Wrinkle treatments

https://www.tga.gov.au/news/media-releases/referring-cosmetic-injectables-advertising

According to the TGA doctors must not even allude to S4 treatments on a website

(1)  Moderate doses

It was apparent to me over 20 years ago that the standard treatment doses recommended by manufacturers and textbook authors were too high in most people, leading to implausible over-frozen outcomes. So we always start with conservatively small doses, then review and add more if required, because, once in, we cannot take the dose back out!

2) Bespoke dosing 

Between different patients optimal dosing can vary 10-fold! And that is to the one location e.g. frown lines. The important thing is to avoid excessive dosing, starting carefully and then up-titrating.

3) Bespoke treatment plan

Faces are all different, obviously. And so is their anatomy. So treatment *plans* have to be designed for each individual face, according to varying muscle distributions and activities. Only knowledgeable, trained and experienced eyes perceive these details.

4) Slightly subcutaneous, and no deeper

I've seen and heard even Professors of Surgery teach that treatment needles need to be injected deep into muscles for optimal effect. This is just plain wrong.

5) Stretch and blanch the skin

This technique reduces discomfort and reduces bruising. Few know it, and few teach it

6) Laughing gas if you need it

Yep. Along with ice &/or EMLA anaesthetic cream. If you need any or all. Most don't.

7)  Fees by dose

We charge *by dose* rather than *by area*. This means those having small doses are not cross-subsidising those wanting big doses. It also implicitly encourages smaller doses for more natural outcomes (think: how much do people eat at "all you can eat for $XX" restaurants? Too much, right?)

8) 25+ years of cosmetic medicine experience, and leadership among cosmetic physicians 

First described by Carruthers and Carruthers in 1992, treatment to treat the frown lines you might get between your eyebrows has been our pleasure since 1998.

These lines arise to the side of your eyes when you smile. They should be treated carefully to reduce the wrinkles while maintaining a natural look. Look up "Duchenne smile" scientific papers to research further.

Horizontal lines across the forehead can be readily reduced with treatment, but if not careful some brow drop might eventuate. We go for the "Goldilocks zone": not too mobile, not too frozen, but just right. Dose, and treatment pattern, must be highly individualised for each patient: more than for any other treated area.

These are the lines on each side of your nose. Patients who have just the frown lines treated will often get exaggerated bunny lines - a "give away" that treatment has occurred. Treating these lines will often help improve a "gummy smile" as well.

The muscle "depressor anguli oris" or "DAO" is responsible for pulling down the corner of your mouth. Treating it can reduce that sad look and improve the marionette lines on either side of your chin.  

People who grind and clench their teeth a lot often get jaw pain/"TMJ" pain, and develop a masculine-looking squareness to the jaw's appearance. Treatment into the masseter muscle can relieve the pain and soften the jawline

Judicious and small doses of treatment around your mouth can help your lips pout and reduce so-called "smoker's lines" (caused by pursing lips moreso than smoking). But doses have to be very careful or you will lose mouth control.

Treatment can have a number of other uses. Treating migraine and treating sweating are two more examples. Explore your options in a consultation.