How and why do wrinkles form?

Many facial wrinkles occur when we use our muscles to form facial expressions. The wrinkles formed during these expressions are called dynamic wrinkles. For example, when we smile our eye wrinkles become prominent and when we frown the vertical lines between our eyebrows become noticeable.

When we are young our skin springs back to its initial position after facial expression, but as we get older dynamic wrinkles remain on the skin to form static wrinkles; these are the wrinkles and folds that are present at rest. This process occurs because natural substances such as collagen (the major structural protein in the skin), elastin (the protein that causes tissue to stretch) and hyaluronic acid (which gives skin volume) decrease with age. This, together with environmental factors such as exposure to sunlight, smoking and stress all contribute to the creation of wrinkles and folds.

Dr Tavakoli has recently been interviewed by Women's Weekly about the hype over Anti-wrinkle Injections:

1. What are Anti-wrinkle Injections and how does it work?

Anti-wrinkle Injections is a natural, highly purified protein derived in a controlled fashion from bacteria, like other agents such as penicillin are derived from mould.

It is administered in a few tiny injections and can be used to relax specific facial muscles that cause dynamic wrinkles (these are the wrinkles that are formed during facial expression). Once the muscles are relaxed, you cannot contract them and continue to make the undesirable facial expressions. Thus, the lines gradually smooth and new lines are prevented from forming.

2. What are the 'target' areas Anti-wrinkle Injections is used for and what effect does it achieve?

The approved indication states that Anti-wrinkle Injections can be injected between the eyebrows in the frown line (or glabeller lines). There are further studies being conducted to ensure the safety of injecting Anti-wrinkle Injections into other areas of the face.

Anti-wrinkle Injections is a medical product that relaxes wrinkle-causing muscles creating a smoothed and improved appearance. Repeat injections of Anti-wrinkle Injections can prevent the onset and/or deepening of wrinkles as the wrinkle causing muscles are not being used.

3. How long does the effect last for?

The cosmetic effects of Anti-wrinkle Injections are usually noticeable within one week of receiving treatment and the results can last between 3-6 months.

The entire procedure takes up to 15 minutes and you can resume normal activity immediately.

4. Can anything go wrong? (Droopy eyelids etc?)

Temporary side effects that some may experience with Anti-wrinkle Injections can include tenderness and bruising at the site of injection. Less frequent side effects can include headache, temporary eyelid droop and nausea.

Anti-wrinkle Injections is a medical product and the way in which it is developed and the amounts used both therapeutically and cosmetically could not lead to poisoning/botulism.

While Anti-wrinkle Injections is best known as a treatment for facial wrinkles, it is known to countless patients as the medication that enables them to function more normally. It has been safely used in adults and children as young as two years old to treat a broad range of medical conditions such as cerebral palsy, post-stroke related spasticity and cervical dystonia (neck spasms).

Cosmetically Anti-wrinkle Injections is the only product of its type with over 10 years of successful clinical experience in therapeutic conditions with dosing specific to treat frown lines and wrinkles.

5. Who's the ideal candidate for Anti-wrinkle Injections?

As a plastic surgeon I am always finding more usage for Anti-wrinkle Injections in my clinical practice. I am finding that the best candidate is someone in their late 20's to early 50's that is concerned about wrinkle lines in the forehead region and around the eyes (crow's feet). The use of Anti-wrinkle Injections eliminates the frown lines temporarily and prevents long-term formation of permanent wrinkles that do not respond to the use of this product.

Unfortunately Anti-wrinkle Injections cannot treat all problems. Although it is true that the rate of patients undergoing cosmetic brow-lift (temporal lift) has decreased due to the success of Anti-wrinkle Injections, there are patients that will need a surgical procedure in order to lift the droopy eyebrows and eliminate the deeper wrinkle lines. This can now be achieved permanently via small incisions in the scalp and the use of an endoscope for better visualization. Endoscopic Brow Lift is performed under general anaesthetic in an operating theatre by plastic surgeons trained in cosmetic surgery.

6. How do you choose the right practitioner?

Anti-wrinkle Injections is a prescription-only treatment and should only be given by a qualified medical practitioner who knows how to administer Anti-wrinkle Injections correctly. Furthermore, a detailed knowledge of muscular anatomy of the forehead and periorbital regions is imperative for the success of this procedure.

A variety of doctors can administer Anti-wrinkle Injections ranging from plastic surgeons to dermatologist and some general practitioners with special interest in cosmetic medicine.

People should directly ask their injector if he/she has been trained in the Anti-wrinkle Injections technique.

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