Lines & Wrinkles

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Injections for lines & wrinkles are more commonly called by their commercial names, which we cannot name here due to
Australian law.

These are all a purified, medical preparation of a protein that is known to block transmission of signals that cause muscle contraction. This protein has been used for a long time in medicine to treat muscular spasms around the eye (blepharospasm), the neck (torticollis), and other areas (in the gut, bowel, gallbladder system).

In cosmetic medicine and cosmetic plastic surgery, this has an excellent application – it acts on the junction between the nerves and the muscles thereby preventing or helping to reduce the muscles in the treated area from temporarily contracting.

Therefore by careful titration, a gentle, pleasing relaxation of certain facial muscles can be achieved to bring about a smoothening of wrinkles especially those that occur with repeated facial movements, like frown or forehead lines. Only muscles treated will respond to BoNTA whilst remaining areas will still be able to animate.

The other medical application of these injections include excessive sweating (hyperhidrosis).

The Skill in Anti-wrinkle Injections: Why Come to a Plastic Surgery Practice?

The skill in administering anti-wrinkle injections for facial rejuvenation is based on a precise understanding of the underlying anatomy of facial muscles.
In a plastic surgery practice the surgeon him/herself may perform the anti-wrinkle injections or they may be performed by experienced practice nurses working in the practice. Nurses working with a plastic surgeon have received direct training from both the surgeon as well as industry leaders to allow them with the skill, knowledge and experience that allows a surgeon to trust them with their patient and reputation.

Seldom do we want to completely paralyse muscles or muscle groups as this can create bizarre, ‘frozen’ and unwanted appearances as these can look ‘done’ and unnatural. Because botulinum toxin is not an all or none effect – but rather the number of nerves blocked is directly proportional to the dosage and placement of the toxin – the skill is in gently, and harmoniously weakening certain muscles which can produce improvements in facial features (such as positioning of the eyebrows) as well as softening of facial wrinkles.
Furthermore being a plastic surgery practice, we will only suggest anti-wrinkle treatment if it’s the right thing for you – for instance if your wrinkles are the result of loose skin, you may require a different treatment or surgical procedure, in which case spending time and money on anti-wrinkle injections may not be worthwhile.

What are the Benefits of Anti-wrinkle Injections?

Reduce the Appearance of Aging

The primary reason most patients seek out treatment is to reduce the common signs of aging. Anti-wrinkle injections can help to fill in wrinkles and reduce the appearance of aging lines, making the patient appear younger. While not a permanent solution, it is a cost-effective and safe alternative to plastic surgery.

Correct Brow Ptosis

Brow ptosis or drooping brow is a common condition related to hereditary characteristics or side effects of certain surgeries. The condition causes the lowering of the periorbital soft tissue. Anti-wrinkle injections can help to lift the tissue back to a normal position.

Reduce Migraine Pain

While many patients misunderstand the use of anti-wrinkle in the treatment of migraines, it is necessary to understand that the injection will not eliminate the condition. However, it will reduce many of the significant side effects of the disorder. For example, anti-wrinkle injections can reduce nausea and sensitivity to light.

Eliminate Excessive Sweating

Hyperhidrosis is a condition that causes excessive sweating. Anti-wrinkle injections works by blocking or shielding the sweat glands in the areas most affected by the condition, like the armpits, feet or hands.

Stop Excessive Eye Twitching

Excessive eye twitching is more common than you may think, and it can lead to vision problems and pain in patients. Anti-wrinkle injections helps to relax the muscles in the eyelid and reduce or stop the twitch.

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Procedure Information

How are anti-wrinkle injections performed?

An initial consultation with our practice nurse is conducted to discuss and prioritise your facial concerns. During the consultation, specifically looking at a holistic ageing process, possible benefits and likely treatment outcomes. A full medical history is taken to determine your suitable to have possible treatments. Some patients may have underlying conditions that will contraindicate anti wrinkle injections, in which case other alternatives may be suggested.
The injections are performed by our practice nurse, under the supervision of Dr Aggarwal.
Most injections are performed the same day except in patients:
- Who are taking blood thinning medications, or other over the counter agents that thin the blood.
- Who have an infection, cold sores, or other wounds at or near the site of potential injection.
- Who have other contraindications such as a neurological or muscular disorder, have had a previous allergic reaction to injections, may need extra consideration as to the suitability of treatment.
The injections are performed in our procedure room, at our main Gordon practice.
- After an initial consultation and assessment by our practice nurse, a treatment plan is made.
- Clinical photographs are taken before to look at muscle strength, wrinkles and skin quality.
- o The injections are conducted in our procedure room in absolute privacy – for your comfort they are conducted using an ultra-fine needle and syringe.
After treatment, you can return to work immediately. Some bruising and discomfort may occur during injection, and you are best to apply an ice pack to the area to reduce this post-treatment. It is important not to massage the area after treatment as this spreads the product to other muscles that may not have been intended to be blocked by treatment.You will be given aftercare guidelines and how to care for your newly injected area.

How much time does it take?

The initial consultation and injections take approximately 1 hour.

How quickly will I notice the effects?

Effects begin after 2-3 days and can take up to 3weeks for full effect. They last 3 to 4 months. The duration depends on location of the injections, the muscles being targeted, and the patient’s overall metabolism, as well as if maintenance dosing is given – we recommend that patients are regularly reviewed and a top up dose applied to restore effects.
In general we will ask patients to return at the 2 week mark, to evaluate the effects, and it is typical for dosing to be added at this stage to produce desired results, rather than a large dose at the first sitting.
Thereafter we suggest a return to clinic at 3 – 4 month mark for assessment and retreatment.

Risks & Complications

Anti-wrinkle injections are not recommended for:

Patients who have disorders of nerve-muscle signal transmission such as Myaesthenia Gravis or Eaton Lambert Syndrome.
Patients who are currently pregnant, breast-feeding or trying to become pregnant.
Patients with an active infection, cold sore or other breakout at the site of intended injection.
Patients with a previous reaction to these injections

General Risks

General risks of antiwrinkle injections include

Bruising
Discomfort
Swelling
Headache

Specific Risks

Specific risks of antiwrinkle injections include

Insufficient effect – the dosing produces effect but not to the degree desired. In some ways this is performed intentionally to titrate the dosing to the required effect. The dosing varies widely between patients and it is therefore safer to titrate up to the effect desired.
Over-paralysis or unwanted blockade. In rare circumstances blockage of unwanted muscle groups can produce an unwanted appearance in unexperienced hands:
- Injections near the eyebrow can cause upper eyelid droop (ptosis)
- Injections in the forehead could cause brow heaviness (ptosis)
- Injections of the crows feet can block muscles that aid in smiling to produce uneven smiling appearances
- Injections near the angle of the mouth/lower lip can block other muscles causing drooling or uneven smiling appearance.
Asymmetry
Note with any unwanted outcomes, all care prior is made to avoid these unlikely outcomes. If you have any concerns please discuss during your consultation.

Hyperhidrosis

Procedure information

In hyperhidrosis (excessive sweating), these injections block the nerves that supply the sweat glands.
The injection is placed within the dermis of the skin and is very effective for areas such as the armpits, palms, and soles of the feet.
The average length of treatment duration is 7 months.
Injections of the armpit can be performed in the clinic (with anaesthetic cream), however a general anaesthetic is required as a day only procedure if the injection is for hyperhidrosis of the hands or feet.
A starch iodine test may be conducted prior to injection to exactly determine the area of sweating that needs to be treated.

Prodcedure cost

This depends on the total number of units

The standard fee for axillary (armpit) hyperhidrosis is $992(for standard number of units per armpit) – this is rebatable from Medicare under item no 18362 which may allow one to claim $185 for a total out of pocket cost of $805.
Please note that additional units required after the first visit will be charged at our standard rates, and these will not be rebatable from Medicare.

Procedure FAQs

What is the cost of anti-wrinkle injections?

Please visit our price list for further information.

I am concerned that a plastic surgery clinic costs more for my anti-wrinkle injections.

In general the cost per unit is often more at a plastic surgery clinic. This is because the injections are being performed by experienced plastic surgery nurses under the supervision of a plastic surgeon. In many ‘cosmetic’ clinics there is often little to no oversight by a medical practitioner.
However the overall cost may not be all that different to other ‘cheaper’ clinics due to the following:
- the skill of injections is in targeting the exact facial muscles to produce the desired effect. You may receive more product elsewhere to achieve the same effect versus precise placement of toxin, which can reduce the dose needed.
- We believe in gentle titration of effect – so rather than give you a big dose upfront, we will give you a smaller dose at the first visit (therefore reducing cost) and will ask you to return at the two week mark. If you require additional dosing, you are only charged for the units used. By titrating the effect, we aim to reduce the cost for you.
- We will happily suggest to you that antiwrinkle injections are not warranted if it will not produce the results you desire. Being a surgical practice, we can indicate to you if the benefits of surgery may outweigh the benefits and cost of nonsurgical treatments.

Brow Lift

Eyebrow lift with antiwrinkle is a safe, quick, relatively easy, non-surgical cosmetic procedure that involves the use of anti wrinkle injections to relax the muscles between the eyebrows, which smoothes out the furrow (frown) lines and at the same time, lift the brows by allowing the upper muscles of the forehead to have a greater pulling effect on them.

How long do the results last?

Results typically last about 3-4 months

What should I expect during treatment?

Your injector may apply anaesthetic cream or ice to reduce discomfort. Small injections using a very fine needle are performed to the eye area into the muscles which causes the eyebrows to be lowered Overall, the treatment will only take a few minutes to complete.

Is There Downtime With Brow Lift?

Any swelling, bruising or tenderness should subside within 48h. You can see results within a week, but some people may not notice improvements until a month later.

Lip Flip

Lip flip involves the precise placement of just a few units of anti wrinkle injections along the upper lip muscle, near the border, to relax and “flip” the lip to make more of the upper lip visible. This creates a fuller, plumper, but natural-appearing upper lip.

How long do the results last?

Results typically last about 3-4 months

What should I expect during treatment?

Your injector may apply anaesthetic cream or ice to reduce discomfort. The procedure involves injecting a very small amount of anti wrinkle product into the muscle just above your top lip. This will relax the muscle around your mouth, which allows the top lip to gently ‘roll out’, creating the illusion of more volume, as well as stop your top lip moving up too far when you smile.

Is There Downtime With Lip Flip ?

After your injections, you can immediately return to your normal activities.

Face Slimming

Facial slimming is a popular procedure, involving the careful anti wrinkle injection into the sides of the jaw, causing enlarged muscles (technically called masseter muscles) to relax and slim. Once relaxed, the muscles shrink to a much smaller and more feminine size and shape.

How long do the results last?

Results typically last about 3-4 months

What should I expect during treatment?

Your injector may apply anaesthetic cream or ice to reduce discomfort. Jawline Slimming treatment consists of a small number of tiny injections and will cause a minimum of discomfort. The procedure will not take more than a few minutes, and the pain level is low.

Is There Downtime With Face Slimming ?

Any swelling, bruising or tenderness should subside within 48h. You can see results within a week, but some people may not notice improvements until a month later.

Why choose us?

Highly Skilled

Know you are in the safest of hands with a Plastic Surgeon who is experienced, highly respected, and appointed at premier Sydney hospitals- including Sydney Adventist, Hunters Hill Private, POWH and RHW.

Safety

If sedation or general anaesthetic is required, it is delivered by an accredited anaesthetist

Accommodation

Have your surgery at premier, accredited Sydney private hospitals.

Upfront Costs

We provide written quotes, so there are no surprises.

Patient Care

We will always make you our top priority. Need to ask a question? Whether its before or after your surgery, we will always be at your beck and call.

Real Reviews

Our patients love us! Feel free to read our reviews online on independent websites, or you can speak to some of our existing patients who will gladly speak about their plastic surgery journey.

Our Promise

We pride our practice in personalised, professional and ethical care. We will treat you, how we would wish to be treated if we were in our patients’ shoes. Your safety and satisfaction is our utmost priority – we only provide sedation or general anaesthesia in accredited facilities and after your procedure you will have direct access to our staff to answer any questions or concerns.

Your First Consultation

At your first consultation, Dr Aggarwal will explain a personalised treatment option for your desired results. A comprehensive medical history and examination is followed by discussion of surgery, examination of before and after photographs and trial of implants in the case of breast augmentation. Please remember that a GP referral is now mandatory for both reconstructive and cosmetic plastic surgery appointments.

Upfront about costs

We will always be upfront about all costs of surgery including surgical, anaesthetic and hospital fees. Our quotes include all follow up care associated with your planned surgery, and there is never pressure to decide quickly.

Customised Options

To help achieve your goals, we will tailor treatment options to what you actually need. We will never recommend surgical or non surgical treatments if its not going to achieve what you want. We will always be honest with what you can realistically achieve, and endeavour to deliver beyond our promise.