As we age, skin and other soft tissue of the face gradually loses flexibility and volume, giving way to fine lines, deep wrinkles, skin folds and dark shadows under the eyes. Loss of volume and fat can also give the face a bony or emaciated appearance, making people appear much older than their actual ages. Gravity and sun exposure speed up the ageing process. Lifestyle choices and habits such as smoking and poor nutrition can make things worse.
Graceful ageing, or looking your age, is not an issue in itself. But in a world that places great value on appearances, looking older than your actual age can often be a liability. In some faces, deep wrinkles and skin folds can cause people to appear angry, upset, or sad, when they are feeling nothing of the sort, and actually feel energetic and happy. These permanently negative expressions can lead to disadvantages and discriminations, both socially and in the workplace.
Although anti-wrinkle treatments cannot permanently hold facial changes at bay, they can help—at least temporarily—hold back some of these visible signs of ageing.
This article lays out the basic information you need before making a decision to undergo anti-wrinkle treatments and indicate what you can realistically expect. It is not intended to be a comprehensive guide to anti-wrinkle treatments or treatment options; nor should it be considered an alternative to a thorough and detailed discussion with your chosen facial plastic surgeon.
Are Anti-wrinkle Treatments for You?
It is essential that you choose to have anti-wrinkle treatments with realistic expectations. A positive attitude is also essential when having any treatment or procedure.
There is a common misconception that anti-wrinkle treatments can be a perfect substitute for facial plastic surgery. This is not so. While it is true that some surgical procedures can be postponed for a time—for months and even years—with the aid of injectables, there will inevitably come a time when nothing short of surgery can improve your face further. Instead of considering anti-wrinkle injectables and surgical procedures to be competitive products or services, it may be more useful to consider them a valuable addition to the anti-ageing suite of enhancements.
Injectable treatments are for the most part temporary; their effects wear off. Whether they wear off within weeks, a few months or over a longer period depends on the exact products and treatments used. This is why with all injectables, repeat treatments are necessary to maintain whatever improvements were achieved in the first treatment round.
As with any cosmetic procedure, surgical or non-surgical, there are limits to what injectable anti-wrinkle treatments can achieve. For example, if you obtain injectable treatments when you first see your neck area ageing, you may see significant improvement. But if you wait until deep skin folds develop under your chin and you have what is referred to as a ‘turkey wattle neck’, injectables are no longer a useful option. The only satisfactory way to firm up the neck area and redefine your chin at this point is neck lift surgery. A neck lift will tighten the neck muscles and remove excess skin and fat from your neck and chin area. Certainly some injectables can help in the muscle tightening process, and other injectables can help provide a youthful volume to your chin area once the excess skin has been removed.
Before You Have Anti-Wrinkle Treatments
If you only have fine lines and wrinkles on your face with little loss of volume, anti-wrinkle treatments can buy time before surgery is necessary. One class of injections can paralyze wrinkle-promoting muscles, minimising the appearance of wrinkles. Others can add volume to the face and its features, giving the face a more youthful, rounded and refreshed look. Still others can help rejuvenate the dwindling soft tissue of the face by stimulating new cell growth.
Choosing a facial plastic surgeon that you can trust is one of the most important decisions you can make before your anti-wrinkle treatment. This trust should be based on the verifiable qualifications and expertise of the surgeon or doctor, his or her reputation and past experience with this type of procedure. The experience of your injector can make a big difference in the quality of the treatment outcome. The rapport you develop with your injector during the initial consultation process is also very important.
When you have made the decision to go ahead, and you and your doctor agree on the details and what is best for you, you will be given details of the clinic where your injectable treatment will take place. He or she will also explain how your treatment will be delivered.
You will be asked to provide a thorough medical history to help your doctor or surgeon take into account any medical conditions that could increase your level of risk during the treatment.
As part of the informed consent process, your doctor will also explain to you alternative means, if any, that can achieve the same outcome and inform you of the costs involved for those procedures.
Because they know their limitations, surgeons don’t consider injectable treatments to be substitutes for surgery, but useful complementary treatments that can enhance the effects of facial plastic surgery. For this reason, you will often find surgeons recommending that injectable treatments be combined with surgical procedures like nose reshaping surgery, an eyebrow lift, facelift, chin lift, mid-face lift and neck lift.
Understanding the Treatments
There are primarily two types of anti-wrinkle injections: Neurotoxin based injectables and soft tissue fillers.
Neurotoxin based injectables
Wrinkles caused by muscle contractions can be temporarily erased by the action of neurotoxins, which block the signals telling your muscles to contract. No muscle contraction means there will be no wrinkling, at least for several months.
A number of branded injectables containing a neurotoxin with a paralyzing effect on facial muscles have received the approval of the Australian Therapeutic Goods Administration (TGA). As their effects are temporary, you will need to repeat treatments every few months.
Exactly what dosages and durations apply depend on the facial area, the brand used and the exact composition of the injections.
Before you decide on a specific product, your doctor will discuss the brands available and help you to understand their benefits, risks and potential complications. To help your decision-making, your doctor will also discuss costs.
It is important that you only be injected with a product and brand that has been approved by the TGA.
Soft tissue filler injectables
Soft tissue fillers that restore lost volume in the skin and facial tissue can be categorised into subgroups based on their key ingredients. They contain various naturally occurring substances or synthetic substances.
There are many soft tissue fillers available in Australia, marketed under various brand names that have obtained approval by the TGA. Each type has its own active ingredients and properties. Some can be used to plump up specific areas such as the lips, while others restore lost volume or volume that has sagged. Some fillers merely improve facial volume; others work by interacting with the soft tissue or by stimulating new tissue growth.
Depending on their content and exactly how these substances work on the skin and soft tissue of the face, fillers can bring about immediate results or continue to produce results that can last as long as one year and sometimes even longer.
Before consenting to treatment, make sure you know all about the TGA approved brand of soft tissue filler that will be used in your treatment. Your facial plastic surgeon will explain why one brand or product is better suited to your needs than other brands.
Successful outcomes in anti-wrinkle treatments, as with all cosmetic procedures, are a result of teamwork and rapport between you and your doctor. Only your doctor can answer questions about what specific treatments will help improve your appearance.
Injectables are approved by the TGA for use in specific ways and for injecting specific areas of the face or body. Use for any other purpose, or on any other part of the face than the one for which TGA has granted approval, is called an off-label use. Your doctor will be able to give you more details about off-label use of injectables.
Little or no preparation is needed for injectable treatments. Depending on the type of injectable, treatment can take a few minutes or up to an hour. Exactly how long the treatment will take depends on the type of injection, the extent of treatment needed and the area of the face.
Neurotoxin injections are typically completed within five to ten minutes, and patients can go home or back to work immediately. Soft tissue filler injections generally take longer.
What to Expect After Anti-Wrinkle Treatments
Compared to cosmetic surgical procedures, injectables require little or no recovery time. Sometimes injectable treatments require the use of a local anaesthetic.
The most common side effects include minor irritation in the treated area and redness, bruising and/or swelling around the injection sites. These reactions typically disappear within a matter of hours. Cold compresses will help reduce discomfort in the treated area.
Most of the swelling should subside within a day or two. However, it is normal to experience minor swelling and irritation for several weeks as your body recovers from the treatment.
If you experience anything unusual after your treatments, such as severe pain, allergic reactions or swelling, contact your doctor immediately.
Anti-wrinkle treatments can help boost self-confidence. When you feel better about your appearance, you feel better about yourself.
In general, insurance does not reimburse costs of elective cosmetic procedures unless they are performed to correct or improve birth defects or as part of treatment for traumatic injury. In these cases they may be reimbursed fully or in part.
Just to be sure, always check with your insurance plan on the specifics of coverage.
You can find accredited facial plastic surgeons who perform anti-wrinkle injections among members of the Australasian Academy of Facial Plastic Surgery.