Frown lines AKA glabella frown lines are the vertical lines which appear in your forehead when you’re expressing a negative emotion like, anger, frustration, concern or worry. Some people use these muscles when they are concentrating.
How long it takes
Approximate treatment time is 20 minutes.
Return to work
Approximately 1 hour after treatment.
Recovery time
Approximately 24–72 hours after treatment.
How long it lasts
Approximately 3-4 months after treatment.
When a person frowns, they often use a combination of muscles including the corrugator and procerus and orbicularis oculi muscles. Over time, these lines etch in permanently and are there even when the person is not frowning. Often there is a genetic component, which predisposes the person to etch these lines in deeply.
Muscle relaxing injections are the first-line treatment for frown lines, dermal fillers can also be used to enhance the effect.
The first-line treatment for frown lines is anti-wrinkle injections and if the line or fold is present at rest, then dermal filler may be considered.
Small injections using a very fine needle are performed to the frown area into the muscles which cause the frown. Somewhere between 3-7 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:
Is there a genetic component? i.e. are there others in the family who have a strong frown line at an earlier age and how has this progressed?
Has the patient had treatment before and were they happy every time?
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 which are bothering the patient?
Have they ever had any complications, eg eyelid droop or eyebrow droop or strange smile etc?
Does the patient want a more natural frown lines treatment, with some movement left, or do they want the maximum effect possible?
Dr Natasha will examine the face and frown line. In particular, she will look at many features, such as:
Where the lines are.
Whether there is any eyelid droop or asymmetry
Whether the frown line/fold is etched in at rest.
The type of skin, whether there are a lot of large pores near the frown line.
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. Men will require a greater dose than females in general due to larger muscle size.
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 may inject approx 3-7 sites in the area. Then pressure with gauze will be applied. The procedure itself takes less than 5 minutes.
Possible side-effects
In general, treatment of the crow’s feet is very low-risk. Most of the anti-wrinkle injection problems occur from treating other areas of the face. 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 coworkers 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 anti-wrinkle 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.
Post-procedure Advice
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).
