Anti-wrinkle injections are used to relax facial expression muscles and therefore soften overlying wrinkles. The most popular areas for anti-wrinkle injections are the frown area, crow’s feet, forehead lines, mouth frown, chin and brow lift.
Anti-wrinkle injection works by temporary weakening the target muscle by blocking transmission of a chemical messenger between the nerve and muscle. When used on facial muscles, it typically lasts 3-6 months. The duration depends on the number of units of anti-wrinkle injections used, the location and the patient’s metabolism.
Anti-wrinkle injections are also used for many non-cosmetic medical purposes, such as treatment of muscle spasm in cerebral palsy, migraines, vocal cord spasm and excessive sweating (hyperhidrosis).
At your initial consultation, your treating doctor will discuss your areas of concern and advise on a suggested treatment plan, which will include the areas to be treated and the number of units of the anti-wrinkle injections that will be required. You will then be asked to sign a consent form and photographs will be taken to allow for future comparison.
Ice packs are used to numb the area and the anti-wrinkle injection is injected using very fine needles. We offer numbing cream if required, but most people find the treatment process surprisingly quick and comfortable. Once the treatment is finished, we advise that you hold ice packs against the treated area for a few minutes to minimise the risk of bruising. It is advisable to avoid alcohol and heavy exercise for the remainder of the day.
Once injected, the anti-wrinkle injections will take between 3-7 days to start working. The best result will be achieved at 2 weeks. It is suggested that after your first treatment that you book a complimentary review appointment at the 2-week mark, so that your doctor can assess your response to the anti-wrinkle injection treatment.
More detailed information about the areas that can be treated with the anti-wrinkle injections can be found below.
Vertical lines are caused by movement of the corrugator supercillii or scowl muscles. Over many years of use, fine lines form at the central end of these horizontal muscles of facial expression. These fine lines gradually deepen with repeated use of the same muscle. To treat these lines, anti-wrinkle injection is injected into the scowl muscles, usually into five to seven sites in the frown area. The anti-wrinkle injection causes these muscles to weaken and atrophy and the overlying lines to soften in appearance.
Once injected into the frown area, the anti-wrinkle injections usually lasts 3-4 months. The longevity is directly proportional to the number of units of anti-wrinkle injections that are injected. Most patients require 20 to 35 units to achieve the optimal result on this area. At your initial consult, your doctor will advise the number of units that they estimate will give you the best result.
Some people have a transverse frown line across the root of their nose. This line is caused by repetitive contraction of the procerus muscle while frowning. This muscle is treated at the same time as the corrugators when treating the frown area.
Most patients will experience a subtle eyebrow lift in the centre of their face when having their frown area treated; this is because the corrugator muscles that are weakened by the anti-wrinkle injections generally are weak eyebrow depressors, and once these muscles are treated with the anti-wrinkle injections, their ability to depress the central eyebrows is reduced.
Horizontal forehead lines are caused by contraction of the frontalis muscle which elevates our eyebrows. Over many years of contracting, the frontalis muscle fine transverse lines can form. With repeated use of this muscle over many years the lines deepen. These lines can be softened by relaxing the frontalis muscle with anti-wrinkle injections. It is important to be cautious with the number of units injected into the forehead, especially in patients with heavy eyebrows or upper eyelid hooding. There is a wide variation in the number of units injected into the forehead area ranging from 4 to 24 units, injected into 4 to 12 points. The variation depends on the size of the forehead (a large forehead requires more units) and the thickness of the frontalis muscle (a thicker muscle needs more units). Patients with heavy brows and upper eyelids need to be treated with minimal numbers of units initially, to ensure their eyebrows do not look/appear heavy.
The forehead area is usually treated in conjunction with the frown area, to offset the eyebrow heaviness that can occur with treating the forehead in isolation.
These lines radiate out from the lateral side of our eyes and are due to contraction of the orbicularis oculi muscle. These lines are affectionately known as smile lines. Crows feet are generally treated with 20 to 30 units of anti-wrinkle injections injected laterally to the eyes. Some of our patients prefer a “half” dose of the anti-wrinkle injections to the crows feet, which is 12 units in total (6 units per side). People who have a smaller number of units will achieve less longevity than people who have more units and will have a more subtle result. Anti-wrinkle injections around the crows feet usually lasts 3 to 4 months. It is important to understand that the anti-wrinkle injections to the crows feet cannot remove excess redundant skin under the eyes that develops with aging. This excess crepy skin under the eyes can be addressed with ablative resurfacing or Fraxel laser.
Eye Brow Lift
As we age, our eyebrows gradually drop due to gravity and an increase in skin laxity. As the eyebrows drop, we can look tired even when well rested. The anti-wrinkle injections can be used to give a ‘chemical’ brow lift that lasts approximately 3 months. This lift is subtle but can help patients look refreshed. Both the lateral and central areas of the eyebrow can be lifted with anti-wrinkle injections. The central area of the eyebrows can be subtly elevated when the frown area is treated in many people. The lateral eyebrows can be elevated by injecting usually 4 to 8 units of anti-wrinkle injections into the lateral ends of the eyebrow. The central and lateral eyebrow lifting with the anti-wrinkle injection is subtle and lasts for 2-4 months.
Mouth Frown Muscles
There is muscle attached to each corner of the mouth, called the depressor anguli oris muscle (DAO), which pulls down the corners of the mouth. When this muscle is activated regularly, it can cause a mouth frown which can make a person look unhappy. This muscle can be treated with anti-wrinkle injections, with the usual dose being 4 to 10 units over 2 injections sites.
These lines can develop on either side of the mid to upper nose. They initially can look quite cute but can deepen with age. These lines can be softened by treating each side of the nose with an injection of the anti-wrinkle injections. Usually a total of 4-6 units are given to treat this concern.
If excess gum is seen above the upper teeth when a person smiles, this is know as a “gummy smile” which some people may find this undesirable. By injecting the anti-wrinkle injections, into one of the muscles that elevates the upper lip, the levator labii superioris alaeque nasi muscle, a gummy smile can be reduced. This muscle has been nicknamed the ‘Elvis’ muscle because this is the muscle of facial expression that gave Elvis Presley his distinctive grin. Usually 4 to 10 units of anti-wrinkle injections are injected over 2 injection sites to drop the upper lip so that there is less gum shown on smiling.
Dimply Chin and Chin Crease
As we age, many of us develop an orange peel or cellulite appearance on our chin, also known as a popply or dimply chin, as well as developing a deepening transverse crease across the chin known as a mental crease. Both of these concerns can be addressed by treating the mentalis muscle. Best results are achieved with injection of 4 to 10 units in 2 or 4 sites on the chin.
Lines on the upper lip are usually caused by a combination of sun damage, smoking and contraction of the orbicularis oris muscle. The later can be addressed by injecting anti-wrinkle injections into the skin above the upper lip. Usually 4 to 8 units of anti-wrinkle injections are injected in 4 injection sites and usually lasts from 2-4 months. Some people find that they cannot whistle or use a straw while these muscles are affected by the anti-wrinkle injections.
Strong Masseter Muscles / Square Jaw Appearance
The masseter or chewing muscles are located laterally on the cheeks. You can locate them by clenching your teeth. These muscles are more active in some people and can enlarge with repeat use. People who chew gum a lot or grind their teeth may have large masseter muscles. These muscles can be injected with the anti-wrinkle injections for both functional and cosmetic reasons. Some people treat these muscles to minimise teeth grinding while others will treat to slim down a square face for aesthetic purposes. Usually 30 to 60 units of anti-wrinkle injections per side are injected over 5 injection sites per side. The optimal result occurs over 1-2 months as the muscles weaken and soften and usually lasts 6-8 months.
As we age, the jawline can lose definition. By injection of the anti-wrinkle injections along the jawline some of the depressor muscles of the jawline can be weakened and the jawline can regain some of its lost definition. Usually one or two of the neck bands (which are a part of the platysmal muscle) are treated with anti-wrinkle injections at the same time, to optimise the results by softening the appearance of these ropey neck bands that can become more pronounced with age. Usually 16 units of anti-wrinkle injections are injected along the jawline and 10 to 12 units per neck band. The results of treating the jawline and neck bands are usually subtle and last 3 to 4 months.
If you are interested in considering anti-wrinkle treatments or for further information, please contact our clinic on (02) 9953 9522 to make an appointment with our experienced specialists.