Background
How a wrinkle treatment actually works
In brief
A wrinkle treatment works on the muscle, not on the skin. The product temporarily blocks the signal from the nerve to the muscle, so that the muscle contracts less forcefully and the line above it softens. The effect starts after three to seven days, is complete after two weeks, and fades gradually over three to four months as the body forms new nerve endings.
Dynamic lines and resting lines
Not every wrinkle is the same. Dynamic lines arise from movement: frowning, raising your eyebrows, laughing. Resting lines are visible even when your face is still; they come from loss of elasticity, sun damage and the way your skin folds after years of the same movement.
A wrinkle treatment works on the first group. If a dynamic line is treated before it has become a resting line, it softens almost completely. If the line has existed at rest for a long time, it becomes softer but does not disappear. We discuss that difference during the consultation, because it determines what you may realistically expect.
What happens inside the muscle
Your nerve passes a signal to the muscle using a substance called acetylcholine. The product we use blocks the release of that substance at the nerve endings in the treated muscle. The signal no longer arrives, so the muscle contracts less forcefully.
Importantly, the muscle is not damaged and not paralysed in the sense of being permanently switched off. In the weeks that follow, the body forms new nerve endings, the connection is restored and muscle strength gradually returns. That is precisely why the effect is temporary.
The timeline of the effect
- Days 1 to 3. You notice little. Sometimes a small bump at the injection site, which settles within an hour.
- Days 3 to 7. The effect begins. Frowning starts to feel heavier to do.
- Week 2. The full result is visible. This is when we check and touch up if needed.
- Months 3 to 4. Muscle strength returns and the line gradually reappears in its old pattern.
Because the effect builds, we never judge it on day three. Anyone disappointed on day three who asks for more runs the risk of ending up with too much. Waiting two weeks is not a delay; it is part of the treatment.
Why the dose differs from person to person
Muscle strength varies considerably between people. A strongly developed frown muscle needs more than a fine one, and men on average have more muscle mass in the forehead than women. Your goal counts too: do you want the line gone entirely, or only softer, keeping your expression?
We would rather start on the low side and top up after two weeks than the other way around. Too little is a matter of topping up; too much is a matter of waiting three months.
Frequently asked questions
Why does it take days before I see anything?
The product has to bind to the nerve endings and the existing store of signalling substance has to run out. That process takes three to seven days. You judge the full result after two weeks.
Will my muscle get weaker if I do this more often?
With repeated treatments, a muscle that goes unused for a long time can become somewhat less bulky. That is usually the desired effect, and it recovers if you stop treating.
Why does the result fade again?
Your body forms new nerve endings, which restores the connection to the muscle. On average that takes three to four months.
Written by Dr Emma van Dijk, doctor at Calla Medical. This article is general information and does not replace personal medical advice; please discuss your own situation during a consultation.
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