Muscle Relaxant Injections

WHAT YOU NEED TO KNOW ABOUT MUSCLE RELAXANT INJECTIONS

Muscle relaxant injections are becoming increasing popular as more people turn to minimally invasive appearance enhancing technology. The growing popularity of muscle relaxant injections has gone hand in hand with this cosmetic treatment being more widely available.

Unlike the muscles in the rest of the body, the majority of our facial muscles lie just below the surface of the skin. They allow us to make facial expressions, which in turn create the pattern of lines on our faces. Whilst certain lines only appear when we make facial expressions (e.g. laughter lines) and are a sign of our individuality, others do not fade with our expressions and have a negative impact on our appearance (e.g. frown lines or crows’ feet). By relaxing different facial muscles, wrinkles can be minimised, resulting in smoothing of the overlying skin.

The three most common facial areas treated with muscle relaxant injections for wrinkle reduction are the frown lines (vertical wrinkles in the glabella area, between the eyebrows), the “crow’s feet” area in the temple to the side of the eyes (caused by squinting), and the horizontal forehead wrinkles (caused by raising the eyebrows).

WHAT MUSCLE RELAXANT INJECTIONS TREAT:

• Frown lines between the eyebrows
• Forehead lines
• Crow’s feet
• Bunny lines 
• A drooping nose
• Gummy smile (excess show of gum above the teeth on smiling)
• Excessive squareness of the face in association with large muscles at the angle of the jaw
• Upper lip wrinkles
• Downturned mouth
• Poor jaw line definition
• Vertical neck bands

MEDICAL USES FOR MUSCLE RELAXANT INJECTIONS:

• Cervical dystonia– This is when neck muscle contracts/spasms involuntarily. Muscle relaxant injections can block the nerves responsible for the muscle spasms.
• Lazy eye– Muscle relaxant injections can fix the imbalance in muscles responsible for positioning the eye.
• Muscle contractions- Muscle relaxant injections can be used to relax muscles for some neurological conditions, such as cerebral palsy.
• Chronic migraine– The exact way that muscle relaxant injections can relieve migraines is unclear, but it is believed that muscle relaxant injections may reduce the nerves’ ability to send pain signals during a migraine.
• Eye twitching- Muscle relaxant injections may help relieve contracture or twitching of muscles around the eye.

Excessive sweating (Hyperhidrosis)- Hyperhidrosis affects about 1 % of the population. Muscle relaxant injections injections may help to block the nerves that stimulate the sweat glands.

HOW DOES THE PROCEDURE WORK?

Muscle relaxants work by causing temporary muscle paralysis where it is injected. In general terms, muscle relaxant 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). Because treatment with injection targets specific, individual muscles, the ability to form most facial expressions should not be affected.

ADVICE FOR USE OF MUSCLE RELAXANTS

If you are thinking about having muscle relaxant injections, be clear about what you want to achieve. It is important to understand the advantages and disadvantages of cosmetic treatments and be realistic about the results. Patients should realise that muscle relaxant injections does not actually erase lines but instead relaxes them.

Muscle relaxant injections are administered to people from a wide range of ages (around 18-65 years). The candidates for muscle relaxant injections are usually healthy men and women who are concerned about facial lines and wrinkles and are eager to gain a more rested and/or happier appearance.

Muscle relaxant injections are not recommended for people who:

• Have a muscle or nerve-related condition
•  Have a skin infection
•  Are currently pregnant or breastfeeding
•  Want to treat ptosis (drooping eyelids)

It should be used cautiously for:

• People at risk of bleeding, including people with blood clotting disorders, or who are taking blood thinners.
• People with extreme weakness or wasting in muscles e.g. patients with a history of stroke.
•  People with breathing problems

WHAT CAN A PATIENT EXPECT BEFORE AND AFTER THE PROCEDURE?

Pre-treatment:

1. Stop taking medication containing fatty acids such as Aspirin and Cod Liver Oil around 3-7 days before treatment as these medications can increase bruising and bleeding.
2. Alcohol and smoking should be avoided 24 to 48 hours before and after treatment.. These can increase the chances of bruising and swelling.
3. It is recommended to stop using Retin-A (often used to treat acne) 2-3 days before treatment to avoid any increased redness or irritation.
4. Consult with your doctor before stopping any prescribed medication and discuss activities that may not be recommended.

During Treatment:

Muscle relaxant injections are usually an in-clinic, non-surgical procedure, with many patients scheduling the treatments in lunch breaks. The procedure only takes around 10 minutes. The patient is seated/laid in a raised position. The areas being treated are cleaned with a non-alcohol cleanser. Some doctors will also numb the areas using anaesthetic (such as numbing creams).

Small amounts of the muscle relaxant are injected with a fine needle into the desired areas. Some patients, (especially first-time patients) may receive a lower dose. It is common for pressure to be applied after the injection to control bleeding and bruising after the injection. There is usually very little discomfort during the procedure.

Aftercare Advice:

1. Keep head upright; do not lie down or bend over for 4 hours after injection.
2. Do not have any facial treatments or massage to treated areas and neighbouring areas, for 48 hours.
3. Avoid alcohol-based products on the treated areas for 48 hours and exposure to UV and extreme heat i.e. sauna, steam, sun beds, very hot showers, strenuous exercise.
4. Take pain relief such as Paracetamol to reduce any pain/discomfort.
5. Avoid the use of Retin-A or similar products for 48 hours after treatment to avoid increased irritation or redness.

Treatment results are assessed about 1 week following treatment. There may still be some undesired movement, lines or asymmetry that needs to be corrected, so a ‘top- up’ treatment might be necessary to achieve the best possible clinical correction to the treated area(s), based on the musculature of face.

The effects of muscle relaxant injections generally last between four and six months. To achieve long-lasting results, it is recommended that a follow-up treatment is given as soon as the effects begin to wear off (after approximately three or four months). By following this advice, the gap between subsequent treatments can be extended.

It is important to understand that there is no ‘standard dose’ for muscle relaxant injections. A personal prescription for treatment is reached by assessing the face, the size and position of the facial muscles as well as the way the muscles move in relation to one another. This personal prescription will form the basis of the next treatment as adjustments can be made at the next treatment appointment.

A consultation is recommended to have a better understanding on the various treatment options . During this consultation, you will be counselled on treatment benefits and risks and expectations will be explored and discussed before proceeding with any procedure.