Anti wrinkle injections - how to enjoy a lifelong relationship
“I don’t want to look frozen.”
We hear this a lot. I think this stems from a fear of looking unnatural, and concern that others will be able to tell that the patient ‘has botox’.
I am hear to tell you that it is actually pretty hard to make someone’s face look frozen! It would takes a lot of product, injected throughout the entire face.
“My injections did not work or wore off really quickly” We increasingly hear this too!
So, how much antiwrinkle product should be injected and how often?
To answer this question, we look to what the research says. We know that frequent (<3 months) and repeated injections of small amounts of botulinum toxin will cause resistance to the product over time. This is because your body will slowly build up immunity to the toxin so that it no longer works to reduce muscle activity. More and more product would need to be used and over time, the product may stop working all together.
We also know that the peak inhibitory action of a botulinum toxin injection is about 1 week, with full action by about 2 weeks. Then, the product will slowly be removed from the body and muscle activity will return.
My preference is to inject an adequate amount of product, which will result in a month of moderately reduced muscle movement, which will then be followed by 2- 4 months of gradual return to movement. With new patients it can be a bit of trial and error to work out the correct amount to use and we need to keep careful records of how the patient has responded so we adjust doses in the future.
If a small dose is injected, yes there will be movement and less ‘freezing’ however the result will not last - one would expect maybe 6-8 weeks of anti wrinkle activity. This is fine as long as the patient understands this and this is the important part - waits the full 3 months before being retreated.
When I inject patients I try to stress this to them. It really helps if I am the first injector they see as I can set good expectations and a plan from the beginning. However we are seeing more and more patients telling us their injections are not lasting as long as they used to. This may be because they have had small amounts injected too frequently. Other factors include - change in diet and lifestyle, new medications and recent illness. There are many things we can’t control, however the amount and frequency of injections is something we can.
Is one product better than another for preventing resistance?
Maybe. One of the newer anti wrinkle products proposes that their product has been purified further to remove some of the proteins that may be responsible for resistance. Studies are still being performed however initial data looks promising. At CWM +S we stock all 3 anti wrinkle products on the Australia market and I prefer to almost exclusively use the new product now.
