Muscle Relaxants (Anti-Wrinkle)

Currently available muscle relaxant injections are a purified form of bacterial neurotoxin — a natural protein which is extracted from bacterial cultures. In high doses it is a poison. However, in much smaller doses that are injected directly into specific sites, it has both cosmetic and medical applications.

Why use muscle relaxants?

Muscle relaxant injections have been available worldwide for more than 20 years and have been used widely to treat various medical conditions including:

  • Twitching or spasm of the eyelid
  • Muscle spasm in the neck
  • Facial or localised muscle spasms
  • Muscle spasticity due to cerebral palsy and strabismus — a condition where the eyes are not properly aligned.

Muscle relaxant can also be injected into the skin to block the action of nerves that control the sweat glands, especially excessive underarm sweating or hyperhidrosis (the use of muscle relaxant for this condition is currently subsidised by Medicare after appropriate criteria is met). Muscle relaxant injection treatments are also recognised and subsidised by the Australian Pharmaceutical Benefits Scheme for the treatment of a number of medical indications including chronic migraine headaches, urinary incontinence, spasticity and other disorders – these all have specific criteria which needs to be met.

The use of muscle relaxants as a cosmetic treatment was only discovered when people using it to treat facial muscle spasms coincidentally noticed an improvement in their wrinkles.

How muscle relaxants work

Muscle relaxants work by causing temporary muscle paralysis where it is injected. It also blocks the activity of sweat glands. Its major cosmetic applications are for facial expression lines and areas of excessive sweating. The toxin cannot spread throughout your body but is naturally broken down over time. This is why the effect of muscle relaxants is in general limited to three to four months. Regular injections may prolong its effect.

In general terms, anti-wrinkle injections are used to reduce ‘dynamic’ lines (lines that appear as the face moves and not lines that are visible when the face is at rest). The most common application sites are the mid forehead frown lines, horizontal forehead creases and the crow’s feet or smile lines around the eyes. Because treatment with injection targets specific, individual muscles, the ability to form most facial expressions should not be affected.

How we apply muscle relaxants

Injections are given by a series of fine needle injections which sting briefly. Usually four to six injections are required for any one cosmetic site. It is a relatively safe treatment when administered by a medical professional trained in its use. As with all treatments, there are some side effects associated with muscle relaxant injections, although most are mild and temporary.

Common side effects

Common side effects of treatment include temporary soreness and mild bruising. A persistent headache is uncommon. With injection of the mid forehead (glabella) frown lines, a drooping eyelid can result, which usually only lasts a few days. However this specific side effect can be treated with a prescription eye drop.

Advice for use of muscle relaxants

These injections are not given to women who are pregnant or breastfeeding or if the patient suffers from a neuromuscular disorder. Following treatment you are recommended to stay upright for at least one hour and to regularly contract the muscles that have been injected. The effect of the relaxant can take up to one week to kick in, but the average is three to five days.

Medicare claims

Muscle relaxant injections are in general a cosmetic procedure for which there is no Medicare or private health fund reimbursement, GST is also charged as part of the provision for this treatment. The cost of injections is based on the number of units needed to treat any area. As a guide, the number of units needed to treat horizontal forehead lines is between 10 – 20  units through 5 – 8 injections. Glabella (midforehead) frown lines require 16 – 20 units, and crow’s feet 9 – 12 units per side. Please ask your doctor for the exact fee before proceeding.

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