Neuromodulators as Wrinkle Reducing Injections

Are Neuromodulator Treatments Safe?

Botulinum toxin type A has been used since the 1970s to treat muscle disorders around the eyes. It was found that one of the results of this treatment was that the fine lines and wrinkles around the eyes caused by muscle contraction, such as crow’s feet, were reduced where the botulinum toxin was injected. Extensive research and clinical practice has now established the optimal way in which to use botulinum toxin, and it has rapidly become one of the most commonly used non-surgical treatments to minimise common signs of ageing, particularly on the upper face. When injected in the correct quantities to the correct site, individuals treated with this substance should still be able to smile and to frown, but the wrinkles that develop when they do this are considerably reduced. Normal facial expression should not be affected and the result is a more relaxed and less tired-looking appearance.

Neuromodulators are used in over 75 different countries. It has been estimated that more than 8.8 million Botulinum toxin injections were performed worldwide in 2023 and the trend seems to be increasing yearly.

What sites can be treated with neuromodulators?

The sites that are most frequently treated are muscles of the brow used to frown (an area referred to as the “glabella”), the muscles around the eyes that cause “crow’s feet”, and the muscles of the forehead that cause the horizontal forehead lines. Treatment of the upper face can often give a dramatic and “rejuvenating” improvement in appearance. 

Botulinum toxin can also be used on the lower face to reduce the downward turn of the corners of the mouth that typically occurs with age, to reduce chin dimpling, elevate the  eyebrows, reduce excessive “bunny line” muscle movements around the nose, and to reduce excessive wrinkling of the neck and chest area with movement.  It can also be useful to soften excessively strong “masseter” muscles associated with excessive teeth grinding (called “Bruxism”) and by doing so reduce jaw pain.   Excessively strong masseter muscles can give the lower face a “square jaw” look and botulinum toxin is also popular to slim the jawline in those who have a “square jaw” and wish to have a “heart shaped” face.

Injecting botulinum toxin along the lower jawline can be used to weaken the large muscle called “platysma” which pulls the neck and jawline down.  This technique has also been shown to give a slight elevation of the cheeks similar to the results of 0.5-1 ml of filler and is sometimes referred to as a “Botox facelift”.

Does neuromodulator treatment hurt?

Very tiny needles are used, so discomfort should be minimal. The sensation feels like a small pin prick. If necessary, a numbing cream can be applied beforehand. Most people report little to no discomfort following the procedure. Usually there are no visible signs left, although sometimes there is a small pin point mark which settles within a couple of days, and some minor redness or swelling. Occasionally there is mild bruising, which can be easily covered with makeup and usually disappears within a few days.

Is there any special preparation beforehand?

There are no special preparations beforehand, but it is usually advisable to avoid aspirin and non-steroidal anti-inflammatory medication for a few days in advance to reduce the chance of bruising.