Can You Be Too Old for Neurotoxin Injections?

Most of the dialog surrounding neurotoxins and age revolve across the youthful finish of the spectrum and prejuvenation: Questions like “How young is too young?” and “If I start young, will I look better when I’m older?” flood docs’ places of work and Google searches. But there’s a complete different group of sufferers—these ages 70 and up—who profit from a little bit of muscle freezing, if you’ll, and this explicit dialog focuses on them.

“I do think older people get concerned thinking they’re past an age where they can do anything, or they have to have surgery at this point, but there is a lot we can do that is nonsurgical and still get good results,” says Campbell, CA dermatologist Amelia Okay. Hausauer, MD. “We often end up skewing toward talking more about millennials and younger people, but there’s a whole other end of the spectrum. We don’t end up talking about some of the older patients and what they may or may not be good candidates for.” Here, we’re.

Is there a really useful “age limit” for neurotoxins?

Dover, OH facial plastic surgeon David Hartman, MD says neurotoxins “work” on older individuals by the identical mechanism that they work on youthful individuals: by reducing the contraction of the underlying facial muscle tissue, which result in the “bunching” of the overlying pores and skin. “‘Dynamic lines’ from bunching skin comprise the majority of lines found on a younger person’s face,” he explains. “By contrast, ‘static lines’—primarily caused by decades of sun exposure—are far more prevalent in an aging face.  Static lines are wrinkles that are present all the time, not just when underlying muscles are contracting. Neurotoxins only work on dynamic lines. Because many of the lines on an aging face are static lines (wrinkles), neurotoxins are not as effective at smoothing an aging face overall. However, in the appropriate aging face, neurotoxins can still be highly effective.”

Dr. Hausauer agrees, saying neurotoxins work for any age group once they’re finished appropriately and with respect to the affected person’s anatomy. “The difference with age is that as we get older, our muscle strength changes and the way the muscles balance one another may change, which a board-certified doctor will be aware of when using neurotoxins. I had a patient who came in last month and she said she didn’t like the lines between her eyebrows and she wanted a little lift here and there, but she wasn’t interested in surgery and didn’t think she was a candidate. I told her there were plenty of nonsurgical things we could do, and she looked great. Then I looked at her chart and she was in her 90s!”

Do neurotoxins final simply as lengthy in sufferers ages 75 and up as they do in youthful sufferers?

“Neurotoxins disable the thousands of microscopic nerve endings (neuromuscular endplates), which trigger muscle contraction,” says Dr. Hartman. “The duration of the effect of neurotoxins depends on how long it takes a person to regenerate new ‘neuromuscular endplates.’ Endplates disabled by neurotoxin injections take three to five months to re-sprout and become active again. Arguably, neurotoxins last longer in seniors simply because seniors ‘regenerate’ nerve endings somewhat slower than younger people do.”

However, this isn’t at all times the case throughout the board. Dr. Hausauer says the explanation some older sufferers are in a position to go longer between dosing is as a result of they’ve been getting neurotoxin injections for a very long time, and consequently, they’ve sort of retrained their muscle tissue, so that they don’t make those self same expressions. “Sometimes as you get older and you’ve done the procedure for longer and longer, you can get a bit of an extended duration out of your treatment. But I don’t think age in and of itself makes you metabolize the neurotoxin faster,” she explains.

Do older age teams want extra items of neurotoxin to realize the identical consequence as youthful sufferers?

Contrary to what we might imagine, the docs agree older sufferers typically really need fewer items. “Sometimes as we get older, our muscles become thinner and weaker, and in fact we may need a little bit of a lower dose in those muscles,” says Dr. Hausauer. “The one place I think the dosage definitely goes down as people age is the forehead. They become more reliant on their forehead muscle to hold up their eyebrows, so especially as they lose volume on the orbital rim (the bone above the eye) and actually in the forehead itself, they become very dependent on the muscle to hold their eyebrows up. We may sacrifice some lines here, but if I put too much in there, your eyebrows are going to be sitting on your eyelids and you’re going to be really unhappy with me.”

However, sufferers at these ages might also need to deal with extra areas, so the general quantity used might go up. “We may end up treating their glabella, their crow’s-feet and some off-label areas to try to counteract any areas where muscles are depressors, meaning they pull down,” Dr. Hausauer provides.

How typically are docs administering neurotoxin injections on sufferers ages 75 and up?

Dr. Hausauer does them regularly—she has a large age vary of sufferers, from millennials to these of their 70s, 80s and past—and most frequently at the side of fillers. “As we age, because of the loss of collagen and the changes in the fat pads, we’re often restoring volume,” she explains. “And then we’re using neurotoxins to minimize some of the more dynamic areas like around the eyes and between the eyebrows. And neurotoxin also helps with the longevity of the filler: If you can not have the muscle contracting against it continuously, the filler will tend to last longer.”

Another vital level to bear in mind, based on Dr. Hartman: “Aging faces tend to have thinner, more fragile skin, which increases the risk of bleeding and bruising,” he says. “All medication use in aging persons must be done with extra care, as they tend to have more complex medical issues and take more medicines—especially blood thinners—which can complicate neurotoxin injections by causing bruising. However, there are many very healthy older people who live extremely active lives, who benefit greatly from the more rested and more youthful appearance of a face treated with neurotoxins.”

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