Forehead Wrinkles

The most superior treatment for horizontal forehead lines is muscle relaxing injections. Small injections using a very fine needle are performed to the forehead into the muscles which causes the eyebrows to be raised (frontalis).

Injectors have to be skilled in this area, as this area has the highest risk for brow droop. There are some patients who will be unsuitable for horizontal forehead line treatments e.g. those who really need a blepharoplasty (upper eyelid surgery), with excessive upper eyelid skin hanging down over their eyes. If the horizontal forehead lines are treated in these people, any minor droop in their lids is going to be a problem.

Sometimes asymmetry or “spocking” will occur because one side just comes on quicker than the other. Usually it will right itself by the time of the review appointment. Treating asymmetry or spocking too early could lead to droop or further asymmetry. It is best to wait for 4 weeks for a review appointment.

As the forehead makes up a substantial part of the face, treatments for lines and wrinkles placed to smooth this area can make a dramatic difference to the overall facial aesthetic.

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.

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.

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.