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Botulinum toxin (Botox), Juvederm and Restylane anti-wrinkle injections

Non-surgical treatment for lines & wrinkles

Background

Dynamic wrinkles on the face arise over time from contraction of the underlying muscles every time you smile, laugh or frown. Eventually these dynamic wrinkles become fixed as static wrinkles. All the lines can be softened with injections of botulinum toxin. Botulinum toxin is not a new drug. It has been used over 20 years to treat muscular problems including eye deviation, eyelid spasm and facial spasms

Botulinum toxin for frown lines and smile lines

Botulinum toxin acts by blocking the impulses from the nerves to
the muscles of expression. It relaxes the muscles so it treats facial lines
caused primarily by the action of the muscles on the skin. The ideal areas
to treat are those wrinkles caused by muscles that have no significant
function. Examples include the deep crease between the eyebrows, crow’s’
feet wrinkles and forehead lines. Recent research has shown some benefit in
treating lines around the mouth and on the neck.

The procedure cannot improve wrinkles due to ageing and sun-damaged skin
since they are not related to facial muscle contractions. It will not
improve sagging skin either.

Limitations of Botulinum toxin injections

Injection into frown lines has proved to be very successful. Good results
may be obtained after a single injection and may last four to six months.
The effect of the injection takes up to 14 days to work. Some patients
with very powerful muscles may not see a complete relaxation of the targeted
area. In severe cases therefore, patients may need a repeat injection within four weeks, and even the injection of fillers into the deep creases. Please inform me if you intend to take an airplane journey in the week following injection.

It appears that the duration of treatment benefit is increased over time so
that fewer injections are required in the future. The duration of effect
does vary from patient to patient and may be less effective for those over
65 years of age.

Do the injections hurt?

Most patients find the injections only cause mild pain, comparable to the
sensation of an insect bite. No sedation or local anaesthetic is required.
Some patients experience minor bruising.

Side effects

Temporary bruising is the most common side effect. In rare cases there can
be drooping of an eyelid or asymmetry of facial expression. The risk of
side effect depends on the muscles injected. Because the effects of botox
are reversible, side effects are temporary as well, lasting only
a few weeks.

Long term effects are unknown, but at present the consensus of opinion is that the drug is fully eliminated over a few months, and there is unlikely to be a problem.