When it comes to the in-clinic easing of wrinkles, muscle-freezing neurotoxins are the go-to. But what happens when needles aren’t an option? For some clients, injecting the same amount of neurotoxins they had administered ten years ago can now make brows look heavy. For others, a fear of needles may have them seeking alternatives; some simply might not want to head down the injectables path at all.

“Patients that want to avoid neurotoxins are often the ones worried about looking fake or overdone,” shares EV Expert and Skin & Medical Cosmetics founder, Dr Raquel Amado. “They’ve only seen the results of treatments done badly and don’t understand that the dose administered can be tailored to individual needs.” Thankfully, aesthetic doctors have a bigger toolbox of treatments at their disposal that can still provide visible results.

Move the needle

When looking at alternatives, first think about your goal. “If your aim is to limit how much your forehead moves, neurotoxins really are the best option as they target the muscle,” advises EV expert, Dr Nestor Demosthenous, founder of his eponymous Medical & Cosmetic Centre. “However if your goal is to soften or prevent wrinkles on the surface, look at treatments that cause controlled trauma to the skin such as microneedling, so skin then starts to repair itself and look smoother.” Radiofrequency, which uses energy to heat deeper dermal layers and stimulate fresh, plumping collagen, offers the perfect partner. “Until relatively recently you would have had to chose between radiofrequency and microneedling, but these modalities have now been combined,” adds Dr Nestor. “So microneedling causes trauma as a first kick to the skin, then radiofrequency gives skin a second kick for great results.”
 
When the anatomical changes that happen with age are the reason for a needle-free alternative, treatments that aim to give lift are a good option. “There are clients with very heavy brows, lid laxity and who use the frontalis muscles (the large muscle that draws your eyebrows towards the scalp) to maintain an open brow, that may want to avoid neurotoxins,” says EV Expert Dr Anna Hemming, Founder of Thames Skin Clinic. “For these patients, there are amazing treatments that smooth, hydrate, boost and tighten skin. Hyaluronic dermal filler can hydrate and lift the brow a lift or, used on the temples, will open out the eye area. Skin boosters such as Profhilo will also help improve firmness while a laser like CO2 is great for remodelling, resurfacing and tightening.”

Next generation ultrasound treatments that are increasingly effective and more comfortable that before are another in-demand option for tightening and toning skin.

These HIFU, or high intensity focused ultrasound treatments, emit an intense shot of ultrasound energy into the skin, creating tiny micro-injuries that kickstart a healing process that produces collagen and elastin production. The layer within the skin that HIFU targets tends to be the one that thickens and then tightens to give a lift. Treatments such as Sofwave can have significant results in just one session with minimal downtime.

EmFace, is another new non-invasive treatment that combines the firming heat of radiofrequency with microcurrent stimulation across the forehead and along each cheek to increase tone in resting muscles by making them contract. Think of it as toning exercise for your face in four to six sessions. Dubbed the needle-free facelift and with no downtime, “it creates better support so muscles can naturally hold up and elevate the brows more effectively,” says Dr Nestor.  

Into the toolbox 

While neurotoxins take one to two weeks to fully work, alternative options take time and patience to achieve results. But with multiple options on offer, the professional treatment toolbox comes into play. “EmFace, radiofrequency and microneedling alone all help with lines and wrinkles but they work differently and target different anatomical structures,” says Dr Amado. “A combination of these can work best for rejuvenated, natural results without looking like you’ve had any treatment at all.”
So, although not a fast fix, these no-needle alternatives do potentially offer better longevity if you take a smart, 360 approach. “Think about your skincare alongside treatments,” advises Dr Nestor. “If you’re using retinol and sunscreen in tandem with treatments you’re improving the quality and health of your skin too and that means better results for longer.”

DIY ‘notox’ options: at-home alternatives to try 

Sensica Sensilift
Dual action heads combine radiofrequency with a massaging action to maximise the lifting and firming results. The radiofrequency waves heat up different layers within the skin, kick-starting collagen and elastin production, while the massage boosts circulation so these waves can penetrate multiple layers, more deeply, at once.

Foreo Bear 
Microcurrent device to give a ‘natural facelift’ using two spheres that channel energy into skin, improving deep lines and wrinkles in as little as a week. It emits low voltage currents that mirror your body’s natural currents, breaking down cells and allowing them to grow back stronger, smoothing the surface and lifting at a deeper level.

SolaWave Radiant Renewal  Skincare Wand 
Focuses on the collagen-boosting benefits of red light therapy, while delivering gentle Galvanic microcurrent, therapeutic warmth and light massage all in one. Used daily for three minutes, it helps improve pigmentation patches, boosts glow and reduces puffiness as well as encouraging plumper, smoother skin.