What are wrinkle-relaxing injections?
Wrinkle-relaxing injections are injections of neurotoxins – nerve poisons – to reduce the ability of specific muscles to contract, and thus relax wrinkles in the skin above those muscles. Wrinkle-relaxing injections are widely used on the face to reduce dynamic lines and wrinkles on the forehead or around the eyes. (‘Dynamic’ lines are the ones formed as a result of muscle movement. When you raise your eyebrows and your forehead crinkles, those are ‘dynamic lines’). They are also used on other areas, such as to smooth a stringy or wrinkly neck.
What’s the difference between anti-wrinkle injections and Botox?
Anti-wrinkle injections are injections of neurotoxins, poisons that damage or destroy nerve connections. Some of these neurotoxins are used for cosmetic purposes; of these, Botox is the best-known brand and most widely used. In the way that ‘Hoover’ became the name that many of us use for all brands of vacuum cleaner, ‘Botox’ has become the catch-all term for all types of botulinum toxin injections. But it is actually a brand name, which is why it always has a capital B. Other botulinum toxins branded for cosmetic medical use include Azzalure, which is the EU version of the neurotoxin elsewhere called Dysport, and BoCouture.
What’s the difference between anti-wrinkle injections, Botox, and dermal fillers?
There’s a huge difference. Anti-wrinkle injections, of which Botox is an example, are one thing. Dermal fillers are something else entirely.
Anti-wrinkle injections, as above, are injections of cosmetic neurotoxins, and Botox is the best-known brand of these.
Injections of Botox or another anti-wrinkle neurotoxin have the effect of softening lines and wrinkles on the area into which they’re injected. The neurotoxins work by reducing the ability of the muscles to contract. They are most commonly injected into the forehead, to soften frown lines.
Dermal fillers – fillers injected into the skin – are completely different from neurotoxins. Fillers are used to add shape and structure to the face, and to replace the volume that gets lost as our fat pads shrink with age. For example, fillers are frequently injected into the cheeks and lips, to stop them looking deflated, or along the jawline, to make it look firmer.
So: anti-wrinkle injections, including Botox, relax muscles to soften wrinkles; fillers add shape and volume, to resculpt the contours of the face.
Do wrinkle-relaxing injections work?
Yes. Treatment with Botox or other wrinkle-relaxing injections is straightforward and effective. The main question is whether you would like the results. To end up with a result you’re happy with, you need to find a sympathetic practitioner who will listen to what you want in terms of treatment (rather than simply doing what they always do or what they think would be best for you) and discuss it all thoroughly before moving on to treatment.
For more, read my blog about Five Questions to Ask before getting Botox.
Are wrinkle-relaxing injections safe?
Wrinkle-relaxing injections are considered safe. As with any poison, the effect depends on the dose: the neurotoxins can be lethal in large amounts – but then, so can paracetamol or aspirin.
In the UK, Botox and the other neurotoxins are prescription-only drugs, so they have to be supplied by a medical professional who is qualified to prescribe. That means a doctor, a surgeon, a dentist, or a nurse-prescriber (a qualified nurse who has taken a further course to become a non-medical prescriber). The injections can legally be given by someone working under the supervision of that qualified professional, though the prescriber is the one who takes responsibility for the treatment.
How do wrinkle-relaxing injections work?
The practitioner carefully injects precise quantities of the neurotoxin into the muscles underlying the area in which you want to relax the wrinkles. The neurotoxins work by reducing the ability of the muscles to contract.
Botox, Azzalure/Dysport, and BoCouture are all compounds derived from the neurotoxin called ‘Botulinum Toxin Type A’. The three branded compounds contain the same amount of the active ingredient, but the compounds differ from each other chemically – for example, Azzalure/Dysport and BoCouture contain fewer proteins than Botox.
Studies so far indicate that there is little if any difference in effect between Botox, Azzalure/Dysport, and BoCouture. That said, your practitioner may feel that one neurotoxin is more suited to your needs than another. For example, Azzalure/Dysport spreads out further from the injection point than Botox does; this difference is sometimes helpful, sometimes not helpful, and sometimes moot.
Where can I get wrinkle-relaxing injections?
You can use the Find a Practitioner tool on this website (follow the link here) to find a practitioner who offers wrinkle-relaxing injections.
How much do wrinkle-relaxing injections cost?
Wrinkle-relaxing injections cost from roughly £200 upward. The cost varies considerably depending on the practitioner and the clinic, and the number of areas that you are having injected. The ‘glabellar’ area between the eyebrows is one area, the crow’s feet at the sides of the eyes is another area, the forehead is a third area…
Do wrinkle-relaxing injections hurt?
You’ll feel the injections, as usual, but the needles are very small and the volume of liquid injected is minuscule, so there’s very little pain. If you are sensitive to pain, you can numb the treatment area beforehand with anaesthetic cream or an ice pack; discuss this with your practitioner beforehand.
How long do wrinkle-relaxing injections take?
Wrinkle-relaxing injections normally take only 10 minutes. If you need anaesthetic cream, that will add 30 minutes to the treatment time.
How long do wrinkle-relaxing injections last?
Wrinkle-relaxing injections typically last from three to six months. Exactly how long depends on several factors, which I go into in more depth in my blog post on How Long Does Botox Last?
Are there any side effects to wrinkle-relaxing injections?
Wrinkle-relaxing injections can have the following side-effects:
- Drifting from the injection site. The product can drift a little from the injection site, but usually not by much, and only within the first hour after injection. Practitioners used to advise you not to lie down for four hours after treatment. This is now thought to be unnecessary and overly cautious, but don’t rub the treated area, or have a facial massage, for a day or two afterward.
- Bruising or bleeding. These can occur at the injection site. Depending on how easily you bruise, these bruises may take a week or so to clear up.
If a practitioner uses too much neurotoxin, or injects it inexpertly, the following problems can occur:
- Frozen-looking face. Too much neurotoxin can prevent your face from expressing emotion.
- Muscle atrophy. If muscles are poleaxed with Botox for too long or too often and don’t get a chance to regain their full range of motion, they may begin to waste away through lack of use.
- Ptosis of the eyelid or brow. Ptosis means ‘drooping’; the eyelid or brow will droop until the effects of the toxin start to wear off.
What is it like to have wrinkle-relaxing injections?
I’ve had enough Botox with different doctors over the past 15 years to know good injectors when I find them, and Dr Tapan Patel, who spends a lot of time teaching Botox masterclasses to other practitioners, is one of the very best. He takes pictures of my face – at rest, smiling, frowning, and gurning – to see which of my face muscles are overactive. He then injects tiny amounts of toxin into the muscles that produce that annoying pleat of skin between my eyebrows, and even less into the ones that lift my brows up and down. He does it so calmly and carefully that I barely feel the needle – and that’s without anaesthetic. It takes all of 10 minutes.
The Botox begins to kick in after four days. It feels as if my forehead is becoming sluggish when I try to move it. But that’s what I want. After two weeks, when I return to be assessed, my face looks terrific. The frown-pleat between my eyebrows is smoothed away, but I can still show interest by lifting my eyebrows, just not as much as before. And he’s done it without giving me the dreaded ‘Joker’ eyebrows, which shoot up too sharply at the corners. Magic. Over the next two months, the lines on my forehead almost vanish, because the skin isn’t constantly being squeezed up into furrows, and it is four months until I need to go back for more.