What are Anti-Wrinkle Injections?
Anti-Wrinkle injections are the most well-known injectable neuromodulator. There are currently 3 brands approved for use in Australia, made by pharmaceutical companies: Allergan, Galderma and Merz. The Department of Health, Therapeutic Goods Administration (TGA) does not allow open discussion of the brand names or ingredients in an open forum in Australia. Consult a doctor on which brand is best for your specific needs.
Anti-Wrinkle injections temporarily relax face muscles. Allowing wrinkles created by repeated muscle movement to look less prominent.
Anti-Wrinkle injections were initially created to treat muscle spasm-related conditions, but are now TGA-approved to treat crow’s feet, forehead lines and frown lines.
Beyond cosmetic application, medical benefits of Anti-Wrinkle injections include treatment for:
- chronic migraines
- excessive sweating (hyperhidrosis)
- urinary incontinence
- lazy eye (strabismus)
- neck spasms (cervical dystonia)
- chronic eyelid twitching (blepharospasm)
- Temporomandibular Joint Disorder (TMJ)
- other types of muscle spasms
- Lip Flip
- Non-surgical Eyebrow Lift
- Masseter Botox
How do Anti-Wrinkle Injections work?
Anti-Wrinkle Injections cause a significant reduction in muscle contractions by temporarily blocking nerve signals to said muscles.
As the injected muscles are prevented from moving, fine lines and wrinkles will smooth out and soften becoming less visible. In addition to smoothing out existing wrinkles, it can also prevent new wrinkles from forming.
What are the pros and cons of Anti-Wrinkle Injections?
- These injectable treatments are relatively quick and painless. Often taking as little as 15 - 30 minutes.
- Recovery is almost instant and you can go about your day right after.
- Your face should still have natural expressions and not look frozen. As long your injector does not overdo the unit dosage
- The most popular anti-wrinkle injection brands have been studied for 20+ years with many practitioners having over a decade of experience treating patients.
- Anti-wrinkle injection results are not permanent. To maintain your desired look you will need to visit your practitioner every 3 to 4 months.
- The anti-aging outcomes from anti-wrinkle injections are less effective than what you could achieve with plastic surgery.
- A common anti-wrinkle injection side effect is mild bruising at the injection area, lasting up to a week.
- Without a skilled injector you may experience asymmetrical results e.g. droopy eyelids and drooping at the corner of the mouth. These issues will persist until the effects wear off in 3 to 4 months' time. Eyebrows can also experience the same type of asymmetry, however, this can be rectified with additional injections.
- If you are pregnant, considering pregnancy or breastfeeding, anti-wrinkle injections are not suitable for you and has not been TGA-approved.
Melon Hint: Using an unlicensed or inexperienced injector, or using a knock-off anti-wrinkle injection formula that has not been approved for human use, could mean risking a medical emergency. Make sure you find a qualified practitioner who will give you the best results.
How much do Anti-Wrinkle Injections cost?
Average Cost: $490
Range: $300 - $1,525
You should expect to pay between $10 and $25 per unit of neurotoxin.
The number of units required will depend on the depth of your wrinkles (an indication of muscle strength) and the size of the targeted area. Clinics will often quote pricing per each area on the face e.g. Crows feet, Frown Lines, Chin etc.
Are Anti-Wrinkle Injections safe? What are the side effects and risks?
Clinical trials have demonstrated that Anti-Wrinkle injections are safe with minimal side effects and risks. Aside from mild bruising at the injection area, common potential side effects include:
- discomfort at the injection site
- neck pain
- dry mouth
- vision problems, including blurred vision and dry eyes
Many patients never encounter any of these temporary side effects.
It’s important to find a licensed injector with proven experience, such as a doctor, doctor assistant, dentist, registered nurse or another licensed healthcare practitioner. Anti-wrinkle injections are prescription treatments, however, most practitioners can see patients independently and perform injections under a medical doctor’s supervision.
Also, feel free to ask to see the box with the Allergan, Galderma/IPSEN or Merz branding, so you have peace of mind.
Serious but rare side effects of anti-wrinkle injections include:
- Trouble speaking, swallowing or breathing. These risks are increased if you visit an injector that is not properly trained and licensed.
- Allergic reactions can occur hours, even days after an Anti-Wrinkle injection. Seek emergency medical attention if you experience swelling in your tongue, throat or face, develop hives and itching, begin wheezing or feel faint.
- There is also the risk that the injection unintentionally spreads to other areas, causing a lopsided smile, drooping eyelids or crooked eyebrows. Eyebrow asymmetry can be rectified with additional injection units placed on the forehead.
If you have any concerns about these risks, please consult your licensed medical practitioner to walk you through the prescribing medication information and answer any questions you may have.
You may experience a frozen look if you are over-injected. Luckily, results are never permanent with Anti-wrinkle injections and the effects will gradually fade over 3 to 4 months. Another reason to find an experienced and skilled injector
How should you prepare for an Anti-Wrinkle Injection?
To reduce your chance of side effects, follow these guidelines before attending your anti-wrinkle injection appointment.
- To minimize your chances of bruising. Stop using non-medically necessary blood thinners, one week prior to your appointment, specifically nonsteroidal anti-inflammatories (NSAIDs), like ibuprofen and aspirin.
- Avoid taking vitamin E and fish oil supplements, these are also known to thin the blood.
- Don’t drink alcohol or smoke one week before your appointment.
- A few days before your appointment, apply arnica cream to the injection area to minimize the chance of bruising.
- Be sure to inform your licensed medical practitioner of any over-the-counter or prescription medication you are taking.
At what age should you start getting Anti-Wrinkle Injections?
Anti-Wrinkle Injections are approved for individuals over 18, but most practitioners recommend starting it in your mid-20s for prevention. Regular treatments starting early can delay the formation of new and deeper wrinkles.
Who should not get Anti-Wrinkle Injections?
A good candidate for Anti-wrinkle injections is a healthy adult who is not pregnant, breastfeeding or planning pregnancy. Anti-wrinkle injections have not been thoroughly studied during pregnancy and are not approved by the TGA.
While this treatment is broadly well-tolerated, you should also avoid it if:
- You are hypersensitive or have had previous reactions to any Anti-wrinkle injection-related product
- You have a neuromuscular disorder e.g. multiple sclerosis, Parkinson's disease etc.
- You currently have an infection at the injection area
Alert your licensed medical practitioner of any over-the-counter or prescription medication you are taking, in addition to any supplements or vitamins.
Who should consider baby Anti-Wrinkle Injections?
Baby anti-wrinkle injection treatments use smaller doses to maintain your face’s natural range of expression. Microdosing can be a good option for anyone not just young adults; especially if you are new to the treatment, don't have deep lines/wrinkles or are worried about looking overdone.
Baby anti-wrinkle injections are one of the best methods to maintain a youthful, well-rested appearance without looking ‘frozen’. However, there are also trade-offs to this lighter procedure.
Individual treatments will be less expensive as your injector is using fewer units than the recommended dose for a target area. Unfortunately, this also means the longevity of the effects is less, to maintain results you may require frequent visits of 1 - 2 months as opposed to the standard 3 - 4 months.
Lastly, depending on the severity and visibility of wrinkles and lines, baby anti-wrinkle injections can be ineffective. The lower dosage may be inadequate in preventing movement, particularly if the muscle is a strong area.
Melon Hint: An increasing number of practitioners are using various techniques to microneedle or stamp the neurotoxin into the superficial layers of the skin. Learn about the benefits of this new treatment trend, often called an Anti-wrinkle facial.
What happens during an Anti-Wrinkle Injection treatment?
Anti-Wrinkle Injection treatments are a lunchtime procedure that usually takes just 15-30 minutes. Here is what you can expect:
- You will begin with a consultation, during which your injector will discuss your goals, concerns and medical history to ensure that the procedure is safe for you.
- Your practitioner may take before and after photos for advertisement, and so you are able to see the changes from your treatment. Feel free to decline photos for advertising purposes.
- Then your face is sanitized, and after a brief meeting with the supervising doctor, the practitioner will inject the areas of concern.
- Once your treatment is completed, you will be able to leave immediately and get yourself home.
Do Anti-Wrinkle Injections hurt?
The needles utilised for anti-wrinkle injections are very small, most patients only experience mild discomfort, a slight twinge akin to an ant bite for each injection. Practitioners should also offer a topical numbing cream before the procedure.
What should you avoid after Anti-Wrinkle Injections?
The recovery process for anti-wrinkle injections is very straightforward. After the injections, it can look as if you have been bitten by mosquitoes. You may experience small bumps on your face that should only last 15 to 20 minutes.
Also as we have previously mentioned, you may experience mild bruising around the injection area.
The most important actions you need to take are to minimize the chance of the anti-wrinkle injections spreading and paralyzing a nearby muscle.
Follow these guidelines to reduce that risk:
- Don’t lie down for 2 hours. Anti-wrinkle injections bind to the muscle after 2 hours. It is recommended to sit upright for these first 2 hours to reduce the risk of the neurotoxin spreading. This rarely occurs but has been documented previously.
- Don’t exercise for the next 24 hours. Exercise increases circulation, therefore increasing the risk that the neurotoxin will migrate from the target areas before being fully absorbed.
- Don’t rub the injection site for at least four hours, or do anything else that could apply pressure. This includes washing your face, wearing a hat or applying an ice pack.
How long does it take for Anti-Wrinkle Injections to work?
Anti-wrinkle injection results start showing as early as 2 or 3 days. However, the maximum effects of these neurotoxins can take up to 2 weeks to fully realise.
The toxin has to bind itself to the receptors on nerve cells before it has time to relax the muscles.
The appearance of wrinkles will continue to improve as your muscles stop moving and stay relaxed over a 3 to 4-month period of time, and will continue to improve by upkeeping consistent treatments
However, results will differ from person to person. Your body will continue to make new neurotransmitters and receptors, giving patients varying lengths of effective paralysis. While the average is 3 to 4 months the range is can be from 2 all the way up to 6 months.
While your muscles are not moving, you are getting ‘wrinkle-free time’. So even if you are not consistent with your treatments, you will still have fewer wrinkles than before.
Do Anti-Wrinkle Injections make you look older after it wears off?
No, it doesn't. If you decide to stop getting injections or take a break from treatments, the results will naturally begin to wear off over time, and your muscle movements will revert to their prior state, this includes being able to frown and wrinkle.
Anecdotally, some doctors say that skipping an occasional appointment can make anti-wrinkle injection performance better in the future.
What are the alternatives to Anti-Wrinkle Injections?
- In Australia there are 3 TGA-approved injectable neuromodulators that all give similar results for a similar length of time.
- Injectable dermal fillers can also be used to ‘fill in’ folds and wrinkles.
- Laser resurfacing plus in-clinic ‘light to medium depth’ chemical peels can also be used to address wrinkles and fine lines, including those caused by sun damage (which injectables can not treat).
Sources & Studies
Cavallini, M, Cirillo, P, Fundarò, SP, Quartucci, S, Sciuto, C, Sito, G, Tonini, D, Trocchi, G & Signorini, M 2014, ‘Safety of Botulinum Toxin A in Aesthetic Treatments: A Systematic Review of Clinical Studies’, Dermatologic Surgery, vol. 40, no. 5, pp. 525–536.
― 2022, Advertising therapeutic goods with related services, Therapeutic Goods Administration (TGA), viewed 8 November 2022, <https://www.tga.gov.au/resources/resource/guidance/australian-regulatory-guidelines-advertising-therapeutic-goods-argatg/advertising-therapeutic-goods-related-services>.