From Hollywood to suburban cafes, it’s impossible to look around without seeing women and men who’ve had some kind of professional assistance in addressing how they’re ageing. Among the most in-demand, non-surgical cosmetic procedures are injectables (aka freezers and fillers) – products injected under the skin to either reduce the appearance of wrinkles or boost facial volume.
These aren’t for everyone, but 35 per cent of Australian adults were considering non-surgical cosmetic procedures when surveyed last year by the Cosmetic Physicians College of Australasia. The research also found 80 per cent of people who worry about premature ageing believe it’s acceptable to use such treatments. So whether you’re considering injectables, or are simply curious, here’s what you need to know.
The technical term for anti-wrinkle injections is neuromodulators.
“Neuromodulators temporarily stop the function of muscles and help relax the look of dynamic wrinkles that are formed most commonly when frowning, raising your eyebrows and smiling,” explains plastic surgeon Dr Steven Liew.
While neuromodulators are useful for smoothing out dynamic lines, they’re not very good at plumping static lines (the ones that remain even when the muscle isn’t active). “For these types of lines, fillers are better as they are designed to plump up the tissue,” Dr Liew says.
Both can be used on the face, depending on whether you’re trying to fill a line, add volume or freeze movement, however, neuromodulators are more commonly used above the nose.
“As a general rule, most facial wrinkles associated with animation (smiling, laughing, getting angry, being surprised) happen around the nose and eye region, so neuromodulators are better at relaxing the muscle and preventing deeper lines forming there,” reconstructive and plastic surgeon Dr Jack Zoumaras says. “Fillers, meanwhile, are most commonly used in the nasolabial fold (also called laugh lines), lips and jaw region to restore volume to where it once was.”
Experts now say a combination often works best. It’s a misconception that fillers should only be used once neuromodulators stop working.
“For those with fixed, deeper lines, volume can be restored with fillers to make the area look good at rest,” Dr Liew says. “But if those lines happen to be in a place where the muscle is actively moving, we can use a combination of the two.
“Using an anti-wrinkle injection will prevent dynamic lines from deepening further by paralysing the muscle.”
“Plastic surgeons are specialists in facial aesthetics because they operate and see the anatomy of the face daily, ” Dr Zoumaras says. “But a dermatologist or nurse who’s had training and supervision by a plastic surgeon should be the minimum qualification that you seek.”
Always do your research before consenting to any type of cosmetic procedure – and ask to see proof of a practitioner’s qualifications.
“After checking these credentials, I recommend going into the practice and having a good look around yourself,” Dr Liew adds. “If the staff look a bit odd, perhaps a bit frozen in the face, that’s probably a good sign you need to look into going elsewhere for your treatment!”
The cost is worked out on how many units of neuromodulator or filler are injected. The units required are entirely individual and depend on which areas are being treated, and whether you want to soften or eliminate lines.
“The average person will have three syringes for multiple injections around the area we’re targeting – that’s roughly 20 units of [neuromodulator],” Dr Zoumaras says.
This can reflect lesser-known neuromodulator and filler brands being bought by practitioners at a cheaper rate than popular or more established brands. Always ask your practitioner for the brand name and the active ingredient of the products that they intend to use.
“Also, having a nurse or someone who doesn’t have the same expertise as a plastic surgeon administering your injections can alter the price,” Dr Zoumaras says. “But remember, you do get what you pay for.”
“With anti-wrinkle injections, most women will notice an improvement within seven to 14 days,” Dr Liew says. “With fillers, you will see results (extra volume and plumpness) immediately.”
Avoid any skin tightening or ultrasound facial treatments before investing in fillers.
“[Ultrasound facials] can dissolve fillers within a six-week period,” Dr Zoumaras says. “Also, avoid lying face down for the first four hours after treatment and restrict strenuous exercise for 24 hours. These actions can cause the injected product to migrate (elsewhere in the face) and cause an unwanted effect.”
Neuromodulators last, on average, three to four months and fillers start dissolving after six months.
“I tend to inject neuromodulators into the same patient three to four times a year and fillers only once or twice,” Dr Zoumaras says.
He adds, “Skin with excessive wrinkles, sun spots and blemishes will react poorly to fillers and neurotoxins, and may require surgical correction instead.”