Muscle relaxing injections have been used for more than a decade in children and adults to treat therapeutic conditions such as involuntary facial muscle spasms and double vision due to eye muscle imbalances.
Their use in Cosmetic Medicine has become widespread over the last 10 years. It is a simple treatment, which is safe and effective. Many facial wrinkles are caused by the action of the underlying muscles of facial expression. Over time these wrinkles become deeper and more ingrained. The appearance of many of these wrinkles can be substantially improved by subtly weakening the responsible muscles. This does not need to result in total freezing of the face and removal of facial expression as untreated muscles continue to function normally. Tiny injections into the muscles improves existing wrinkles and can prevent new ones forming.
After an injection into a muscle it begins to weaken in 2-‐3 days and maximal effect is at around 14 days. Occasionally refinement treatments are needed at 14 days to further improve the outcome. The amount of muscle weakens is determined by many factors including the dose and the depth of the injection. The effect usually lasts around 4 months but can be for a longer or shorter period. The muscle regains normal function after this time.
Re-‐treatment with further doses is required to maintain muscle weakness. It is advisable to re-‐treat before the prior dose has entirely worn off. Typical re-‐treatment interval is 3 months.
Over a period of repeated injections the muscles become weaker and treatments can often be reduced or even ceased.
It is important to enter all cosmetic treatments with realistic expectations. Your doctor is the best source of guidance for what can be expected from your treatment.
There are no alternate treatments that achieve the same effect as these injections.
Side effects and complications are usually minimal. Your doctor will monitor you closely, and, should a complication occur you should contact them so they can use their best medical judgment to manage the problem.
Occasionally, headache, slight swelling, bruising, pain, burning or tenderness may occur after injection. There have been rare reports of infection and allergic reaction. An adjacent muscle may be weakened for several weeks after an injection, which may cause a temporary drooping of the eyelid or an eyebrow. Very rarely there can be drooping of the corner of the mouth, double vision of difficulty swallowing. This could last 2-‐3 weeks. Systemic side effects have been described rarely. They include nausea and flu-‐like symptoms.
Injections should be avoided in patients who are pregnant, breastfeeding and in those with neurologic disease (like myasthenia gravis or motor neurone disease) or glaucoma. You also shouldn’t be using certain antibiotics when you are having these injections. Injection treatments are best avoided if there is local skin infection in the area to be treated. Make sure your doctor knows about any allergies you may have.
You should avoid taking any medicine or supplements that might increase your chance of bruising or bleeding for a week before and a day after your treatment. The commonest offenders are Aspirin, Anti-‐ inflammatory medication, Vitamin E and Fish Oil. Please consult your usual practitioner regarding regular medication to be sure it is safe to withhold.
After your injections you should do the following to maximize your benefit:
- Exercise the injected muscles every 10 minutes for 4 hours
- Avoid massage and rubbing the treated area
- Avoid lying face down or other direct facial pressure for 24 hours
- Avoid strenuous exercise, facials and facial waxing for 24 hours
- Avoid excessive sun exposure and solarium use for 24 hours