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Wrinkle Smoothing

What is botulinum toxin and how does it work?

Doctors have been using botulinum toxin injections in medical practice for decades to treat muscle spasticity and facial spasms in adults and children. They are also successfully used by medical aesthetic doctors to treat facial lines and wrinkles by relaxing the muscles that cause the skin to crease, making wrinkles fade or disappear altogether, and allowing the overlaying skin to regenerate. Effects are temporary, lasting 3-5 months, before muscle movement returns.

What are the treatments available?

In the UK, there are different types of botulinum toxin available to use. The main areas of the face that are treated include the frown lines (glabella complex of muscles), forehead wrinkles (frontalis muscles) and the crows feet (orbicularis oculi muscles) wrinkles around the corners of the eyes.

Muscle relaxing injections can also be used to treat jaw clenching and teeth grinding, excessive sweating, hyperactive muscles in the lower face and to smooth the neck (platysma muscle).


What are the limitations of treatment?

Wrinkle smoothing injections do not remove wrinkles which are present at rest when there is no muscle movement, although it may soften them. Wrinkle smoothing injections need to be maintained every 3-5 months.


What is the difference between wrinkle smoothing injections and dermal filler injections?

Wrinkle smoothing injections are used to relax wrinkles in the upper half of the face.

Dermal fillers plump areas of lost volume, such as nose-to-mouth lines, or to enhance lips.


What will happen during the treatment?

After deciding which areas are to be treated, the area is cleansed with antiseptic solution. The injection sites are marked with a pencil while you frown or squint, which demonstrates the muscles in motion and where the lines are. These spots are then injected with a fine needle. There may be some mild discomfort. The muscles targeted are the ones that contract, pulling the skin into folds and wrinkles; relaxing these muscles essentially relaxes or removes the wrinkles.


How long does the treatment take?

The treatment usually takes 15-20 minutes.


Are wrinkle smoothing injections safe?

Toxin is a safe treatment when administered by a qualified and experienced medical professional. However, as with any medical procedure, there may be some potential side effects. Common side effects include temporary redness, bruising, or swelling at the injection site, which typically subside within a few days. Severe complications are rare but can occur if the treatment is performed by an untrained individual.


Are there any side effects?

The side effects are minimal, and all are temporary. The injections may sting very slightly but they are not painful. Other side effects are minimal redness and swelling at the injection sites that usually disappears after an hour or so. There is also a very small risk of bleeding, bruising or infection at the injection sites. You may experience transient headaches.

There is a very small risk of eyelid drooping (ptosis) and slight puffiness following treatment. In the unlikely event that this occurs, it is always temporary and usually settles after 2-3 weeks. The incidence of ptosis is about 2%. Signs and symptoms of botulism, including problems breathing, swallowing, or speaking (very rare).


What aftercare should I take after having wrinkle smoothing injections?

To prevent the injected substance from spreading to areas where you do not want it, you’ll need to take a few precautions:

  • For the first 2 hours after treatment, it’s important not to rub the affected areas.

  • For the succeeding 24 hours, don’t engage in any vigorous exercise, drink alcohol or experience prolonged sun exposure – whether natural or artificial.

  • Do not apply makeup for 24-48 hours 

  • As Botulinum toxin has no recovery time, there is little aftercare required. 

  • Immediately following treatment, you can enhance its effects by gently moving the treated area with mild facial exercises.


What happens to botulinum toxin in the body?

Botulinum toxin is broken down by the body during the first 48 hours of treatment, so does not accumulate in your system. Improved effects are visible with multiple treatments because the muscle is already relaxed from the previous session so your skin is creasing less and the wrinkles are not being reinforced.


Who cannot have muscle relaxing injections?

It is not recommended in anyone who is pregnant or breast feeding, or who suffers from a neuromuscular disorder. You should make your doctor aware of any medication you are taking including Gingko Biloba, aspirin and other blood thinners like ibuprofen, fish oils (omega3) and St John’s Wort.

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