin to develop in the areas such as the forehead, and around the eyes and lips.

Anti-wrinkle injections are indicated to smooth and eliminate forehead lines, frown lines, crow’s feet, bunny lines, and neck bands.  Wrinkles that occur when we use the muscles in our face are called “dynamic lines/wrinkles”.  Over time and with aging, these wrinkles turn into “static wrinkles” meaning that they are present all the time even when we are not using the muscles that caused the wrinkles to appear in the first place.  When these wrinkles are around the eyes and lower forehead they may give a person an angry, tired, or displeased appearance – even when they are not experiencing that emotion. Treatment with anti-wrinkle injection reduces muscle movements and results in a more youthful relaxed appearance.

Which wrinkles can be treated with anti-wrinkle injections (neurotoxins)?
Neurotoxins are the most common non-surgical method for treating wrinkles. Neurotoxins are particularly effective for targeting the lines that form when we move our face such as in smiling or frowning. These include the forehead lines, crow’s feet lines and frown lines.

Procedure: It is a simple office procedure. The area to be treated is cleansed thoroughly.  Consultation occurs regarding which areas you would like treated and what the desired result is.  Pre and post photos are taken (for confidential medical records only).  An ice pad may be applied to reduce discomfort and the small amounts of anti-wrinkle agents are injected with an ultrafine needle directly into the muscle beneath the wrinkle. The muscle function becomes weakened over the following 7-10 days, eliminating part or all of its function. Long standing static wrinkles will soften and may eventually disappear. The final results will be a softer, more relaxed and pleasing appearance.

The procedure may last for 10 minutes. You may return to work immediately. It is a relatively painless procedure, though a mild stinging sensation may be felt.

What are the potential side effects of using anti-wrinkle injections (neurotoxins)?
Side effects of using neurotoxins can be due to the injection itself or related to the treatment. Injection related side effects include tenderness, bruising or headaches. Treatment related side effects include an increased risk of bruising with some herbal medications such as vitamin E, ginseng, gingko and high doses of garlic and fish oil. A rare side effect may be a transitory droop of the eyelids or eyebrows.

Precautions: To reduce bruising after treatment

• Avoid alcohol consumption at least 1 week before treatment
• Stop taking anti-inflammatory medicines, aspirin and fish oil 2 weeks prior to treatment
• Avoid massaging or rubbing the treated area or lying down after your treatment as the injected botulinum toxin can spread to other areas nearby.

Results: The outcomes of anti-wrinkle injections usually last from four to six months. If you are dissatisfied with the benefits from a single injection, a second injection can be given after 1 week. Once you get a satisfactory result, the next visit is scheduled after 3-5 months.

Who should not have treatment with neurotoxins?
People who are known to be allergic to this product or have a neuromuscular condition known as myasthenia gravis or Eaton Lambert syndrome should not be treated with neurotoxins. Treatment is not recommended during pregnancy or breast-feeding, or if there is an infection in the treatable area.

Whilst no drug interactions have been reported, care should be taken with aminoglycoside antibiotics (such as neomycin and gentamycin) as these inhibit neuromuscular signalling. Care should also be taken if an individual has bleeding tendencies or experiences bruising with treatment.

Is this treatment reversible?
The effects of neurotoxins are not permanent and, over time, the nerves become functional again. This usually takes about 3-6 months depending on the area being treated and the dose of neurotoxin used.