Cosmetic Wrinkle Injections (Nerve Blockers)


cosmetic wrinkle injections

Both of these pictures show her without a smile. BEFORE on the left and AFTER on the right. There is an appreciable improvement in fine lines.*

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facial wrinkle treatment

This is the same woman, but this time she is shown smiling before and after treatment.*

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eye wrinkle treatments

Before and After nerve blocking treatment. It's not hard to see that she is smiling both times.*

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forehead wrinkle treatment

Frown lines Before and After*

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Smiling Before and After*

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This is an example of combination therapy at work. After regular use of nerve blockers and fillers, this patient looks 10 years younger 3 years later !*

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neck wrinkle treatment

Neck bands Before and After*

laser treatment for neck wrinkles

*Results may vary.

Questions and Answers

What are Cosmetic Wrinkle Injections?

This refers to injection techniques to treat lines, folds, and wrinkles primarily on the face.

Two different methods are used: nerve blockers and dermal fillers.

This page will discuss nerve blockers.

You can read about dermal fillers by clicking here

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What nerve blocker does York Vein and Laser Clinic use?

The substance is known as botulinum toxin Type A. There are currently three nerve blocking agents available in Canada. We use the one which is the most common, has been around the longest, and has hundreds of scientific studies.

Because this substance is a prescription drug, federal legislation prohibits mentioning it by name.

The following is an excerpt from Health Canada’s website:

Food and Drug Regulations:

Section C.01.044: Prohibits consumer-directed prescription drug advertising beyond the drug’s name, price and quantity. This means, for example, that when a prescription drug is advertised by name to consumers, no reference can be made to its therapeutic use and/or benefits.

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How do nerve blockers work?

Nerve blockers stop nerve endings from sending the message to a muscle that makes it contract. Without a nerve impulse the muscle stays in a completely relaxed state. This is useful in the treatment of dynamic lines (see next question).

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What are nerve blockers used for?

Doctors first began using neuromuscular blockers in the mid-80s to help people with blepharospasm, annoying muscle spasms around the eyes that disturb vision. While treating this condition, a Vancouver ophthalmologist noticed that it reduced wrinkles around patients' eyes, and she told her husband, a dermatologist, about this phenomenon. He began to use it for wrinkles, and the rest is history. In 2014 in the USA about 6,700,000 cosmetic nerve blocking treatments were performed.

In cosmetic wrinkle treatments, nerve blockers reduce dynamic wrinkles that are produced by muscle activity such as frowning and smiling.* Nerve blockers will not help static wrinkles that are the result of the aging process (loss of collagen and elastin).

Nerve blockers are now also used for the treatment of migraine headaches, excessive sweating, neck tension headaches, chronic back pain, spasticity, and bladder problems.

*Results may vary.
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What areas can be treated?

The most common areas treated are the forehead, glabellum (between the eyebrows), and the outside rim of the eyes (for crow's feet). Less commonly, the upper lip and the muscle that turns the corners of the mouth down can be treated.

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Who is a good candidate for nerve blocking treatments?

Women and men in their 30s to 60s are candidates. Generally speaking, by the time people are in their 70s, static wrinkles predominate, and nerve blockers have no effect on these wrinkles. However, there certainly are many people over 70 who would still benefit.

Younger people will benefit from nerve blockers because early use will prevent deep dynamic wrinkles from forming.*

Smoking and excessive sun exposure age skin more rapidly, so there are many people younger than 70 who are poor candidates for nerve blockers.

Look in the mirror and compare the wrinkles in your relaxed face with the wrinkles that appear when you frown, smile, and raise your eyebrows. If there is no substantial difference, then nerve blockers will not help. (If you find yourself in this category, don't despair! There are several treatment options that can improve your skin including dermal fillers, peels, laser resurfacing, and facelifts.* You should also stop smoking and wear sunscreen!)

*Results may vary.
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How are treatments done?

At each site where you want your dynamic wrinkles reduced, several tiny injections are placed in the muscles using a very short very fine needle. Generally 5 shots are given for the forehead, 3 around each eye, and 5-7 shots are given in the glabellum (between the eyebrows).

Treating the entire face takes 10 minutes.

There is no downtime. The tiny holes created are usually not visible by the time you get to your car to drive home.

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Do these treatments hurt?

When done properly, the injections are almost painless. Cooling and topical anesthetics can be used to reduce discomfort, but almost no one needs these.

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How long does it take to see results and how long do the effects last?

It takes 2 to 7 days before results are noticeable. The effect wears off after about 4 months.*

Treatments are most commonly repeated at 3 to 4 month intervals in the first year. In the second year, treatments are usually done at 5-6 month intervals, and up to 20% lower dose is required. Some people experience benefits for as long as 8 or 9 months.*

*Results may vary.
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What are the side effects of nerve blockers?

Bruising can occur but it is not very common. Bruises tend to be small and disappear in a week or less.

If the nerve blocker spreads too far, weakness of muscles other than the targeted muscles can occur. This is uncommon.

As with any drug, there is a limit to how much can be used before an overdose occurs. An overdose of nerve blockers can result in weakness of the muscles for breathing and swallowing. A typical cosmetic treatment only uses about 1% of the potentially fatal dose, and this means it is very safe.

Nerve blockers can aggravate nerve and muscle disorders, so it cannot be used in people with rare nerve diseases such as myaesthenia gravis, Eaton-Lambert syndrome, and amyotrophic lateral sclerosis.

Occasionally, headaches and flu-like body aches can occur.

Rarely, the immune system produces antibodies against the nerve blocker, neutralizing it as it enters the body. In these cases, it will no longer work.

Allergic reactions are extremely rare.

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What are the alternatives to nerve blocking treatments?

There are several treatment options that can improve your skin including peels of varying strengths, laser resurfacing, and facelifts. You should also stop smoking, start using cosmeceuticals regularly, and wear sunscreen.

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