The ultimate guide to anti-wrinkle injections

By Dr. Aaron Stanes

Treatment guide

Discover the vital information you MUST know about anti-wrinkle injections with our detailed guide written by expert cosmetic doctors.



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    Anti-wrinkle injections are one of the most popular and commonly performed cosmetic treatments worldwide, and have been so for decades. No matter whether you’ve never had anti-wrinkle injections before, or you’ve been getting treatment for years, you must be informed.

    What are anti-wrinkle injections and how they work

    What are anti-wrinkle injections?

    Anti-wrinkle injections (often referred to as Botox) are a non-invasive cosmetic treatment that improves the appearance of fine lines and wrinkles. They work by relaxing muscles that bunch your skin, reducing skin folding and creasing, and are most commonly used to treat wrinkles on your forehead, along your brow, and around your eyes.

    They are one of the most popular and commonly performed cosmetic treatments worldwide because they are fast, highly effective, consistent, and safe. In addition to softening wrinkles, they also give a refreshed appearance to your eyes.

    How do anti-wrinkle injections work?

    Anti-wrinkle injections work by interrupting the communication signals between nerves and muscles. This results in a controlled and temporary weakening of the injected muscles, reducing skin bunching which improves the appearance of lines and wrinkles. This muscle-relaxing effect is also why anti-wrinkle injections are also used to treat muscle spasms, and headaches caused by hyperactive muscles.

    In more detail, botulinum toxin (the active ingredient in anti-wrinkle injections) prevents the release of a chemical called acetylcholine from the nerve terminal (nerve endings) at the neuromuscular junction (where the nerve meets the muscle). Over time, the botulinum toxin is degraded by natural enzymes known as proteases, and the muscle strength returns.

    Are anti-wrinkle injections the same as dermal filler?

    Anti-wrinkle injections are very different to dermal fillers. Dermal fillers are an injectable gel used to volumise your skin and fatty tissue. We use fillers to restore ageing-related volume loss, reshape facial features, and fill in deep wrinkles and folds.

    Anti-wrinkle injections are an injectable product that reduce nerve signals to the treated muscles. We use anti-wrinkle injections to soften wrinkles by reducing skin bunching.

    It is common to combine anti-wrinkle injections with dermal fillers in non-surgical facial rejuvenation treatments. They can also both be used in the treated of deep wrinkles where anti-wrinkle injections alone are insufficient.

    Are anti-wrinkle injections the same as wrinkle relaxers?

    Yes, anti-wrinkle injections and wrinkle relaxers are different names for the same treatment.

    Are anti-wrinkle injections the same as Brotox?

    Brotox is a marketing term that refers to anti-wrinkle injections for male patients.

    What is the difference between regular botox and baby botox?

    Baby botox is a commercialised name for conservative anti-wrinkle treatment that more focusses on the prevention of wrinkles rather than the treatment of one’s that have already emerged. The key difference between regular and baby botox is the strength or dose (number of units used).

    Safety and duration

    Are anti-wrinkle injections safe?

    While all cosmetic treatments have risks, anti-wrinkle injections are considered to be a safe and effective treatment for fine lines and wrinkles affecting the face. The most common side effects from anti-wrinkle injections include slight skin redness and bruising around the injection sites. Uncommon risks include temporary headaches, while rarely, anti-wrinkle injections can cause a heavy eyebrow or eyelid. Fortunately, most side effects from anti-wrinkle injections are self-limiting, and wear off on their own.

    To minimise the risks of anti-wrinkle injections it is important to go to a dedicated doctor-led cosmetic clinic, and carefully follow all preparation and aftercare instructions.

    Can I get anti-wrinkle injections while using vitamin A products like retinol or Accutane/Roaccutane?

    Yes, you are able to get anti-wrinkle injections when using retinol. You can even get treatment while on Roaccutane. Neither topical or tablet vitamin A medications have any affect on anti-wrinkle injections. Always ensure that you inform your practitioner if you are using retinol or Roaccutane, as they may want to use a gentle skin cleanser to avoid irritation.

    How long do anti-wrinkle injections last?

    The result from anti-wrinkle injections typically lasts 3-4 months for most people. The effect peaks 2 weeks after your treatment, and slowly wears off over the following few months (i.e. you don’t get a full strength result for the entire duration).

    The longevity of your anti-wrinkle injections depends on the amount of product injected, the precision of the injection, the strength of the treated muscles, and how consistently you get treatment.

    How can I make anti-wrinkle injections last longer?

    There are a few ways to make your anti-wrinkle injections last longer.

    The first is to have a higher dose. Increasing the amount of product used will make your results longer lasting.

    Your results will also last longer if the treatment is performed more precisely. This is why it is important to see an experienced medical doctor for anti-wrinkle injections. Many clinics compensate for poor precision by using unnecessarily high doses, which increases the cost.

    Another way to make your anti-wrinkle results last longer is to have treatment regularly. Start by scheduling anti-wrinkle treatment every 3 months, and over time you’ll notice that you can space your appointments out by longer periods of time, often up to 6 months.

    Do wrinkles come back worse after getting anti-wrinkle injections?

    Despite what some people say, your wrinkles will not be worse when the result from your anti-wrinkle injections wears off. In fact, consistent anti-wrinkle injections can slow down the progression of your wrinkles, and slow the development of new ones.

    What is a permanent fix for wrinkles?

    Unfortunately, there aren’t any permanent fixes for lines and wrinkles. The most effective treatment for wrinkles is to prevent them developing, and slow down their progression. This is easy to do but requires consistency.

    To prevent wrinkles you should stay healthy, drink plenty of water, avoid cigarette smoke, use sun protection and high quality skin care, invest in collagen stimulating treatments like micro needling, and get anti-wrinkle injections a few times per year.

    What anti-wrinkle injections last up to 5 years?

    There are no anti-wrinkle injections that last up to 5 years. The results from anti-wrinkle injections typically wear off over 3-4 months, although some people with weaker facial muscles or who have had consistent anti-wrinkle treatments for years find their result last longer.

    Comparisons and alternatives

    What injection is best for wrinkles?

    The best injections for your wrinkles depends on their type, location, and severity.

    Anti-wrinkle injections are most effective for dynamic wrinkles (those seen when making facial expressions) on your forehead, along your brow, and around your eyes. They can also be used to smooth wrinkled chin skin, and treat vertical lip lines (often called smoker lines).

    For deeper wrinkles, static wrinkles (those visible when your face is relaxed), and lines in areas where we can’t use anti-wrinkle injections (like your cheeks), dermal filler injections are more suitable.

    Often, combining anti-wrinkle injections with dermal filler is the best way to treat wrinkles, especially when they are deeper.

    Which is better for wrinkles: anti-wrinkle injections or fillers?

    Whether anti-wrinkle injections or fillers are better for wrinkles depends on their location, severity and type.

    Anti-wrinkle injections are best used for expression lines on the upper part of your face. Dermal fillers are more suitable for deeper lines, those present when your face is relaxed, and for wrinkles affecting the middle and lower part of your face.

    What is a cheaper alternative to anti-wrinkle injections?

    There are no cheaper alternatives to anti-wrinkle injections that are as effective or work in the same way. Treating wrinkles is best done using a multi-modality approach targeting all causes. Only anti-wrinkle injections target the muscles that bunch and wrinkle the skin. Other treatments for wrinkles work closer to the surface to improve skin quality.

    What is safer than anti-wrinkle injections for wrinkles?

    Topical creams are generally considered to be a safer treatment for wrinkles than anti-wrinkle injections. However, they target a different area (the skin’s surface), and often don’t achieve as significant or lasting an improvement.

    Can you get rid of wrinkles without injections?

    When wrinkles are just starting to develop, they are often seen intermittently. This is because the development of wrinkles depends on the quality of your skin. If you are dehydrated, your skin will be drier and thinner, and wrinkles will be more visible. These fine lines can be treated by staying healthy and hydrated, and by investing in high quality skin care.

    Over time, the lines will progress to a point where you will require anti-wrinkle injections to get rid of them.

    Age and suitability

    Is 60 too old for anti-wrinkle injections?

    There is no age considered too old for anti-wrinkle injections. Many people into their 60’s are enjoying the smoother, refreshed skin that comes with anti-wrinkle injections. As you get older, you must be careful treating horizontal forehead lines, as it can result in a heavy brow. By being conservative, and also targeting the wrinkles between your brows and around your eyes, you can look forward to softening your lines and a refreshed appearance.

    Who is not suitable for anti-wrinkle injections?

    Anti-wrinkle injections are not performed in people who are pregnant or breastfeeding, and those under 18 years of age.

    It is also important to consider your expectations and psychological suitability, as well as any nerve or muscle diseases before undergoing anti-wrinkle injections.

    What age should you get anti-wrinkle injections?

    There is no right age to start getting anti-wrinkle injections. Generally speaking, it is always easier to prevent wrinkles by having regular anti-wrinkle treatments and looking after your skin, than treating those that have already emerged. However as a general rule, the right age to start getting anti-wrinkle injections is when it is important to you.

    What’s it like to get anti-wrinkle injections?

    It is normal to feel nervous when you first get anti-wrinkle injections. There’s a few things to expect at your first appointment for anti-wrinkle injections. You will have a detailed consultation about your concerns and expectations. You’ll learning about the risks and benefits of anti-wrinkle injections, what to expect, and the aftercare.

    After your consultation, numbing gel is applied to the skin to reduce discomfort. The treatment generally takes just a few minutes, and it is normal to experience a slight sting during the injection.

    Once the treatment is complete, your skin may appear slightly red for the next 30 minutes.

    Can you get anti-wrinkle injections while pregnant or breastfeeding?

    Unfortunately, you cannot get anti-wrinkle injections while pregnant or breastfeeding. This is because anti-wrinkle injections have not been assessed for safety in pregnant or breastfeeding women, meaning there may be potential risks to you or your baby.

    How many units of anti-wrinkle do I need?

    Anti-wrinkle injections are measured in units. The number of units you need for your treatment depends on a few factors. These include:

    • Whether you’re male or female
    • The strength of the muscles responsible for your wrinkles
    • What kind of result you’d like
    • How long you’d like the effect to last
    • How consistently you’ve been getting anti-wrinkle injections

    Generally speaking, the stronger the muscle or the more pronounced a result you want, the more units you’ll need.

    What should I ask before getting anti-wrinkle injections?

    Before getting anti-wrinkle injections it is always important to ask your injector a few questions to ensure you’re fully informed about your treatment. Some of the most important questions to ask include what the risks are, how to look after the injected areas, and what kind of results you can expect.

    Cost

    How much is an anti-wrinkle injection in Australia?

    The cost of anti-wrinkle injections in Australia can vary significantly depending on the quality of the clinic you choose. The average cost for anti-wrinkle injections is between $5 and $15 per unit (depending on the product). The cost per unit be higher when you have treatment with someone more experienced, as they are more likely to get a better result with a lower risk of side effects. When considering the cost of anti-wrinkle injections you should also consider the following:

    • The strength of a unit is not the same between brands, which is why some ‘per unit’ prices vary significantly. Generally, you’ll need 2.5-3 times more of the lower cost brand to get the same effect as the higher cost per unit brand
    • More experienced professionals can get better results with less product, meaning while the cost per unit may seem more, you may end up paying a similar price
    • You should aim to get a result you’re happy with using the lowest possible dose as this reduces the chance of side effects

    How much should 3 areas of anti-wrinkle injections cost?

    There is no exact cost for 3 areas of anti-wrinkle injections. This is because the dose required to treat three areas of your face can vary significantly depending on the severity of your wrinkles and the type of result you want. Most clinics who advertise a price ‘per area’ have caps on the amount of product that can be injected, meaning you often end up paying far more than you need to.

    What determines the cost of anti-wrinkle injections?

    The cost of anti-wrinkle injections depends on the following factors:

    • The number of units required
    • If you’re having anti-wrinkle injections alone, or combining them with other treatment modalities
    • The location of the clinic you go to
    • The skill and experience of the professional performing your treatment

    Pain & side effects

    How painful are anti-wrinkle injections?

    Anti-wrinkle injections have slight discomfort. They are often described as feeling like a quick pinch or having a slight burning sensation. The discomfort only lasts while the injection is being performed, with each injection taking less than 1 second. After the injection there is generally no discomfort.

    To minimise the discomfort from anti-wrinkle injections, topical numbing gel can be used before the treatment. An ice pack can also be used to reduce sensation in the area just before the injections are performed.

    What hurts worse: anti-wrinkle injections or filler?

    Anti-wrinkle injections are generally more painful than dermal fillers. However, the discomfort from anti-wrinkle injections is very quick because the actual treatment is much faster.

    What are the side effects of anti-wrinkle injections?

    Anti-wrinkle injections have a number of common (but minor) side effects. These include temporary skin redness and bruising. Other risks depend on the area treated, but can include headaches, and heavy eyebrows and eyelids.

    Side effects from anti-wrinkle injections are usually mild, self-limiting, and resolve on their own.

    You can reduce the chance of a side effect by choosing an experienced professional at a dedicated, doctor-led cosmetic clinic, and by carefully following all preparation and aftercare instructions.

    How to treat eyebrow spocking after anti-wrinkle injections?

    Spocking is an unintended side effect from anti-wrinkle injections where the outer part of your eyebrows (the tails) hitch up creating a very angular eyebrow shape. They are named for the resemblance to Dr Spock from Star Trek, and are sometimes also called Mephisto brows.

    Spocked eyebrows result from an inadequate treatment of forehead wrinkles. If you have been adequately treated in the central part of your forehead and under-treated in the outer parts, then these outer muscle fibres can become hyperactive. This causes the outer parts of your brows to elevate, resulting in the typical spock appearance.

    Fortunately, treating eyebrow spocking is very easy. A touch up anti-wrinkle treatment targeting the hyperactive muscle fibres on your outer forehead will resolve the problem, although it will take a few days to work.

    Sometimes spocking can be seen temporarily if the anti-wrinkle treatment works faster in some areas compared to others. In these instances, the spocking will resolve in its own in 2 weeks. Any persistent spocking should be corrected with a touch up.

    Maintenance & aftercare

    How often should you get anti-wrinkle injections?

    Depending on your preferences and the severity of your wrinkles, you can get anti-wrinkle injections up to 4 times per year. Some people find that having treatment 1-2 times per year is sufficient. The frequency that you get treatment is a personal decision, and you should consider your own circumstances when choosing how often to book in for anti-wrinkle injections.

    What happens if you stop anti-wrinkle injections?

    If you stop anti-wrinkle injections, the effects will slowly wear off. You will retain the preventative benefits that you’ve experienced with previous treatments, and your lines won’t come back worse compared to before you had treatment.

    What to avoid after anti-wrinkle injections?

    After having anti-wrinkle injections it’s important to look after the treated areas to optimise healing, and reduce the chance of side effects.

    The most important thing is to avoid applying pressure to the injected areas for up to 6 hours, as this can disperse the product, causing it to affect unintended areas. You should avoid alcohol and intense exercise for 24 hours, as they can worsen swelling and bruising. Always follow the anti-wrinkle aftercare every time you have treatment.

    How do you make anti-wrinkle injections last longer?

    There are 3 ways to make anti-wrinkle injections last longer. The first is to ensure that the injections are done precisely, and this is the responsibility of the medical professional performing your treatment. The second is to have a higher dose of anti-wrinkle product (although this also results in a stronger result and less expression). The third is to be consistent with your anti-wrinkle treatments, having regular maintenance treatments.

    What not to do before anti-wrinkle injections?

    There are a few things to avoid before anti-wrinkle injections. You should avoid alcohol and intense exercise in the 24 hours prior to your anti-wrinkle injections, as this can increase the risk of swelling and bruising. Also ensure your skin is clean and makeup free when you arrive to your appointment.

    What to do after getting anti-wrinkle injections

    After getting anti-wrinkle injections its important to carefully follow all aftercare instructions to minimise the risk of side effects. Gently apply an ice pack to minimise bruising, swelling, and skin redness, and keep your skin clean and makeup free for the rest of the day.

    Can I drink coffee after getting anti-wrinkle injections?

    Yes, you can drink coffee immediately after getting anti-wrinkle injections. There is some weak evidence that caffeine may increase the risk of bruising, but this has not been proven with high quality evidence, and won’t affect your final result.

    Does retinol really work for wrinkles?

    Long-term use of topical retinol cream can improve the appearance of wrinkles. It does this by increasing the rate of skin cell turnover, and stimulating the production of skin collagen. Together, these both make your skin stronger, and less prone to wrinkling.

    Retinol is best used in conjunction with sun protection and anti-wrinkle injections for the best improvement in your wrinkles.

    General information & worth

    Where can anti-wrinkle injections be used?

    Anti-wrinkle injections are most commonly used to soften wrinkles around your eyes, along your forehead, and across your brow.

    The same product used in anti-wrinkle (botulinum toxin) is also used to slim bulky muscles along your jawline, neck and shoulders, and calves.

    We also use anti-wrinkle injections to treat areas on your lower face, like chin dimples. Anti-wrinkle injections also lift your mouth corners by relaxing the muscles that pull them down.

    Can anti-wrinkle injections treat brow lines?

    Anti-wrinkle injections are a highly effective treatment for expression lines along your brow. As these lines become deeper, anti-wrinkle injections alone with not suffice, and you’ll need to consider a combination of treatments, including dermal fillers.

    Are anti-wrinkle injections worth it?

    Whether or not anti-wrinkle injections are worth it depends on your personal circumstances. Consider how severe your wrinkles are, and what developing signs of ageing like wrinkles would mean to you. You should also consider the cost, risks, and potential benefits.

    The far majority of people who get anti-wrinkle injections believe them to be worthwhile. Users of the cosmetic medicine website ‘Realself’ have given anti-wrinkle injections a 96% worth-it rating, making it one of the most popular cosmetic treatments worldwide.

    What’s it like to get anti-wrinkle injections?

    It may surprise you just how easy it is to get anti-wrinkle injections. Here’s an overview of what to expect with your first anti-wrinkle treatment. First, you’ll have a consultation to discuss the concerns you’d like to address with anti-wrinkle injections. A treatment plan will then be designed in line with your treatment goals and expectations. Clinical photos will then be taken as a reference point to track your progress.

    The actual injections take just a few short minutes, with each injection having a slight, but short-lasting pinch. After the injections, you’ll notice small lumps beneath your skin which settle over the following 15 minutes.

    You’ll begin to notice an improvement in your wrinkles after 3-4 days, with the final result being seen 14 days later. The effect then slowly wears off over an average of 12 weeks depending on how much product was injected.

    What do celebrities use instead of anti-wrinkle injections?

    Perhaps unsurprisingly, many celebrities rely on anti-wrinkle injections for their smooth skin. However, they take things further by complementing their anti-wrinkle injections with treatments to support general skin health. These include high quality skin care products, sun protection, and needling.

    Which anti-wrinkle injection lasts the longest?

    All anti-wrinkle injections last approximately the same amount of time. The most important factors that determine how long your result lasts are the dose used, the precision of the injections, and how consistently you’ve had treatment. Higher, more precise doses of anti-wrinkle product will last longer, and people who regularly get anti-wrinkle injections find their results last longer than those who get them sporadically.

    How quickly do anti-wrinkle injections work?

    Anti-wrinkle injections can start working as early as 3 days. The time it takes for anti-wrinkle injections to work is related to the amount injected, and how precise the treatment was.

    What are the common myths about anti-wrinkle injections?

    There are a number of myths surrounding anti-wrinkle injections which have been disproven time and time again.

    Firstly, you’re wrinkles won’t look worse if you stop getting anti-wrinkle injections. In fact, anti-wrinkle injections slow down the development of fine lines and wrinkles.

    Second, not all results leave you looking fake and expressionless. Anti-wrinkle injections can be tailored to your personal preferences. If you’d like to soften wrinkles while retaining movement, this is easy to achieve.

    Lastly, another common myth is that you don’t need to get anti-wrinkle injections until you have wrinkles. This ignores other benefits of anti-wrinkle injections, which include preventing the development of wrinkles, reducing facial sweating, and keeping your makeup smooth.

    Anti-wrinkle injections at Cosmetic Connection

    At Cosmetic Connection, we provide personalised anti-wrinkle injections tailored to your unique concerns, and aligned with your treatment goals and expectations. If you’d like to know more, get in touch with our friendly team, or book a consultation with one of our experience medical professionals today.

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