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    Application and effect of neuromodulator substances

    The wrinkle injection with the neuromodulator substance is a classic, non-surgical treatment in aesthetic medicine. The active ingredient is used in particular to combat expression lines (dynamic wrinkles) on the face. The neuromodulator substance is a bacterial protein that specifically blocks nerve signals for muscle contraction. Injected in very small quantities with a very thin needle under the skin into the facial muscles, this is minimally weakened and existing wrinkles, e.g. on the forehead, are reduced. So it can help remove wrinkles and regain a visibly fresh look.

    In addition to the treatment of wrinkles, the active ingredient can also be found in other medical fields. A qualified doctor can treat excessive sweating (hyperhidrosis) with the help of neuromodulator substance. The substance has an obstructive effect on the nerve transmission to the sweat glands. In addition, it works effectively in the context of other treatments and therapies: In the event of spasticity as a result of a stroke, it effectively releases blockages in the muscles and thus supports rehabilitation. The same applies to cases of infantile cerebral palsy. In the right amount, the substance has a function as a drug for movement disorders and is used successfully in these diseases.

    What is a neuromodulator substance

    A neuromodulator is a protein produced by the bacterium Clostridium b.. This bacterium produces eight different varieties of the active ingredient (A, B, Cα, Cβ, D, E, F and G). The strongest effect has the drug of group A. The substance has been used since 1980 for muscle relaxation and since 1990 for the treatment of wrinkles. Since 1996 it has also been used to treat sweaty hands. The well-known active ingredient was first approved by the US Food and Drug Administration (FDA) in 2002 for the treatment of frown lines and forehead wrinkles. Since 2013, it has also been used for the treatment of eye wrinkles, also known as crow’s feet. Currently, there are three FDA-approved products containing the Variant A ingredient for wrinkle treatment. Nowadays it is used on the face to smooth wrinkles and also for eyebrow lifting (aesthetic lifting of the eyebrow).

    How does the neuromodulator substance work?

    In very low concentrations, the neuromodulator injection inhibits the signal transmission from the nerves to the respective muscles and thus relaxes the muscle. The visible wrinkles on the skin are reduced and the complexion becomes smoother. The signal is transmitted by the messenger substance acetylcholine. This is stored in small vesicles within the nerve switch points. When a nerve impulse reaches the muscles, the messenger substance acetylcholine is released from the vesicles, like an air bubble that comes to the surface of the water. On the inner surface of the nerves, the neuromodulator substance prevents the vesicles from rising to the surface. They get stuck below the surface of the water, so to speak. After a certain time, the nerve cells regenerate the protein that is required to open the vesicles (synaptosomal protein weighing 25 kilodaltons, SNAP-25 for short). Therefore, the effect of the neuromodulator gradually decreases. It unfolds in a certain radius around the injection point of the treatment. The size of the treated areas is determined by the product properties of the neuromodulator substance, the dose administered and the volume, as well as the technique of wrinkle injection. At a diameter of about one centimeter around the injection site, the muscles relax and the sweat gland production decreases.

    How long does treatment with a neuromodulator last?

    The result of the method begins to unfold on the face just two days after use. Ninety percent of the patients show a clear result of the wrinkle treatment on the skin on the seventh day. The desired, natural result can be expected from the fourteenth day. When and to what extent the result unfolds depends, among other things, on the product, the dosage and the injection technique used to smooth out the wrinkles. Of course, it also plays a role whether the wrinkles are particularly deep (e.g. pronounced frown lines / deep frown lines on the forehead). The effect lasts for an average of four months. In a third of the patients, a satisfactory effect can still be demonstrated five months after the wrinkle treatment procedure. The general indication is: A repetition of this minimally invasive wrinkle treatment makes sense after three months at the earliest. After multiple wrinkle injections as part of a continuous anti-aging therapy of aesthetic medicine, the duration of the action can be extended and the skin and its wrinkles are smoothed for longer, as the cross-section of the relaxed muscles is reduced.

    What does a wrinkle smoothing with the neuromodulator cost?

    An exact cost calculation is made individually, at the consultation appointment with the doctor. If you would like to get an overview of the price range in advance, please take a look at our cost page.

    For which treatments with the neuromodulator substance are the costs covered by the health insurance?

    Your health insurance will only cover the costs of medically necessary treatments. If you would like to find out more about this, please visit our page on the health insurance companies’ obligation to pay benefits.

    What is considered a unit of the most common neuromodulator?

    One unit of a neuromodulator substance is one quantity. The unit of this agent was defined in laboratory tests and is abbreviated as “E”. Since the test conditions were not specified down to the smallest detail, the units differ from one manufacturer to another. These units are specific to each product and are not interchangeable.

    Can I get immune to wrinkle treatments with neuromodulators?

    This is a common question. The organism can develop different antibodies. However, only neutralizing antibodies can lead to a loss of effectiveness and a reduced result. Neutralizing antibodies only develop in very rare cases. The risk of this is very low indeed. Very few cases have been described in the world literature in which patients have developed neutralizing anti-bodies after aesthetic treatment. If, for example, small wrinkles next to the eyes, so-called crow’s feet, are treated with a neuromodulator substance injection, very small amounts are required. In addition, it is only necessary to repeat the wrinkle injection with the active ingredient after a long time.

    Some patients do not respond well to neuromodulator substance treatment. Occasionally, undesirable side effects occur in the first week after the injection, but they do not last long and can be mild to moderate. The cause of an allergic reaction can be insufficient dosage, improper storage or preparation, or incorrect injection technique. However, allergic reactions are very rare. Normally only a slight swelling occurs after the procedure.

    What should I watch out for after a wrinkle injection with a neuromodulator?

    In any case, it is recommended that neuromodulator substance therapy only be carried out by an experienced doctor. The treatment is carried out on an outpatient basis. No inpatient stay in a clinic is necessary. Choose a specialist in aesthetic and plastic surgery, because they don’t just know about cosmetic surgery. With him you are in the best of hands for a wrinkle injection, as he has extensive experience. The attending physician analyzes the initial situation in detail. He explains in detail which different types of folds exist (static folds, dynamic folds, etc.) and recommends the most suitable method for you. Of course, you will also receive information about alternative methods, such as the use of fillers for wrinkle injection on the face (e.g. hyaluronic acid or autologous fat). The specialist with many years of experience will explain the process, as well as any pain, possible risks, side effects and complications that can occasionally occur when injecting the type A neuromodulator. Of course, he also answers any further questions about wrinkle treatment.

    What should be considered after a wrinkle injection with a neuromodulator?

    How you should behave after the procedure so that a good result is achieved and you prevent swelling, you will find out in the consultation with the doctor. The treating specialist will take this opportunity to point out appropriate precautionary measures.

    Before and after pictures of a wrinkle injection with neuromodulators

    Patients naturally want to be able to imagine how their appearance can be improved aesthetically before treatment. People often mistakenly believe in the myth that neuromodulator substances freeze facial expressions. Ask your treating doctor of cosmetic surgery for pictures of treatment results (without make-up) to convince yourself of the specialist’s abilities. Such images may not be published online, but during a face-to-face consultation, the doctor may present recorded images of results, provided that the patients have given their consent for this. The selection of the images by the physician is subject to certain criteria, since the initial situation of the patient as well as the desired result must be comparable. You can learn more about this topic on our before and after pictures page.

    Experience reports on wrinkle injection with a neuromodulator

    The above image presents the testimonial of a patient who received a neuromodulator treatment at Centerplast. You can find more reviews from our experienced specialists and testimonials on a wide range of treatments on our testimonials page.

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    The author

    Dr. Adelana Santos Stahl

    “Our goal is to provide the best, most discreet and precise treatment based on our extensive expertise in plastic surgery. „

    Dr. Adelana Santos Stahl is distinguished by a unique international perspective with a feminine view of plastic surgery. Her personalized and detailed approach is key to the beautiful and natural results she achieves. Having trained in Brazil, one of the largest and most well-known countries for aesthetic and reconstructive plastic surgery, she understands her patients’ desire to look and feel their best.She completed her medical studies and her training as a specialist for plastic and aesthetic surgery in Brazil. In 2009, she also successfully passed the German equivalence examinations for the medical state examination. Two years later, in 2011 she received the German and in 2012 the EU specialist recognition (EBOPRAS) for plastic surgery.From 2009 to 2013, she deepened her knowledge of aesthetic and reconstructive facial surgery with world-renowned representatives of plastic surgery such as Professor Gubisch at the Marienhospital and Madame Firmin in Paris.A VDÄPC Fellowship (continuing fellowship for graduate students) in Switzerland, France and the USA has further enriched her professional experience.Dr. Santos Stahl is active in several prestigious professional societies. Besides the DGPRÄC and DGBT, she is also a member of the Brazilian Society of Plastic Surgery – SBCP.She is also the author of several scientific articles and, together with her husband, is dedicated to research and clinical studies in the field of plastic surgery.

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