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Who is injecting what into your face?
Anti-wrinkle treatments include both muscle relaxing injections and filler injections. These work very differently.
To relax the muscle, the product is taken up by the nerve terminal. The nerve is then inhibited from releasing a chemical messenger, acetyl choline. The muscle cannot be stimulated and therefore does not contract. These wrinkles are in response to muscle movement and are known as dynamic wrinkles. An example is the frown lines or small creases around the eyes.
Once a dynamic wrinkle is repeatedly activated it becomes present at all times, even at rest. This is known as a static wrinkle. By injecting a filler product deep to or adjacent to the wrinkle it is filled and smoothed out. An example is the smile lines extending from the base of the nose to the corners of the mouth, naso-labial folds.
Treatments can be combined. The indented and downward sloping corners of the mouth can be filled with filler injections and the muscle that pulls the edges down can be relaxed or paralysed.
Anti-wrinkle treatments are one of the most popular cosmetic procedures performed. They do have a wide safety margin. Because of this safety and the popularity of treatments there is always a risk that the procedures become trivialised. It is important to remember these are medicines and classified as schedule four drugs – the same classification as antibiotics.
The recommendations are that every person receiving these medications should be assessed by a doctor and the medication prescribed. It is then deemed safe for them to be injected. Similar to antibiotics, once assessed and prescribed by a doctor, a registered nurse can administer the medication. Doctors may choose to inject the medications themselves.
Recently there have been increasing reports that this has not been happening. Certain individuals are injecting without doctors assessment or prescription and in premises without doctors. To cover themselves a retrospective paper trail is set-up with prescriptions being issued later or authorization being given by telephone. This is still without a doctors assessment.
Reading the package inserts contained with these products highlights the more severe adverse risks include: allergies, anaphylaxis, heart conduction disorders, seizures, hypersensitivity, tissue loss and even death is listed. This excludes more common adverse results such as bruising, swelling, redness, headaches, fainting, itching, pain, inflammation, nerve damage and tenderness. Some series report up to twenty percent of some degree of adverse outcome. With muscle relaxing injection there is no international standardization of the units measured and used.
A full consent should be explained. The mechanism of action should be understood. Contra-indications, precautions, risks and adverse outcomes should be explained and the likelihood of these occurring highlighted. An examination and assessment by a doctor should be performed before products are injected.
Quick fix, short time treatments performed in inappropriate premises or suburban neighbourhood parties are not conducive to appropriate high standards of medical care. It is unlikely people would allow antibiotics to be administered to themselves in these settings and it should be the same with these products. Remember they are classified as medications.
Please take care and have an appropriate practitioner with relevant training administer these treatments in a safe and optimized fashion. Your care and safety should be paramount to allow you to be satisfied and happy with your outcome. Correctly used, the results can be excellent.