Where can muscle relaxant / anti-wrinkle injections be useful?
Wrinkles and lines can be dynamic or static. Dynamic lines are lines which occur when the person is animating. Static lines are those which you can see when your face is at rest. Anti-wrinkle injections are commonly used to treat dynamic lines effectively. They are especially useful for the top half of the face. Anti-wrinkle injections also yield some benefit for static shallower lines by softening them. Treatment of static lines is usually coupled with injectable dermal fillers.

Anti-wrinkle injections are useful and highly effective for the treatment of:
- Forehead lines
- Frown Lines (lines between the eyebrows)
- Crows feet
- Bunny/Wolf Lines (lines on the bridge of the nose)

And to a lesser extent:
- Marionette lines (lines from the angle of the mouth extending to the jaw)
- Vertical lip lines
Back to top

What other applications are there for muscle relaxant injections besides reducing wrinkles?
Muscle relaxants can also be administered to selectively relax certain muscles to achieve other cosmetic effects unrelated to wrinkles. They are commonly used for:
- Lifting the eyebrow and/or changing the shape of the brow – flared, arched or elevated
- Treating a gum exposed smile by relaxing the muscle that elevate the upper lip
- Correcting “sad mouths” by elevating the downward angles of the mouth
- Treating muscle bands on the neck commonly known as “turkey necks”
- Focal hyperhydrosis or excessive sweating in certain areas e.g. armpits
- Treatment of dimply chin
Back to top

Are these injections painful?
These injections are done with minimal discomfort and they are very well tolerated. The needles used are the same as the ones used by diabetics who inject themselves with insulin on a daily basis. The size of the needle is a small fraction of the ones used for taking blood.

Is it safe?
The safety profile of muscle relaxant / anti-wrinkle injections is excellent. After over 15 years of use for cosmetic purposes, there is no reported major side effect. There is also not a single reported case of anaphylaxis. The same substance is used to treat a myriad of medical conditions ranging from cerebral palsy in children to migraines and anal fissures.
Back to top

Is it a toxin and would it intoxicate my body?
The protein used in muscle relaxant / anti-wrinkle injections was initially found in food poisoning called botulism. In this condition this protein “intoxicates” the victim by relaxing the muscles of the entire body resulting in suffocation. However, the dose used for cosmetic purpose is extremely small and the muscle relaxing effect is limited to the small area of muscle where it is injected. In fact, it’s “toxin” effect is used to our advantage to achieve the desired cosmetic result without major side effects. There is no systemic side effect on breathing and when used cosmetically, there is no known adverse effect on the heart, lung, liver, kidneys, brain or any other organ.
Back to top

Are all Botulinum Toxin Type A the same?
Not all botulinum toxin type A are the same. There are 2 main products marketed in Australia and they have different efficacies and safety profiles. There are also products available overseas which have not been approved for use in Australia. The risk profiles of these products are different and cannot be guaranteed. At Le Temple we only use the product with the longest history of use and according to the latest scientific data, safest and gives superior longevity of treatment results. In Australia, this is a schedule 4 drug which can only be prescribed by a medical doctor.
Back to top

What is the down time?
There is usually nearly no downtime with these injections. Immediately post treatment, expect minimal swelling in the injected areas. These resemble mosquito bites and they should subside within less than half an hour. They are also easily camouflaged with a concealer. Bruising is uncommon and in the unlikely event of it happening, they tend to be small and they usually fade away within a week or so. You can resume normal activities post treatment but it is advisable not to rub the injected area hours after the treatment to limit product migration.
Back to top

What are the risks and side effects?
Generally, there are few side effects and they are usually transient in nature. The swelling and redness at injection sites usually resolve within half an hour. As there may be small invisible vessels under the skin, injections may result in small bruises but with utmost care, we will try to avoid puncturing these vessels. In the unlikely event of bruising, they usually resolve within a week or so and they can usually be easily camouflaged with a concealer. Very rarely, due to product misplacement or product migration, adjacent muscles may be affected e.g. treating the frown or brows resulting in a brow or lid droop. This may last for two weeks to a month and an eye drop may be administered to reduce the effect of the lid droop. As with all injections, infection of the injection site is a possibility but very rarely occurs.
Back to top

How long does the procedure take?
All the appointments at Le Temple are scheduled in half hour blocks and there would be ample time for questions and answers. After informed consent is obtained, the procedure itself should take less than 10 minutes.
Back to top

When would I see the effects of the treatment?
The treated area will start to take effect usually within 2 to 3 days and the maximum effect is usually seen in 7-14 days.
Back to top

Do I get an unnatural “stunned” look with no expression?
Administering muscle relaxant / anti-wrinkle injections is a science but more importantly also an art. The effect of the injections can be very injector dependant and therefore it is crucial for the injector to have studied the anatomy of the face and have a good aesthetic eye. In the hands of a good injector, the resulting look should be natural looking (only with less lines) and the client should be able to express with his / her face. Rather than looking “stunned”, the client usually attracts comment about looking “fresher”, “more well rested”, “younger” or having better skin.
Back to top

How long does the treatment last?
The effect of the injections usually last at least 3 to 4 months but potentially longer for some individuals. This can be dose dependant and therefore it is important not to under dose. After repeated treatments, the effect may last longer as the injected muscles atrophy or become smaller and weaker. As the effects of the injections wear off, the expression lines return gradually to their original appearance and in some cases to an improved appearance.
Back to top

What is the point of spending money on a temporary treatment?
This treatment is not only suited for clients who would like to look better for a special occasion. When the skin is allowed to relax temporarily, it is also given an opportunity to repair. It is like resting a sprained ankle temporarily will allow the ankle to heal and walking on a sprained ankle will contribute to its further deterioration. The frequent administration of these injections may prevent further deterioration of the skin and as the saying goes, prevention is better than cure.
Back to top

When should I start having anti-wrinkle injections?
There is no fixed time or age when someone “should” start anti-wrinkle injections. To start when the lines are faint and short usually yield better results. It may also prevent deeper lines from forming. When lines are left till they are very deep and static (i.e. present when not animating), anti-wrinkle injections are less effective and other treatment modalities like dermal fillers may be needed.
Back to top

How often should I have this done?
It is advisable to be treated on a regular basis every 3-4 months at least in the first year. Studies have shown that response to treatment is increased with regular repeated treatments. When the "sprained" skin is allowed sufficient time to rest, it will have a better chance of healing itself. It will also allow the small amount of injected muscles to become smaller and weaker so that the results may last longer in the future. However, as with all relaxation or healing, doing some is better than doing none at all.
Back to top

Does my skin appear worse when I stop treatment?
When treatment is ceased, the skin will gradually return to its original state and the lines will gradually return. The skin will continue to age due to genetic factors and environmental insult e.g. UV from sun exposure but anti- wrinkle injections will NOT accelerate this process. In fact, when the injections are kept up for a period of time, some individual skin with good healing capacity will reverse this process of aging and the skin will end up looking fresher and more radiant.
Back to top

Who is not a suitable candidate?
You are not a suitable candidate if you have any of the following conditions:
- Pregnant
- Breastfeeding
- Neuromuscular / muscular weakness disorder e.g. Myasthenia Gravis or Eaton-Lambert Syndrome
- Active infection at the proposed injection site
Back to top

How much does it cost?
The cost of treatment varies depending on the area treated, the strength and distribution of the muscle and the nature of the lines treated. In general the stronger and bigger the muscle and the longer the lines, the more product is needed and hence the higher the cost. As everyone's musculature is different, our cosmetic physician with be able to make a more accurate assessment during the consultation and advise you on the appropriate cost of your proposed treatment.
As a rule of thumb, forehead lines may be treated from $100 to $300, crows feet from $250 to $500 and frown lines from $$250 to $550. Please bear in mind that these are rough estimates and some people will need less or may choose to have less and some will need or choose to have more.
Back to top

What can I do to prepare myself for these treatments?
To prevent bruising, it is best to stay away from anti-inflammatories e.g Aspirin, Nurofen or Voltaren a few days prior to the procedure. Alcohol is also not a good idea on the day and should be kept to a minimum the day before. A good sleep the night before and minimising stress helps with the perception of pain. Remaining calm and relaxed means the procedure will be done usually with relative comfort.
Back to top

Why should I choose to have my anti-wrinkle injections at Le Temple?
At Le Temple, these injections are administered by our highly trained cosmetic physician. It is crucial that the injector is trained in anatomy and medical emergency should any such medical procedure go wrong. Besides your physician is also a highly skilled aesthetician with superior qualifications in the arts and ultimately cosmetic work is an art form. You will not choose anyone who could hold a paint brush to paint your portrait, let alone having someone inject your face to alter the way you look. At Le Temple, we also make half hour appointments so that you have ample time to have all your queries answered and for us to achieve the optimal result. Your cosmetic physician will make an accurate assessment of your skin and provide you with an honest, balanced and realistic opinion about what is achievable. We also review our patients at the 2 week mark to ensure that you are happy with your results.
Back to top

Links:

www.wrinkles.com.au

www.plasticsurgery.org.au/procedures/botulinum_toxin.html