Forehead Wrinkles Treatment

Small injections using a very fine needle are performed to the forehead into the muscles which cause the eyebrows to be raised (frontalis). Somewhere between 6-16 injections will be performed.

Consultation

A £50 no-refundable deposit is required and can be used toward either the face to face consultation OR the treatment on the day.

For this treatment, we must take into consideration the following:

• How large is the forehead? Are their upper eyelids sagging? How have these progressed?
• Has the patient had treatment before and were they happy with the treatment? Were there complications e.g. eyelid droop or eyebrow droop or “spocking”.
• Did the effect of the anti-wrinkle 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 that are bothering the patient?
• Does the patient want a more natural appearance, with some movement left, or do they want the maximum effect possible?

Dr Natasha will examine the face and horizontal forehead lines. In particular, she will look at many features, such as:

• Where the lines are,
• Whether there is any eyelid droop or asymmetry,
• The size and particular height of the forehead compared to the other thirds of the face,
• Whether the horizontal forehead lines are etched in at rest,
• The type of skin, whether there is fine wrinkling or deeper wrinkling
• How is the brow position? Does the patient need a brow lift or an upper blepharoplasty?

Choosing the dose of injection

Dr Natasha 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 maximum 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.

If a patient has a history of eyebrow droop, then a small dose would be recommended.

Pain relief during injections

A numbing cream 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.

What happens during the treatment itself?

The face will be cleaned with alcohol and chlorhexidine. Ice will be applied to the area briefly before treatment Dr Natasha will inject approx 6-16 sites around the forehead above the brows, injecting the muscles which will cause the eyebrows to raise ie the frontalis muscle. Then pressure with gauze will be applied. The procedure itself takes less than 5 minutes.

Possible side-effects

In general, treatment of the horizontal forehead lines is very low-risk. However, headaches can occur in around 10% of new users and bruising occurs in a significant number of cases.

What to expect after the treatment

Due to the nature of this treatment, sometimes the effect is not immediate. Sometimes there can be bruising, redness or small lumps, which can look like mild acne and usually resolves quickly.

Most people could come during their lunch break during work and go back to work without their co-worker’s noticing anything. The effect will not start to occur for 2-8 days. The onset of action of treatment of one of the brands of anti-wrinkle injections is quicker than the others.

The maximum effect of the treatment will be at 4 weeks, so a review should be booked in at 4 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required).

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.

For the majority of patients, typically at 3-4 weeks, there is a maximum 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.

When should I have my next treatment?

Patients should require another treatment when the movement is between 50%-80% back, so, around 3-4 months. Some patients prefer to have the treatment every 8 weeks as they do not like movement.

Post-procedure Don’ts

• Do not smoke for at least 24-36 hours (smoking is not recommended post-procedure).
• Avoid any alcohol consumption for 24 hours before treatment and 24 hours post-procedure.
• Avoid any exercise for 24 hours post-procedure.
• Avoid using any make-up or skincare products/spray tan/direct sunlight, sun exposure and do not use tanning beds.
• Use a facial cleansing wipe to clean face, avoiding the treated area.
• Avoid touching or massaging the injected area, unless absolutely necessary.
• Use Arnica Cream (TM) after your treatment to help with any bruising or discomfort (if required).
• Apply cool compresses to injected sites for five minutes up to four times a day if required.
• Restrict facial movements where possible for up to 1-3 weeks post-procedure.
• Try to keep the head elevated while sleeping for the first 48 hours post-procedure to help prevent swelling.
• Sleep in an upright position, face-up, to help reduce any swelling (3-7 nights post-procedure).
• Avoid any dental appointments, facial appointments and chemical treatments 4 weeks post-procedure.
• Avoid excessive heat – swimming pools, sauna, steam rooms, hot showers for at least 48 hours post-procedure.
• Paracetamol is advised to patients for post-procedure discomfort (Ibuprofen should be avoided).