Anti-wrinkle injections and neuromodulators

What are Anti-wrinkle injections?

Anti-wrinkle injections (ona-botulimum-toxin A) is a neuromodulator that acts on nerves at the neuromuscular junction to paralyse specific muscles. It’s medical origin was for treating blepharospasm (twitching eyelids), but more recently it’s use has greatly expanded (see below). Nowadays, it is most commonly used for, and highly effective at treating, facial wrinkles (rhytides).

Common target areas include:

• Forehead
• Crow’s feet (sides of the eyes)
• Between the eyebrows
• Platysmal bands (cords in the neck that develop as we age)
• Facial contouring (slimming the face to make it more round)

There are two different kinds of facial wrinkles, dynamic and static.

• Dynamic wrinkles: these are lines that are only seen when a person contracts the muscles of facial expression. After a person stops contracting the muscle (eg. they stop frowning), the lines go away. Sometimes, there is enough unintentional muscle stimulation at rest that dynamic lines are seen that don’t match the intended expression (eg. a person is frowning and appears angry even though they don’t wish to have this expression). These are effectively treated by Anti-wrinkle injections.

• Static wrinkles: these are present even without contracting the muscles of facial expression, and are the result of deeper damage to the skin such as scarring or collagen breakdown. Static wrinkles can result from years of untreated dynamic wrinkles, and therefore many young patients are using Anti-wrinkle injections to prevent deeper and more permanent skin damage. Dynamic wrinkles can usually be softened and improved with Anti-wrinkle injections, but will not be eliminated full. In that scenario, a combination of Anti-wrinkle injections and a collagen stimulating treatment are often necessary.

What else can Anti-wrinkle injections be used for?

• Excessive sweating (aka hyperhidrosis): Anti-wrinkle injections can be quite effective for reducing the impact of sweating in certain areas of the body. It is commonly used in the underarms, but can also be used in the palms, groin, and feet (basically anywhere that is sweaty!)
• Cold sensitive fingers: Anti-wrinkle injections can be administered around the digital arteries to minimize their constriction which can help with cold, pale fingers.
• Migraines: Anti-wrinkle injections can be quite effective for certain types of migraines
• Muscle spasms such as jaw clenching and night-time dental grinding

Did you know…Anti-wrinkle injections can also help contour the face?

• Many women desire a heart shaped face but their lower jaw is a bit more squared off then they would like. Anti-wrinkle injections, administered into specific areas of this muscle can contour the jawline, producing a softer more curved appearance. This is possible because it can thin the muscle and, over time, this can actually cause the jawbone to remodel to a smaller size. Fortunately, nature made a second muscle that controls our jaw (which rests on the side of our head) and patients do not have problems with chewing. It is important to have this injection done by an experienced plastic surgeon, as clinicians or nurses without a complete understanding of facial anatomy can inject the wrong location which can have side effects.

How long does it take to work?

Anti-wrinkle injections usually takes 7-14 days before maximal effect is reached. If patients require a quicker response, a faster acting agent such as Dysport is commonly used.

How long does Anti-wrinkle injections last?

Anti-wrinkle injections typically lasts for 3-6 months. It often has a progressively longer duration of action after multiple uses.

Lots non-plastic surgeons inject Anti-wrinkle injections, why should I see a plastic surgeon?

The real benefit of having a board-certified plastic surgeon inject your facial muscles in their more in-depth familiarity with facial anatomy. Most plastic surgeons encounter those muscles in their practice and have dissected them out in the lab numerous times to appreciate the anatomic subtleties (most other clinicians and nurses have never actually seen the muscles directly). Dr. McInnes performs all his own injections, uses a custom, high-potency numbing cream, and a much smaller injection needle than most offices carry, all to minimize discomfort. Dr. McInnes learned his Anti-wrinkle injections injection technique in Beverly Hills, California, from a high-volume surgeon who still does all his own injections.

Risks

Anti-wrinkle injections does not have a readily available reversal agent, therefore incorrect placement of Anti-wrinkle injections, or over-administration, can cause temporary detrimental side effects, such as eyelid ptosis (drooping), eyebrow ptosis, dry eye, and so on.

Please download the consent form designed by the American Society of Plastic Surgeons (ASPS) for a detailed list and description of the risks involved (found here). Risks of surgery will be discussed prior to your consent. It is important to address all your questions directly with Dr. McInnes.