This is a post on what I have learnt from my time training and treating upper face anti-wrinkle treatments, as well as my personal experience and opinion on what I think generally gives the most aesthetically pleasing results.
Firstly, I need to point out this is purely my opinion from my own experiences, so I am not in any way saying this is the right or only way to do things. It is also a very generalised overall view, and circumstances and aesthetic goals differ from person to person. Although sometimes there is a guideline of treatment steps, everyone is different, and treatments need to be completely customised to suit the individual. Please always remember that cosmetic injections are a medical procedure/treatment and you need to take them very seriously. Education is key, I still have a lot of learning to do and experience to gain so please don't be too harsh of a critic here!
Okay so, after that little spiel- here you go! Please enjoy.
1. Conservative dosing is best.
Overall, I am a big believer in starting an anti-wrinkle treatment with caution, I prefer to take on a very conservative approach. Muscles and movement of the face are dynamic, they are always wanting to move and animate, so perfecting the unit dose of areas treated is the key to getting great results. Over treating an area of the face may cause some displeasing results. An example of this is over treatment of the frontalis muscle (forehead). If this is carried out you risk the patient having zero movement of the forehead, I suppose this is all well and good if the patient wants to have no movement, but keep in mind how their glabella (frown) and orbicularis oculi (crow’s feet) are still being able to move, but their forehead cannot. This means the contraction of the muscles that can still move often end up looking worse or more obvious in comparison to the frozen forehead. Not a good look. Also, the frontalis muscle is an elevator of the face, if it is over treated, you risk dropping the brows or feeling heavy. This is why conservative dosing is best, you can always add more at your two-week review. Which is imperative you attend by the way. If you want perfect aesthetic results, it may take time for your practitioner to get you there. Trying to create symmetry and balance of the face cannot always be done in one treatment. Everyone’s anatomy is different and how your muscle responds to treatment is very different to your best friend.
2. Don’t freeze one muscle of the face without considering treatment of other muscles.
As mentioned above, if you treat the frontalis you risk dropping the brows, to try and avoid a heavy feeling or look I think a combined approach of treating the frown and the forehead gets best results. The glabella (frown) is made up of a few different muscles, which create movements both inferiorly and medially which means they pull down and in, if you relax these muscles with anti-wrinkle then it can help to open the face up. This is good, most of the time. There are circumstances where doing this treatment is not ideal. As an injector it is my personal preference to treat the glabella and the frontalis at the same time. Or treat the glabella first, see how much this reduces the movement and thus see if treating the frontalis is even necessary. Sometimes it isn’t. I think the results are better when done this way. Sprinkle Sprinkle!
3. Brow lifts are fab.
When you treat your upper face, consider treating the lateral brow too, this helps to open up the eye and lift the face. When treating the forehead and glabella, I usually always recommend treating this area too. Treating the frown, forehead and brow areas with a sprinkled dose of anti- wrinkle gives ultimate results for most patients. Usually only a small dose is required.
4. Crow’s feet are not all bad, you don’t always need to get rid of them.
If there’s one area of the face that I think can be left alone, it is the lower region of the crow’s feet. Crow’s feet are associated with smiling, which is a positive animation so in my completely personal opinion I don’t always think treating them is necessary. Once again, reducing them or softening them is great, but completely riding your face of a movement that contributes to your smiling face is not always aesthetically pleasing to me. If you treat the lower crow’s feet too much you risk reducing this muscle too much, in doing so it creates a funny appearance between the cheeks and the eye area, almost like a ledge or a chipmunk look (hard to explain but trust me). I did it to my friend (sorry lil), soften but don’t rid it. If you’re concerned about the creasing or wrinkling of this area when you smile, it might be that you actually have some volume loss, and instead of anti-wrinkle, you could consider filler to help restore volume or bone loss in the area. The results here can be excellent, see below image.
5. Make sure your injector is right for you.
Ensure your injector and you are on the same page, that you understand your treatment and what you are having done. I have learnt some valuable advice from my mentor Associate Professor Graeme Southwick – he taught me to always treat my patients as if they were my family or friends. I give the same advice and treatment education to my patients that I would give to my mum, my dad or my friends. If it doesn’t feel right - I simply won’t do it. I am honest and I don’t like to get caught up in treating people for the sake of it. :) And that’s it for this post! Please remember this is not set in stone, this is just what I think, and my opinion could change in the future as I experience more and learn more. You need to find the injector that is right for you and what your facial goals are. It’s just like art, beauty is in the eye of the beholder and everyone has their own idea and perception of what beauty is.
I hope (at least some) of you found this useful.
Please reach out if you have any questions!
Much love always,