Wrinkle Relaxing Injections

Wrinkle relaxing injectable products originate from botulinum toxin, a purified protein created by the bacterium Clostridium botulinum. Botulinum toxin works by trimming off a receptor to prevent the release of acetylcholine, a neurotransmitter that signals muscles to contract. This results in temporary relaxation of the muscles responsible for fine lines and wrinkles. The receptor regenerates in 3-6 months when the treatment ‘wears off’ and the muscle is able to contract again. 

Botulinum toxin, a prescription-only medicine regulated by the Medicines and Healthcare Regulatory Agency (MHRA), was initially used cosmetically in 1990 to reduce facial lines caused by muscle contractions. According to a paper published on the National Library of Medicine, botulinum toxin treatment is widely considered safe, effective, and mostly free from serious side effects. The NHS further emphasises that the risks associated with botulinum toxin injections are small when performed correctly by a suitably qualified practitioner.

To determine suitability for wrinkle relaxing treatment at Projuvenate, a face to face consultation with Dr. Libby is essential. During this session, a comprehensive health history will be obtained, and a physical examination will be conducted to explore suitable treatment options. 

While wrinkle relaxing treatments may offer benefits to many individuals, they are not suitable for everyone. It's important to note that botulinum toxin Type A injections may not be suitable for some individuals due to concerns about increased risks of complications or adverse reactions. These injections may not be recommended under the following circumstances:

-          Active skin infections or skin affected by psoriasis or eczema.

-          Any acute illness, such as a fever or other health issues.

-          Certain neuromuscular or neurological conditions like myasthenia gravis, Lambert-Eaton Syndrome, or amyotrophic lateral sclerosis (ALS).

-          Pre-existing cardiovascular disease.

-          Compromised respiratory function or dysphagia.

-          Pregnancy or breastfeeding.

-          Being under the age of eighteen.

-          Certain medications, such as antibiotics, anticoagulants (blood thinners), immunosuppressants, acetylcholinesterase inhibitors, muscle relaxants, and antimalarials.

-          Known hypersensitivity or allergy to eggs or any components of the product*.

Additionally, while botulinium toxin itself is vegan, to ensure its safety, it was tested on animals at some point. Therefore, wrinkle relaxing treatments are not recommended for vegans.

Consulting with a suitably qualified healthcare professional is crucial to assess individual suitability and ensure safety before considering wrinkle relaxing injections as a potential treatment option. They can evaluate medical history, current health status, and potential risk factors to determine the appropriateness of these treatments. Prioritising safety is paramount.

*product components include: onabotuliniumtoxinA, human albumin**, sodium chloride. 

** This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products. 

At Projuvenate, the first stage towards any potential wrinkle relaxing treatment is a face-to-face consultation with Dr. Libby, conducted separately from any treatment appointment. This ensures that we gather a comprehensive health history and perform thorough physical examination to explore suitable treatment options. 

We provide ample time and information during the consultation, allowing clients to make an informed decision about proceeding with potential treatment options. Additionally, we reserve the right to refuse any treatment if it is not deemed to be in the client's best interest, as we prioritise transparency and honesty in our advice.

If wrinkle relaxing treatment is deemed appropriate as part of a treatment plan, clients will receive detailed information about pre-treatment care, the recommended treatment schedule, post-treatment care instructions, and follow-up arrangements. We believe in empowering our clients to make informed decisions about their care.

Botox® is a trademarked product containing a specific type A botulinum toxin, with several other brands available, such as Vistabel, Dysport, Bocouture, and Azzalure. In the UK, Botox® is licensed for cosmetic use and indicated for temporarily improving the appearance of moderate to severe facial lines that have an important psychological impact in adult clients. These lines include moderate to severe vertical lines between the eyebrows (glabellar lines) visible during maximum frown, moderate to severe lateral canthal lines (crow’s feet lines) visible during maximum smile, and moderate to severe forehead lines visible during maximum eyebrow elevation. It’s important to note that wrinkle relaxing injectable treatments are most effective for dynamic facial lines caused by facial muscle activity, so lines present at rest may not improve and outcomes can vary. 

After wrinkle relaxing injections, initial effects typically appear within 2-5 days. The peak effect on the muscle occurs at around 14 days, with results continuing to develop for 4 weeks or longer. In case of insufficient dose, a second treatment session may be initiated within the first 4 weeks. Treatment intervals should not be more frequent than every three months. Generally, the effects of wrinkle relaxing injections diminish after 3-4 months. Occasionally the treatment wears off very quickly or does not work at all. 

At Projuvenate, we prioritise care and safety in relation to wrinkle relaxing injections. The process begins with an initial consultation with Dr. Libby, separate from any potential treatment appointment.

After a consultation, if wrinkle relaxing treatment is deemed suitable as part of a treatment plan, the duration of the appointment is customised to address individual needs. We allocate sufficient time for tasks such as obtaining informed consent, preparing the skin, administering injections, and discussing after-care instructions. As a general rule, to assist with your planning, we would not expect this to exceed 1 hour. 

Botulinum type A injections for cosmetic purposes, targeting glabellar lines, crow's feet lines, and forehead lines, are generally safe and effective when administered by a suitably qualified healthcare professional. However, as with any medical procedure, there are potential risks and side effects to consider.

Common side effects at the injection site may include discomfort, pain, swelling, redness, bleeding, and bruising. These effects are usually mild and temporary, resolving within a few days to a week. Individuals taking medications with anticoagulant effects or certain herbs may have an increased likelihood of bruising or bleeding at the injection site. Other side effects that have been reported include twitching, itching, rash, puffiness (oedema) around the eyes, numbness, or other changes in sensation. Flu-like symptoms, such as transient headache, nausea, muscular aching and fatigue, may also occur but typically resolve quickly.

In some cases, asymmetry (unevenness) or temporary drooping of facial features, including eyebrows, cheeks, and mouth, may occur. Dry eyes, dizziness, and double or blurred vision have been reported as well, which may pose risks such as unsafe driving if severe. While rare, allergic reactions, including anaphylaxis, are possible. 

If you encounter any issues after receiving botulinum toxin injections, it's essential to communicate with your practitioner. You can also report any side effects directly through the Yellow Card scheme website at https://yellowcard.mhra.gov.uk/.

Important note: All botulinum toxin products, as medications, carry a boxed warning regarding the potential distant spread of toxin effect. This refers to the spread of toxin from the injection site, leading to symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection and can include serious issues such as swallowing and breathing difficulties, which can be life-threatening. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those clients who have an underlying condition that would predispose them to these symptoms. If you experience a significant problem after botulinum toxin injections, such as difficulty breathing, it's crucial to seek immediate medical attention. You can either dial 999 to request an ambulance or go directly to your nearest accident and emergency (A&E) department.

Overall, the benefits of botulinum type A injections for cosmetic purposes generally outweigh the risks, but it's crucial to undergo treatment under the supervision of a suitably qualified healthcare professional and to follow their instructions closely.

Before undergoing wrinkle relaxing treatment, we suggest avoiding vigorous exercise and alcohol consumption for 24 hours prior. If possible, please arrive for your appointment without make-up. If not, don’t worry, we can remove your make-up at the clinic. Staying well hydrated is also beneficial for your overall wellbeing.

After receiving wrinkle relaxing injections, it’s important to adhere to the following instructions to reduce side effects and protect your result:

- Remain upright for at least 2 hours following the treatment

- Perform small muscle contractions in the treated area every 20 minutes during the first hour

- Maintain skin cleanliness by washing your hands immediately after the treatment. Avoid touching the treated area for 6 hours and refrain from applying make-up for 12 hours

- When cleansing, avoid pressure and use gentle strokes away from the eyes

- Avoid vigorous exercise, overheating (such as hot showers, sauna, or steam room), alcohol consumption for 24 hours

- Steer clear of direct exposure to natural sunlight or sun lamps, and avoid wearing tight caps or garments in the treated area for 48 hours

- Refrain from facial massages or using electrical stimulation of the face for 2 weeks