Frown Lines Treatment

Author: Dr Naomi / 28 Oct 2015
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Frown line wrinkle injections

Before and after frown line injections

Before and after frown line injections


Before and after wrinkle injections and dermal filler to forehead

Before and after wrinkle injections and dermal filler to forehead

Before and after treatment with wrinkle injections for frown lines

Before and after treatment with wrinkle injections for frown lines

Before and after frown line injections

Before and after frown line injections

Before and after muscle relaxants patient not frowning. This result is not always possible without adding dermal filler as well, but in this case it was

Before and after muscle relaxants patient not frowning. This result is not always possible without adding dermal filler as well, but in this case it was

Frown lines treatment is one of the most popular treatments at our Sydney clinic

Frown lines / glabella frown lines / cranky lines / vertical forehead / elevens lines occur when a person frowns, using a combination of muscles including the corrugator and procerus and orbicularis oculi muscles. Over time, these lines etch in permanently and are there even when the person is not frowning. Often there is a genetic component, which predisposes the person to etching these lines in deeply.

Muscle relaxing injections are the first line treatment for frown lines, dermal fillers can also be used

TREATMENT OF FROWN LINES

The first line treatment for frown lines is antiwrinkle injections (due to Australian regulations, we are not allowed to name the drugs used) and if the line or fold is present at rest, then dermal filler  may be considered
Small injections using a very fine needle are performed to the frown area into the muscles which cause the frown . Somewhere between 3-7 injections  will be performed

The consultation for antiwrinkle injections for frown lines
History-taking  is very important in the treatment of frown lines. The following should be explored:
Is there a genetic component? ie are there others in the family who have a strong frown line at an earlier age? How has this progressed?
Has the patient had treatment before?
Were they happy every time?
Did the effect of the antiwrinkle injections last well?
Which area came back first?
How is the patient’s metabolism? Do they exercise? Are they very muscular? Do they have trouble putting on or losing weight?
Is it the vertical frown line, or the horizontal line between the brows which are bothering the patient
Have they every had any complications, eg eyelid droop or eyebrow droop or strange smile etc
Does the patient want a more natural appearance, with some movement left, or do they want the maximal effect possible?

The examination
The doctor will examine the face and frown line. In particular, she will look at many features, such as:
Where the lines are.
Whether there is any eyelid droop or asymmetry
Whether the frown line/fold is etched in at rest.
The type of skin, whether there are a lot of large pores near the frown line.

Choosing the dose of toxin
The doctor will assess the face and decide on the best dose after taking a history and examining the patient.
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, then a higher dose may be suggested
If a patient has a history of complications with muscle relaxing injections, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.

Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Most patients do not bother with numbing cream because it takes so long to work and because the treatment isn’t very painful anyway.
Ice is always used to decrease pain and to reduce the risk of bruising.
Very rare patients will use Penthrox for frown line treatments

Nitrous oxide / Happy gas is available to patients

 

If the patient requires dermal filler, then typically local anaesthetic will be injected in the area of the frown line first

What happens during the frown line treatment itself?
The face will be cleaned with alcohol.
Ice will be applied to the area briefly before treatment
The doctor will inject approx 3-7 sites around the middle of the forehead above the brows, injecting in the muscles which cause frowning. Then pressure with gauze will be applied.
The procedure itself takes less than 5 minutes.

How do I look afterwards?
Sometimes there is nothing to see. Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.
Most people could come during their lunch break during work and go back without their coworkers noticing anything

Side Effects and risks of antiwrinkle injections in frown line
In general, treatment of the frown line is very low risk.
Headache happens in around 10% of new users.
Bruising occurs in a significant number of cases.
Asymmetry: Often one side is better treated than the other, this is usually because the patient is asymmetrical to start with.
Infection is a very rare complication, but always a possibility when the needle goes into the skin.
Eyelid droop and eyebrow droop are possible risks with treatment of frown lines. It is very uncommon and in our practice below 0.01% over the last decade which is much lower than the stated rate. The risk increases with larger doses

Instructions for care afterward
No makeup for 4 hours
No massage that day
No heavy exercise that day
No lying down for 4 hours
Lots of frowning is suggested for a few hours
Lay off the acid face products for 24 hours

What to expect after frown line treatment?
The effect of the injections will not start to occur for 2-8 days.
The maximal effect of the drug will be at 3-4 weeks, so a review should be booked in at 3 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required)
What if I get asymmetry at some time before the 3 week point? Do I call the doctor?
No. No need to call the doctor. Sometimes asymmetry will occur because one side just comes on quicker than the other. Usually it will right itself by the time of the review appointment. If it doesn’t, then it can be treated at the review appointment. There is no point in coming in early for treatment of asymmetry. Treating asymmetry too early could lead to droop or further asymmetry

What do I do if at 3 weeks post treatment I still have movement?
This is not uncommon, it really depends on the amount of movement and the look you are going for.
Patients often come in and they only have 5% of movement left and are concerned about this. We believe that a little bit of movement is not a bad thing! There are no lines when there’s 5% movement, just a small amount of movement. You don’t look older or worse in any way. I fact, you will look slightly more “natural” with more movement. We would like patients to move away from complete loss of movement as their goal. The goal should be to look younger and more attractive.
However, it is up to the individual, and further treatment can be performed at 3 weeks.

What to do if at 3 weeks after the treatment all of my movement has gone but I still have an etched in frown line or fold?

Dermal filler for the frown line can be considered at this stage
#LINK to blog post

How long will the treatment last?
The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
Typically this is what happens:
At 3-4 weeks, there is a maximal effect
at 8 weeks, movement starts to return
at 12 weeks, 50% of movement should be back
at 16 weeks 80% of movement should be back.
With an adequate dose, for most patients, this is very close to what occurs.

When should I have my next treatment for frown lines?
Patients should be retreated when the movement is between 50%-80% back ie sometime from 3-4 months.

Some patients have treatment every 8 weeks because they do not like any movement at all

Price for antiwrinkle injections in frown lines
Typically $360. If other areas being treated then it will be cheaper

Frown lines wrinkle injections

  • Microlaser Peel 
  • Fractional laser 
  • Dermal Fillers in frown line 
  • Skin Boosters 
  • Antiwrinkle injections in other areas

Improving frown lines is so quick and effective. #injectables #beautyformen #bbloggerau πŸ’‰πŸ˜ƒπŸ˜·

A video posted by Dr Naomi πŸ’‰πŸ’‹πŸ˜·β€οΈ (@drnaomi1) on


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