Cosmetic Denervation of Frown Lines, Forehead, and Eye Expression Lines


What is Cosmetic Denervation?

Cosmetic denervation is a ​procedure used to improve the appearance of "worry lines", "crow's feet", and other so-called "dynamic" or aging wrinkles. "Dynamic" wrinkles occur when we smile, laugh, or frown and the delicate muscles underlying the skin contract. In cosmetic denervation, Botox or other neuromodulator is injected into these tiny muscles. Neuromodulators work by weakening these tiny facial muscles. By doing so, the overlying skin will smooth out, whereas untreated facial muscles contract normally, allowing facial expression to be unaffected. Hence, those frown lines between the eyes, forehead creases, and crows feet around the eyes can be softened.

Although cosmetic denervation is a relatively new treatment for wrinkles, botulinum toxin injections were FDA approved in 1989 and have been used safely and effectively for over a decade for many neurologic disorders. No irreversible clinical effects have been reported. Today the use of Botox, Dysport, and Xeomin has emerged as an exciting new treatment for erasing the visible consequences of aging skin.

How is Cosmetic Denervation Performed?

Cosmetic denervation is a safe and simple procedure. A small amount of diluted neuromodulator is injected with a very fine needle into several locations in the muscles of the face. Because the needle is so fine and only a small amount is injected into each site, the pain associated with the injections is usually minimal without any anesthesia. The medicine may sting during the injection and has been compared to the sting of an insect bite, but clears rapidly within minutes. You will be able to drive and engage in your normal daily activities immediately after your injections. A small number of people will have some bruising on the skin at the injection sites, which will fade over several days. Foundation may be applied if this occurs. Otherwise, there will be no visible sign of your treatment.

What are the contradictions to neuromodulators?

1. Persons allergic to human albumin or Botulinum toxin.

2. Pregnant or lactating women.

3. Those with neurological disorders such as myasthenia gravis.

4. Active infection at the injection site.

Are there any side effects?

Mild, temporary bruising may occur. The very slight droopiness of the upper eyelid occurs in about 2% of people who have frown lines injected. About 5% of people who have their foreheads injected immediately above their eyebrows may notice this effect. A much smaller number of people will notice the slight asymmetry of the lower face after injection of crow's feet muscles. These effects are usually not noticed by others and fully recover after 3-5 weeks. To minimize the possibility of such rare side effects, please be sure to follow the post-treatment instructions.

What kind of results may I expect?

If dynamic wrinkles are making you look older and more "serious", cosmetic denervation can smooth these out and give you a more youthful and relaxed appearance. However, this treatment will not improve the more common "static" wrinkles that are unrelated to facial muscle contraction, nor does it improve loose or sagging skin. Results are typically seen within 2 to 10 days of treatment. (Most patients achieve 60% to 90% improvements in wrinkles in 3-14 days). Occasionally, there is a muscle that does not respond, and a "touch-up" may be required in 2 weeks.

How long does the result last?

Initially, most people require repeat injections every 3-4 months to maintain the effect.

What instructions should I follow after treatment?

Do not rub the injection site for at least 4 hours as this may spread the solution to adjacent muscles. Do not lie down for at least 4 hours for the same reason. If you see no improvement after 2 weeks, please call us for a touch-up as some people may require higher doses to obtain the effect desired. Occasionally, someone may not respond to one neuromodulator but will have better results from a different neuromodulator.

How much will it cost?

The cost per treatment area is approximately $280.00. For example, crow's feet would be one treatment area and forehead/brow area is a second treatment area.