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Anti-wrinkle injections are still the most popular non-surgical cosmetic procedure, according to statistics released by the American Society of Plastic Surgeons.
These injections are commonly used to relax the facial muscles that cause lines and wrinkles, especially on the forehead and around the corners of the eyes, in the crows’ feet area.
While many people think these injections are a new treatment, they have actually been used since the 1960s to treat a range of medical conditions, and it is only their use for cosmetic indications that is relatively recent.
The bacterium that these injections are derived from, in much the same way that penicillin is from a mould that grows on bread, was first isolated in 1895 by Emile Van Ermengem.
In the 1970s Dr Alan Scott of the Smith-Kettlewell Eye Institute demonstrated that the substance was a powerful therapeutic agent that could be used to treat ophthalmic disorders associated with muscle over-activity such as lazy eye. Since then it has been used to treat a variety of involuntary muscle contractions or disorders. Its use as a cosmetic treatment was only discovered when people receiving it for facial muscle spasms also noticed an improvement in their facial wrinkles.
It has many medical indications and, in much higher doses, can be used to treat children two years of age or older suffering from cerebral palsy to help them walk. It can also be injected into the skin to block the action of the nerves that control sweat glands, and in this way treat excessive localised sweating (hyperhidrosis), especially severe underarm sweating.
In recent years it has been used to treat patients suffering from migraines and severe tension headaches, as well as to relieve teeth clenching and grinding.
In cosmetic procedures, these anti-wrinkle injections work by relaxing the muscles that cause dynamic wrinkles, and this softens existing facial lines and can also prevent the formation of new ones.
A few tiny injections are administered just under the skin, reducing nerve stimulation to the targeted muscles. The procedure usually takes about 10 minutes but this can vary depending on the number of areas being treated. Because men tend to have larger and stronger muscles, they often require a higher dose to achieve satisfactory results.
Generally, no anaesthetic is required. The needles are very fine and only a small volume of the product is needed, so the procedure is relatively painless. If the patient is particularly concerned, the physician can numb the skin over the area before administering the injection.
After treatment for lines on the forehead, for example, the muscles gradually relax, and it often takes three to four days for results to become visible, normally reaching their full effect by one week. Since the injected substance is gradually metabolised by the body, repeat injections are necessary every three to five months in order to maintain results. With continued use, the effects may start to last longer because the targeted muscles have ‘unlearned’ the response that originally contributed to the development of the lines.
Common side effects are generally restricted to minor temporary redness or bruising at the injection site. There is a very slight risk that it can cause a temporary weakness in nearby muscles, which can result in a slight drooping of an eyelid or eyebrow lasting from one to six weeks. Occasionally patients may experience a slight headache or nausea.
For two weeks prior to having anti-wrinkle injections, avoid the use of aspirin, anti-inflammatory drugs or blood-thinning agents, unless they are medically required, in order to minimise the chance of bruising.
Treatment with anti-wrinkle injections is not recommended for women who are pregnant or breastfeeding.
Character makes individual faces interesting, gives insight into the personality and is often very attractive. A natural-looking appearance is achieved by preserving normal expression while relaxing unwanted lines. The optimal way to achieve a more youthful appearance is by softening features that reflect the ageing process, such as crows feet, forehead furrows and sagging brows. With careful placement, a talented and experienced injector can achieve a youthful appearance for patients while maintaining their natural expression with character.