Neuromodulators:
eliminate wrinkles and expression lines

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Wrinkle removal
with neuromodulators

Wrinkle removal with neuromodulators
Facial treatment to smooth expression wrinkles while maintaining a natural look

MADRID | ZURICH

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Expression wrinkles are not only a consequence of the passage of time, but the cumulative result of repetitive facial muscle activity.

Every gesture, such as frowning, smiling, or raising the eyebrows, generates creases in the skin. At an early age these disappear at rest, but with time they gradually become fixed, giving rise to visible wrinkles even without movement.

Treatment with neuromodulators can act directly on this mechanism, reducing in a controlled way the muscle contraction responsible for these lines.

In Dr. Richard Fakin's practice, the goal is not to eliminate facial expression, but to balance it. A well-planned treatment should smooth wrinkles without altering the naturalness or mobility of the face

DURATION 15 minutes
DISCHARGE FROM THE CLINIC Same day
RETURN TO WORK Same day

DURATION 15 minutes
DISCHARGE FROM THE CLINIC Same day
RETURN TO WORK Same day

SOCIALLY PRESENTABLE Same day
ANESTHESIA None or numbing cream
FULL RECOVERY Do not rub the area or exercise for 24 hours.

SOCIALLY PRESENTABLE Same day
ANESTHESIA None or numbing cream
FULL RECOVERY Do not rub the area or exercise for 24 hours.

Indications

When to consider wrinkle removal treatment

Neuromodulator treatment is indicated when wrinkles are dynamic component, i.e. when they are caused or accentuated by the repeated contraction of certain facial muscles.

Not all wrinkles are the same. Some depend mainly on movement, while others are related to the loss of volume or the quality of the skin. It is therefore essential to correctly differentiate their origin before considering any treatment. Neuromodulators are particularly effective in:

Horizontal forehead wrinkles, caused by the constant raising of the eyebrows
Frown lines (glabella), associated with the gesture of concentration or tension
Crow's feet, generated by the contraction of the orbicularis oculi muscle during smiling
Neck bands (platysma), in selected cases

In the early stages, treatment can have a preventive effect, preventing dynamic wrinkles from developing into more pronounced permanent wrinkles.

The indication should always be made after a medical assessment that analyses not only visible wrinkles, but also muscle dynamics and overall facial balance.

Techniques used

How neuromodulators work

Neuromodulators act at the neuromuscular level, temporarily blocking the release of acetylcholine, the neurotransmitter responsible for muscle contraction. As a result:

the muscle reduces its activity
the skin stops folding repeatedly
wrinkles are progressively smoothed out

This effect is not immediate, but progressive, allowing for a natural transition in facial expression. It is important to understand that the objective is not to completely paralyse the muscle, but to modulate its intensity, maintaining natural facial expression.

Personalised approach to treatment

Each patient has a different movement pattern. Some people have a more active musculature, others compensate with different muscle groups or have asymmetries in expression. For this reason, the treatment must be adapted to:

the individual anatomy
muscle strength
facial movement patterns
the balance between different areas of the face

Proper planning avoids artificial results such as loss of mobility in the forehead or drooping eyebrows.

The aim is to achieve a more relaxed and rested expression, without the treatment being obvious.

Combined treatments

In many cases, wrinkles do not depend exclusively on muscle movement.

When there is a combination of factors, loss of volume, sagging or deterioration of skin quality, neuromodulator treatment can be complemented with other procedures. Among the most common combinations:

Hyaluronic acid, to restore volume in areas where the wrinkle has a structural component
Biostimulation treatments, that improve skin quality and firmness
Technologies such as lasers, IPL or peelings, which act on the texture and luminosity of the skin.

This combined approach allows for a more comprehensive and balanced approach to facial ageing.

Recovery and results

Evolution after treatment

After application, the patient can return to normal activity immediately. The effect starts to become noticeable 3 to 5 days after the treatment and reaches its full effect after about two weeks. During this time:

the musculature progressively reduces its activity
wrinkles are smoothed out
expression becomes more relaxed

The result is not abrupt, but progressive, which helps to maintain naturalness. The duration of the effect is usually between 4 and 6 months, after which muscle activity gradually recovers.

To maintain the results, maintenance sessions can be tailored to each patient.

Wrinkle removal with neuromodulators:
Frequently Asked Questions

What are neuromodulators?

These are substances that act on the nerve signal that activates the muscle, reducing its contraction and smoothing wrinkles.

How long do the results of neuromodulator treatment last?

The effect is usually maintained for 4 to 6 months, although it may vary depending on the area treated and the characteristics of the patient.

When do you start to see results?

The results begin to show within a few days, reaching their full effect in about two weeks.

Is facial expression lost with the use of neuromodulators?

No, when the treatment is properly planned. The aim is to soften the expression, not to eliminate it.

Can it be combined with hyaluronic acid?

Yes, it is common to combine both treatments to address both the dynamic and structural components of facial ageing.

Dr. Richard Fakin
Internationally recognised plastic surgeon

Dr. Richard Fakin is a Plastic, Reconstructive and Aesthetic Surgeon with extensive experience in gender-affirming procedures. He specialises in breast surgery, facial surgery and advanced body contouring procedures. His practice combines technical precision, aesthetic sensitivity and a deeply personalised approach to every procedure.

At his clinics in Madrid and Zurich, Dr. Fakin leads a highly professional and committed team of specialists who share the same philosophy: to provide medically rigorous care while maintaining a warm, compassionate approach. Each patient receives personalised support, from the first consultation through to postoperative follow-up.

As a boutique plastic surgery clinic, the approach is never standardised. The team takes the time to understand each patient's expectations, carefully assess their anatomy, and develop a surgical plan tailored precisely to their individual case. This personalised structure allows us to maintain the highest standards of quality, confidentiality, and attention to detail in every procedure. Dr. Fakin uses refined surgical techniques that prioritise safety, natural-looking results, and an optimised recovery process. Through meticulous planning and advanced technology, the clinic is able to achieve harmonious results that remain true to each patient’s identity.

Beyond surgical technique, the commitment of Dr. Fakin and his team is reflected in transparent, honest and personalised care, where each patient is treated with dedication and professionalism at every stage of the process.