Muscle Relaxing Injections
What are muscle relaxing injections?
Doctors have been using Botulinum toxin injections in medical practice for over 15 years to treat muscle spasticity and facial spasms in adults and children. They are also successfully used by aesthetic doctor to treat facial lines and wrinkles.
What are the treatments available?
In the UK, the only product that has a licence to treat frown lines (glabellar area) is Vistabel. Other areas of the face can be treated off ‘licence’ and this has been done safely for well over a decade using products such as Botox.
How does it work?
Acetylcholine is a chemical messenger produced in our nerves to stimulate the muscles to contract. The Botulinum toxin reduces the release of acetylcholine therefore reducing muscle contraction. The action on the muscle is never permanent.
How does it work to reduce facial lines?
Facial lines are caused by repeated use of the facial muscles of expression e.g. squinting and frowning. By reducing the amount of facial muscle movement the lines can be softened. Injections are given into the muscles, temporarily reducing their strength for a period of three to six months. The effect on the muscle is always temporary. The aim of the treatment is to break the habit of frowning or squinting and so reduce the appearance of the lines and also reduce the development of further facial lines. Prevention is often better than cure.
After your treatment it will take 7-12 days for the effects to start to be seen reaching its maximum effect at 28 days. The results may last from to 3-4 months. With ongoing treatments the effects may last longer but they may not.
Occasionally you may require a top-up injection at two weeks if the muscle is not fully corrected. It is always better to inject a conservative amount of the Botulinum toxin and add more if required. The Botulinum toxin will make it difficult to frown and squint and therefore reduce facial lines However if you try very hard you will be able to move the muscles a little. This does not mean the treatment has not worked. It is most important to retain normal facial expression.
Where can wrinkle relaxing injections be given?
- Eyes – to reduce crow’s feet
- Forehead and brow – to reduce frown lines
- Mouth – to reduce the fine vertical lines on the upper lip or to treat down turned mouths
- Neck – to treat lines and lift the jowl line.
Are there any side effects?
The side effects are minimal and all are temporary. The injections may sting very slightly but they are not painful. Other side effects are minimal redness and swelling at the injection sites that usually disappears after an hour or so. There is also a small risk of bruising at the injection sites. You may experience transient headaches.
There is a very small risk of eyelid drooping (ptosis) and slight puffiness following treatment. In the unlikely event that this occurs, it is always temporary and usually settles after 2-3 weeks. The incidence of ptosis is about 2% but always ask your practitioner what problems they have had with treatments as this will differ between doctors. After several treatments, very rarely, some patients become resistant to the drug and it no longer works effectively.
Who cannot have muscle relaxing injections?
It is not recommended in anyone who is pregnant or breast feeding or who suffers from a neuromuscular disorder. You should make your doctor aware of any medication you are taking including Gingko Biloba and St John’s Wort.
Here is a list of questions you should ask your doctor prior to any muscle reducing treatment.
- What are your qualifications?(the BCAM would always recommend an experienced doctor for your treatment).
- How long have you been carrying out muscle relaxing injections?
- How many patients have you treated?
- What form of Botulinum toxin do you use?
- Are there any alternatives that I should consider?
- How often have your patients had “droopy eye”?
- Are muscle relaxing injections dangerous?
- Do you audit your results and patient satisfaction?
- What do I do if there is a problem with my treatment?
- Do you routinely follow up at 2 weeks?(this is neither a good thing or a bad thing just important for you to know).
- Do you have any patients who you have previously treated whom I could speak to?
- How much does it cost?(this is the least important question).