Cosmetic Injections for Wrinkles: What You Need to Know

The injection is a neurotoxin that inhibits muscle movement. It was first approved by the FDA for cosmetic use in 2002. It can reduce the appearance of dynamic lines, which are wrinkles that are formed by expressing emotion and resolve when the muscle relaxes. It can also soften the appearance of static lines, which are wrinkles that do not resolve when the muscle is relaxed. Injections are most effective on dynamic lines and can help reduce static lines if used regularly.

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As we age, our skin loses elasticity and wrinkles start to form. While this is a natural process, some people may want to slow down the effects of aging on their appearance. Scientifically known as botulinum toxin A, this neurotoxin is a popular cosmetic treatment that can help reduce the appearance of wrinkles.

What are injections and why should I get them?

Injections are a neurotoxin that inhibits muscle movement. It was first approved by the FDA for cosmetic use in 2002. It can reduce the appearance of dynamic lines, which are wrinkles that are formed by expressing emotion and resolve when the muscle relaxes. Injections can also soften the appearance of static lines, which are wrinkles that do not resolve when the muscle is relaxed. Injections are most effective on dynamic lines and can help reduce static lines if used regularly.

How long does it last?

Injections typically last for about three months. After this time, the effects will gradually wear off and the muscles will start to move again.

How many units will I need?

The number of units needed is patient-specific and treatment area-specific. On average, patients receive between 30-60 units. During your consultation, your provider will discuss your goals and make recommendations for treatment areas and the number of units.

What areas do you treat?

 

We commonly treat the horizontal forehead lines, crow’s feet, and the lines in between your eyebrows (known as the elevens).

What is the downtime and the aftercare?

There really isn’t any downtime needed. After the treatment, you may have some small red areas that are occasionally raised for a short period of time. This dissipates usually before your provider leaves your location, but occasionally the red and/or raised areas can linger for a few hours. Sometimes you may experience bruising, and we do our best to mitigate this. If you do experience bruising, you may apply ice to the area, but do not massage the area.

We recommend avoiding hot yoga, saunas, hot tubs, and any moderate to intense exercise for 24 hours. Do not lay flat for 4 hours or get massages or facials for 24 hours after your treatment.

What are the complications?

The most common complications are bruising or inject site reactions. Bruising can take up to two weeks to resolve, and injection site reactions typically resolve within a few hours or sooner. Brow ptosis or eyelid ptosis, meaning a drooping of the eyebrow or eyelid, are rare complications occurring in about 1-5% of the population. There are techniques utilized to help avoid these complications.

What should I do to prepare for my appointment?

Stopping any aspirin or anti-inflammatory use a few days to a week before your visit can help reduce the chance of bruising.

What should I expect during my appointment?

The appointment will last anywhere from 15-30 minutes depending on your needs. Your provider will discuss your desired outcome and map out a plan. You will then receive several injections in each treatment area. The number of injections depends on a number of factors. We use a very small insulin needle, which helps with the discomfort. Once the treatment is complete, the provider will go over aftercare instructions and answer any questions you may have. The provider will then reach out in 2 weeks to answer any questions and assess your results. If more is needed, we will schedule a follow-up at that time.

Does it hurt? 

Patients tend to tolerate injections well. We use a very small needle and change needles often to help reduce any discomfort. Everyone experiences discomfort differently but for most patients they report minimal discomfort or none at all. 

Small R. Botulinum toxin injection for facial wrinkles. Am Fam Physician. 2014 Aug 1;90(3):168-75. PMID: 25077722.

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