Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Last updated 9 June 2020
Anti-wrinkle injections are the most popular cosmetic procedure in the world today. It is a simple yet effective procedure; a few injections, no downtime, and wrinkles disappear. Despite this, to produce natural and consistent results requires experience and an understanding of the underlying facial anatomy. Anti-wrinkle injections have been performed at the Victorian Cosmetic Institute’s Melbourne clinics for the past 15 years. During this time, we have constantly refined our methods to produce the best outcomes and experiences for our patients.
Often those seeking anti-wrinkle treatments choose their practitioner based on cost. The price should not be the primary factor, however. A good relationship between the practitioner and patient is paramount. Patients need to be able to comfortably communicate their concerns to their practitioner. Practitioners need to get to know your face and how it responds to anti-wrinkle treatment. Often minor adjustments are required over several sessions to achieve the ideal result for you. This requires careful documentation of the treatment, follow-up, and appropriate adjustments based on this.
Our systems and protocols also encourage consistency from treatment to treatment. For example, we utilise tools such as the Accuvein Vein Finder and injecting guns. The Accuvein allows us to find and avoid veins and reduce bruising. The injecting gun reduces discomfort and improves injection precision, including the depth of injection and dosing accuracy.
At Victorian Cosmetic Institute we utilise a purified anti-wrinkle injection. Impurities may stimulate antibody formation to the active components of anti-wrinkle injections, leading to immunity to the treatment and secondary treatment failure. Utilising a purified version is essential anti-wrinkle injections are a treatment that is repeated long-term in most cases.
Anti-wrinkle Quick Facts
- Anti-wrinkle injections help to relax certain wrinkle-causing muscles in the face to produce a younger and more refreshed appearance.
- By altering the dynamics of muscle activity, it is possible to improve the aesthetic appearance of the face.
- Injectables are relatively painless when performed using special techniques including ice, vibration and the injecting gun.
- Bruises from anti-wrinkle injections can be reduced through the use of the Accuvein.
- The onset of action is 4 days and the average longevity of anti-wrinkle injections is usually 3 to 4 months.
- The treatment has a proven safety record for over 25 years.
What are anti-wrinkle injections and how do they work?
As the name suggests, anti-wrinkle injections reduce wrinkles formed by the muscles of facial expression. Composed of a bacterial toxin from Clostridium botulinum, they inhibit the transmission of the nerve signal to the muscle. Botulism is a form of food poisoning caused by this bacterial toxin. Ingesting food contaminated with this bacterial toxin, often from improper food preservation, can cause muscle paralysis in the body amongst other symptoms.
Anti-wrinkle injections are a commercially prepared form of Clostridium botulinum toxin. When injected, it is possible to target and relax specific facial muscles and reduce facial wrinkling. When the muscles of facial expression contract, they may crease the skin and cause wrinkles. Continual contraction unabated over time may form lines that are etched in and present even at rest. Anti-wrinkle injections may help to prevent this.
The effect of anti-wrinkle injections is temporary. They last from 3 to 4 months on average when used at doses specific to each muscle. The treatment needs to be repeated to maintain the effect.
The frown, forehead, and around the eyes are areas commonly treated with anti-wrinkle injections. However, the treatment does not simply aim to freeze facial muscles and expression. By adjusting the dynamics and interplay between facial muscles, it is possible to improve the aesthetics of the face. For example, through modulating muscles that push and pull the brows, it is possible to vary the height and shape of the brows.
What are the most common facial areas treated with anti-wrinkle injections?
However, they can also be used to;
- alter brow height and shape
- stop the mouth corners from pulling down
- reduce gummy smiles
- evert the upper lip (also known as the lip flip)
- reduce vertical neckbands
- reduce the bulk of the masseter (chewing) muscles
- reduce bunny lines on the nose
- reduce dimpling of the chin
In addition to this, anti-wrinkle injections can also be used to treat armpit, hand, feet and facial sweating.
What does treatment with anti-wrinkle injections involve?
Many start their cosmetic journey with anti-wrinkle injections. The treatment may relatively non-invasive and seemingly simple. But to achieve consistent and natural results requires a regimented and scientific approach. At the Victorian Cosmetic Institute, we have established treatment protocols and systems to optimise the patient experience and cosmetic outcomes achieved.
Photographs of the face and videos of facial expressions are required prior to each treatment and follow-up appointments. This allows for before and after treatment comparison. Standardised photography (camera equipment, lighting, camera settings) is used to ensure that the only changes are the changes in the subject.
Careful cleaning of the face with anti-septic to remove make-up and skin pathogens is the first step of treatment.
We then use the Accuvein vein finder to establish the locations of any veins in the treatment areas. Visualising and avoiding veins helps to reduce bruising post-treatment.
The muscle movements of the area(s) to be treated are then assessed, and injection points marked. This is a critical step in the planning of the treatment to ensure accurate placement of injections. These markings may also be photographed and recorded for the purposes of documentation for future treatments.
The anti-wrinkle injections are injected with a fine needle and syringe, using an injecting gun, into the pre-marked areas. The injecting gun allows for a more precise injection than by hand. Depth and dosage are highly accurate using this method. Furthermore, discomfort is significantly reduced as the movement of the needle through the skin is significantly faster and straighter than what can be performed by hand. Ice cubes or a vibration device can also be used on the treatment area prior to injection. This also significantly reduces discomfort.
After treatment, the skin is cleansed again with anti-septic, removing any blood or markings.
Can I resume normal activities after treatment?
We do advise to not massage the treatment areas after or perform vigorous exercise that may shift the positioning of the anti-wrinkle injections. Otherwise, normal daily activities can be continued immediately post-treatment.
How long do anti-wrinkle injections last?
The duration of effectiveness is dependent on the dose administered and the strength of the muscle injected. On average, anti-wrinkle injections last for 3-4 months.
In a percentage of cases, patients may find their anti-wrinkle injections lasting a shorter time with repeated treatments or even failing to work. In these cases, it is possible that neutralising antibodies have been produced by the body’s immune system. The anti-wrinkle injections, therefore, may act as a vaccine onto itself. To prevent this, we utilise a purified version of the anti-wrinkle injections. The impurities, including proteins and inactive toxin are often responsible for the immune response which fight against the action of anti-wrinkle injections. The purified anti-wrinkle injection has these impurities removes and does not cause an immune response.
Is it possible to become resistant to anti-wrinkle treatments?
Anti-wrinkle treatment needs to be performed at regular intervals to maintain the results. Most patients continue to have treatment periodically in the long-term. However, it is possible to become immune to anti-wrinkle injections. The treatment may become a vaccine on to itself.
The active component of the anti-wrinkle injections is a bacterial toxin and interestingly does not cause an immune response. However, the associated components that are manufactured with the bacterial toxin, including complexing proteins and inactive toxin, are more stimulating to the immune system and may cause an immune response. This means that neutralising antibodies are formed that cause future treatments to be partially or completely ineffective. Interestingly, the associated components have no clinical effect.
The greater the dose, and the more frequent the treatment, the more likely the immunity will occur. When anti-wrinkle injections are used for medical purposes such as spasticity or dystonia in much higher doses the problem becomes more prevalent. However, even with the typically lower doses used in aesthetics, we see cases of resistance – especially given the need to repeat the treatment over the long-term.
There is one anti-wrinkle brand that has been purified so it only contains the active component. This product has the least risk of causing an immune response and subsequent non-responsiveness to treatment. Because of this, at the Victorian Cosmetic Institute, this is our chosen product to use.
However, once immunity has been conferred, it is important to note that none of the brands will work – even the purified version. In the case of immunity, it is necessary to wait, often for years before the immunity is reversed.
Are anti-wrinkle injections safe?
Anti-wrinkle injections have been used for cosmetic purposes for over a decade and for medical purposes for even longer without any reports of long-term side effects.
Furthermore, they are used for various medical conditions, often in much higher doses, for their long-term management. This may include; spasticity, migraines, dystonia, and excessive sweating.
What are the side effects of anti-wrinkle injections?
Generally, there are few side effects to treatment, and no downtime involved. Occasionally, a bruise may appear over the treated area, and this is more common around the eyes. This can be covered with make-up if applicable. There is usually some transient redness and swelling of the treated area (similar to a mosquito bite), and this usually lasts for less than one hour. Other possible adverse outcomes include ; asymmetrical results, failure to cause a significant change in the wrinkles (usually due to inadequate dosing), puffy eyes (for treatments around the eyes), and a drooping mouth corner (from misplacement of the injections).
When treating the frown with anti-wrinkle injections, approximately one percent of people experience movement of the product into one eyelid and this causes a partial eyelid droop that can last for one month. Any side effect of treatment is temporary and will resolve naturally. A particular eyedrop can be given to temporarily reduce the effect of this side effect if necessary.
What else can be treated with anti-wrinkle injections?
Anti-wrinkle injections can also be used for a wide variety of medical conditions. These include; teeth grinding or clenching, excessive sweating or hyperhidrosis, cervical dystonia, facial spasms, spasticity and migraine prevention.
Injected into the skin of the armpits, hands, or feet, anti-wrinkle injections can reduce excessive sweating in these areas for approximately 8 months.
The masseter muscle, one of the main facial muscles responsible for chewing, can also be treated with anti-wrinkle injections. Teeth grinding or clenching may cause hypertrophy or growth of this muscle. This can further lead to jaw pain and a more prominent ‘square jaw’ appearance. Treating the masseter with anti-wrinkle injections can help aesthetically to slim the jawline and relieve associated headaches or pain. For more information on jawline slimming and the treatment of bruxism, click here.
Case Study - combining anti-wrinkle injections and filler
This patient presented to Victorian Cosmetic Institute with concerns of the way her frown lines made her appear. She is a happy and joyful person and wanted her face to reflect her kind nature. The results is a youthful and natural appearance with no surgery. The static lines have been smoothed using dermal filler and reduced the cause of her frown lines with anti-wrinkle injections.
How much do anti-wrinkle injections cost?
Most clinics charge per unit of anti-wrinkle injection. Some charge per area. Each area and person requires a different number of units, so the per-unit pricing is more consistent and fair.
The factors that determine dosage or number of units include muscle strength and the desired outcome, that is, whether the goal is to stop movement altogether or just reduce movement.
The unit price of anti-wrinkle injections is commonly advertised. This may be deceiving due to the different unit equivalents between different brands of anti-wrinkle injections. For example, 3 units of a particular brand may be equivalent to only 1 unit of another. To further complicate matters due to regulations from the Therapeutic Goods Administration (TGA) in Australia, we are unable to name the brand names of the anti-wrinkle injections used. This further confuses those shopping for prices. The cost per unit cannot be associated with a certain brand name and therefore its unit equivalents.
The price we charge allows us to provide a premium service and the best aesthetic outcomes. We have experienced injectors with excellent technical and aesthetic skills and systems and protocols to achieve consistent results. We aim to achieve your aesthetic goals with each treatment, and should there be any concerns, a free top-up is provided. The motivation for most people seeking anti-wrinkle injections is to improve their aesthetics. However, price is often the dominant factor in choosing a clinic or injector. Clinics offering cheap prices often need to make compromises to achieve these low prices and this may result in sub-standard results.
Case Study - jawline slimming
This patient presented to the Victorian Cosmetic Institute for jawline slimming. She had anti-wrinkle to each of her masseter muscles which are the muscles responsible for chewing. Anti-wrinkle injections work as a muscle relaxant reducing the size and firmness of the masseter muscle. This treatment has both aesthetic and functional purpose. Aestheically, the jawline appears slimmer and more defined. Functionally, relaxing this muscle can help reduce headaches, jaw pain, and dental issues such as teeth grinding and clenching.
Why should I choose Victorian Cosmetic Institute as my provider of anti-wrinkle injections?
Our Cosmetic Doctors and Cosmetic Nurses perform anti-wrinkle injections and have extensive experience in their application. We allow you ample time to communicate your aesthetic goals to us, and use our expertise to help you achieve your desired outcome. The experience you have with us is also important. We offer various ways to help alleviate any discomfort or anxiety from the procedure.
The first step is simply contacting us for your initial anti-wrinkle injection consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.
Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.
It’s as easy as clicking the ‘book online’ button or you can phone us directly on 1300 863 824.