Muscle Relaxing Injections is a prescription drug. Under the Medicines (Advertising) Regulations 1994 which implement Title VIII of European Directive 2001/83/EC, regulation 7 prohibits advertisement of prescription only medicine.

Information about Muscle Relaxing Injections is provided to ensure that our patients using or receiving advice on this prescription drug are informed about the drug and possible side-effects.

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First medical uses of Muscle Relaxing Injections

Since 1973 Muscle Relaxing Injections has been used as a treatment for patients with crossed eyes as an alternative to surgery and also as a treatment for muscular disorders of the eyes including squinting and uncontrolled blinking. This is an example of where "natural" products are used for medicinal purposes. For example funghi produce penicillin, cowpox virus protects against smallpox and foxglove plants produce the "poison" digitalis which millions of patients take daily for heart disease.

Now with bioengineering, bacteria produce some of the necessary medicines for treatment of specific diseases.

Pioneered by an ophthalmologist in 1987 to treat muscle disorders, Muscle Relaxing Injections (botulinum toxin type A) was quickly adopted by cosmetic surgeons as a valuable aid to temporarily eliminate wrinkles.

Most frown lines are formed by excessive contraction of muscles in the forehead and Muscle Relaxing Injections acts to place these into hibernation. Tiny amounts are injected into specific facial muscles so only the targeted area will be blocked. Since the offending muscle can no longer be so active the treatment will prevent further damage and more wrinkles, giving a more relaxed and youthful appearance

Muscle Relaxing Injections is a prescription drug and it can only be used under medical supervision by a doctor or dental surgeon using sterile techniques. The procedure is safe, not painful and is quick to perform. The effect is not permanent lasting at least three months.

The dose and injection site can be varied to achieve a more relaxed and youthful face which still has expression. On very rare occasions an eye brow or eye lid may droop slightly. This condition is known as ptosis. The chances of this happening are greatly reduced when careful attention is paid to the dose, injection site and the muscular anatomy of the face. Accuracy and precision play an important part in achieving a natural result without side-effects.

This is the most significant side effect and occurs in less than 1% of all injections. Special eyedrops are available to reduce the drooping in the unlikely event that it occurs.

Other specialist uses of Muscle Relaxing Injections

Neurologists use Muscle Relaxing Injections therapy for spasmodic neck muscles, spasmodic laryngeal muscles, writer's cramp, certain tremors, tics, multiple sclerosis, cerebral palsy, post-stroke states, spinal cord injuries, nerve palsies and speech impediments.

It is also used for congenital muscle disorders or acquired nerve injuries which can be improved by balancing muscles with Muscle Relaxing Injections.

Safety

In cosmetic treatments Muscle Relaxing Injections is used in very small quantities compared to medical uses to give high margins of safety. The aim of the treatment is to break the habit of frowning and reeducate the patient in his or her facial movements so that the muscles "forget" how to frown. This means that the desired result can be achieved with less frequent treatments over time.

FDA Approvals

Cosmetic treatments using Muscle Relaxing Injections received FDA approval:in April 2002

Is Muscle Relaxing Injections safe?
Muscle Relaxing Injections® is recognised as one of the safest cosmetic treatments. Side effects are rarely serious and always temporary.

The most common side effect is bruising. To avoid bruising don’t take aspirin, anti-inflammatory tablets or vitamin E for 48 hours before treatment. Rarely a transient numbness may develop in the treated area. If you are pregnant or breast feeding the treatment is not recommended.

Are there are any potential long term consequences?
The lethal dose of Botulinum toxin is 3,000 units. The average dose for the treatment of the forehead, crows feet and frown lines between the eyebrows is approximately 50 units in total. It has been used in much higher doses to treat muscular disorders for over 10 years. Your body regenerates neuromuscular connections so the muscle activity will return to normal with time.

What does Muscle Relaxing Injections treatment involve?
You will be asked to frown or smile to assess muscle movement. This will determine which site will achieve the best results for you. Several injections are administered and it feels like an insect bite. Some patients feel no discomfort at all.

As patient comfort is a priority at Sherwood Clinic anaesthetic cream is routinely applied to the skin for the recommended time period before any treatment begins.

Topical anaesthetic is not always required but can be applied to make treatment more comfortable.

Where does it work?
• Vertical lines between the brows (frown lines)
• Crow’s feet
• Squint lines
• Horizontal forehead lines
• Lines on the bridge of the nose
• Downturned corners of the mouth
• Chin puckering

When will my treatment start to work?
It usually takes 3-5 days to see the result and in a week it will look even better. To enhance the uptake of your treatment, smile and frown a lot for two hours following treatment, don’t touch or massage the area and remain in a vertical position so it stays where it belongs.

How long does it last for?
Muscle Relaxing Injections lasts up to four months initially but each case is different. A two week reassessment is always good to assess the effect and consider a top up if necessary in certain areas.

Will Muscle Relaxing Injections work for me?
In clinical trials 90% of patients reported improvement in their lines.

What are the alternatives to Muscle Relaxing Injections?
Filling agents such as Restylane may help eliminate deeper expression lines.

Will my lines look worse if I do not continue my treatment?
No, lines will gradually revert to their pre-treatment appearance over a period of months. Continued muscle activity will clearly make them worse over time if treatment is not resumed.

What unexpected benefits can come from Muscle Relaxing Injections® therapy?
Tension headaches and migraine for some patients have disappeared. This occurs in patients using the muscles of the forehead and brow during periods of stress and tension. When muscles are relaxed using Muscle Relaxing Injections the headaches fade.

Finally, would you have Muscle Relaxing Injections treatment yourself?
Yes absolutely! I have had Muscle Relaxing Injections treatment myself for my crows feet, forehead lines and frown lines for a number of years and been very pleased with the results.

Not only do I look and feel younger and more refreshed, I feel calmer. The Muscle Relaxing Injections injections are so minor that I am able to perform them on myself.

• Facial rejuvenation treatments to:
  • smooth frown lines and forehead lines
  • reduce crows feet and squint lines
  • uplift down turned corners of the mouth
  • eliminate "bunny" lines on either side of the nose
  • treat puckering of the chin
• Facial enhancement treatments to:
  • create an enhanced natural lip border
  • produce a lip pout
  • enhance cheek bones
  • create a more pronounced chin
• Facial corrective treatments to:
  • reduce lines around the mouth
  • reduce lines running from base of the nose to corner of mouth
  • reduce scars
  • reduce frown and forehead lines
  • reducte facial wrinkles
• Skin care & beauty treatments:
  • anti-ageing skin care products
  • semi-permanent make up