Superficial lines to the face, usually in the upper face can be approached in a few different ways. The types of lines discussed here are lines of the upper face such as:

• Vertical between the brows
• The horizontal forehead lines
• Crows feet
• Lips lines

A proper assessment is always needed first. Some types of lines are amenable to using dermal fillers. Our preferred semi-permanent filler is Juvederm 2. It is soft and pliant and fills the line leaving a natural appearance and in most cases lumps are easily avoided. More than one treatment is usually needed. This approach work very well in the lip area too. A dental block is needed for lip work.

Another popular approach is to treat the underlying muscle which can be relaxed using a specialized muscle relaxing injection technique. This has the effect of softening the appearance of the overlying wrinkles. This method has been used in cosmetic medicine for over a decade. A natural appearance can be achieved.

Muscle relaxing injections have been used in main stream medicine for two decades in the treatment of muscle spasms in cerebral palsy , migraine, squints, torticollis.

However extreme caution and specialized knowledge is needed.

In the right hand cosmetic treatments using muscle relaxation injections have a high safety profile. However a thorough understanding of anatomy and knowing how to use various approaches is necessary, as each person is different.

This technique is suitable in women and men. Men usually have a requirement for more treatment with muscle injection as the muscle mass is denser. Men also need a more meticulous approach in order to ensure the end result ins natural and does not result in a "high arched brow" which can look oddly false in a male.

Several injections are usually needed. A tiny needle is used and it is usually very well tolerated The most popular area to treat is the vertical line between the brows causing the technique is usually quite swift.

• The skin is clean
• The area is marked out using a soft marker pen
• Ice is applied before hand
• You will be asked to make the expression as each injection goes in. each site needs between 2 -5 injections
• There are small needle marks visible for an hour after
• Small bruises can occur with crows feet treatment
• A variety of injection types are available and we will advise what is best for you.

Onset of action is between 3- 14 days so you must plan for a special occasion .In some it comes on rapidly in other more gradually. Everyone is different.

Usually treatment last for 3-4 months. In the first year it is anticipated 3-4 treatments are needed. Try to keep up the treatment to maintain the effect. Thereafter perhaps 3 or in some individuals only 2 per annum may be needed. With time, and on-going treatment even etched in lines can de-etch on a long term basis as the skin repairs.

• Do not bend down to the floor or lie down for 4 hours. Bend the knees if you drop something;
• No alcohol that night;
• No heavy exercise that night;
• No saunas or facial massages for 2 days;
• Do not massage the area yourself.

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