The 2-week review assesses the settled effect of anti-wrinkle treatment, identifies any asymmetry or unintended weakness, and decides whether additional dosing is appropriate. The review is conducted at 14 days because by this point the neuromuscular effect has stabilised and any unintended diffusion has manifested. The review is part of the standard treatment plan and is included in the original treatment fee.
Why 14 Days, Specifically
Anti-wrinkle treatment does not produce its visible effect immediately. The neuromuscular effect develops gradually as the product binds to the nerve terminal and prevents acetylcholine release at the muscle. The full effect typically takes 7 to 14 days to manifest.
Reviewing earlier than 14 days risks assessing an incomplete effect, which can lead to inappropriate dose adjustments. Reviewing significantly later than 14 days delays the opportunity for adjustment if the treatment outcome is not optimal.
The 14-day window is the established clinical convention for anti-wrinkle review. Some areas, particularly the masseter, may take longer to show full effect (up to 4 to 6 weeks for visible muscle reduction), and review timing for these areas is calibrated accordingly. The standard 2-week review applies to the typical upper-face areas: forehead, frown lines, and crow’s feet.
What the Practitioner Assesses
The review involves a structured assessment across several dimensions:
Symmetry: comparing both sides of the face at rest and during animation. The expected pattern is symmetric weakening of the treated muscles. Asymmetry warrants discussion of whether the right side or left side requires top-up dosing.
Depth of effect: assessing whether the treated muscles are appropriately weakened (good clinical effect), insufficiently weakened (under-dose), or over-weakened to the point of producing unintended ptosis or expression flattening.
Unintended diffusion: assessing whether the product has affected adjacent muscles. The most common is brow ptosis from forehead treatment, eyelid heaviness from frown-line treatment, or lateral spread from crow’s feet treatment.
Residual lines: assessing whether static lines (visible at rest, not just during animation) have softened as expected. Residual static lines are normal in older or deeper lines and may require complementary approaches over time.
How to Prepare for Your Review
Useful preparation includes: writing down any specific observations from the past 2 weeks, taking photographs at home in similar lighting before the appointment for comparison, and noting any unexpected sensations such as heaviness, asymmetry, or unusual expression.
It is also helpful to attend the review without makeup on the treated areas, or with makeup that can be removed at the appointment. The clinical assessment is more accurate without cosmetic concealment of the treatment outcome.
If you have specific concerns or questions, write them down. The review is structured but conversational. There is time for discussion. Patients sometimes find that concerns they intended to raise during the appointment do not come to mind in the moment, and a written note ensures all concerns are addressed.
What ‘Optimal Effect’ Looks Like
The clinical goal varies between patients and across treatment areas, but the general pattern of an optimal 2-week effect includes:
The treated muscles show appropriate weakening. The patient can still produce some expression in the area, just at a reduced range. Complete inability to move the muscle is not the goal in most cases.
The surrounding muscles are unaffected. Brow position is preserved or modestly elevated. Eyelid function is unaffected. Smile is not flattened. Speech and chewing are unaffected.
Static lines (visible at rest) have softened, particularly in areas where the patient is younger and the lines are more dynamic than static. Older or deeper static lines may persist and represent collagen-level changes that anti-wrinkle treatment alone does not address.
The overall facial expression looks natural. Friends and family may notice the patient looks well-rested or refreshed without being able to identify what has changed. This is the typical aesthetic goal in conservative practice.
When Top-Up Dosing is Appropriate
Top-up dosing at the 2-week review is appropriate when: the assessed effect is below the clinical target, asymmetry is observed and the difference is clinically significant, or specific small areas show insufficient effect.
Top-ups are generally small, targeted doses to the specific areas requiring adjustment. They are not a ‘second treatment’ in the sense of repeating the original dose. The total cumulative dose at 2 weeks is calibrated to achieve the clinical target with appropriate margin for variation.
Not every patient requires a top-up. Many 2-week reviews confirm the original dose was appropriate and no further treatment is indicated until the standard rebooking interval. The decision is based on the assessment, not on a default expectation that top-ups should occur.
When the Review Reveals Unintended Effects
The review is the structured opportunity to identify and discuss any unintended effect. The most common are:
Brow ptosis: the treated forehead has caused the brow to descend slightly, creating a heavy or sleepy appearance. Time-limited and resolves as the product metabolises. Some patients find prescription eye drops helpful in managing the symptom while it resolves.
Eyelid heaviness: similar mechanism, where frown-line treatment has caused mild diffusion to the levator muscle. Also time-limited.
Asymmetric brow elevation (Spock brow): one side of the brow elevates more than the other due to differential muscle response. Adjustable with a small lateral dose at the review.
Flat smile: from over-treatment of crow’s feet or unintended diffusion to the zygomaticus. Time-limited.
In each case, the review provides assessment, discussion of the time course (typically resolving over 4 to 8 weeks as the product metabolises), and any management options. Most unintended effects are minor and self-resolving.
Why Some Areas Look ‘Frozen’ Initially
In the days immediately following anti-wrinkle treatment, the affected muscles may feel unusually still. Patients sometimes describe the area as feeling tight, frozen, or not their own. This is a normal sensory adjustment to the new neuromuscular state, not an indication of over-treatment.
By the 2-week review, the patient has typically adjusted to the new range of expression and the sensation has settled. The clinical effect is assessed against the visible result rather than the patient’s perception of feeling.
Where the visible result is appropriate but the patient continues to feel uncomfortable with the sensation, the review includes discussion of expectations and whether dose reduction at future appointments would better suit the patient. Anti-wrinkle treatment dosing can be adjusted at each appointment based on the patient’s preference for movement preservation.
Photographs and Documentation
The review typically involves clinical photography to document the settled effect. Photographs are compared with the pre-treatment photographs to confirm the change.
The documentation supports continuity across appointments. At the next treatment, the practitioner can review the previous outcome and decide whether to: repeat the same dose pattern, adjust the dose pattern based on the previous response, or change the technique based on what the previous review revealed.
Photographs are stored in the clinical record. They are used for clinical purposes only. They are not used in marketing because TGA Therapeutic Goods Advertising Code prohibits before-and-after imagery of identifiable patients in cosmetic injectable advertising.
Discussing Rebooking at the Review
The 2-week review is also the appointment at which the rebooking interval is discussed. The standard interval is 12 to 16 weeks for upper-face anti-wrinkle treatment, with variation based on individual metabolism, treatment history, muscle bulk, and patient preference.
The review documents the date of treatment, the dose, the assessed effect, and the recommended rebooking interval. The patient leaves with this information and can book the next appointment accordingly.
For first-time patients, the rebooking interval is often shorter (10 to 12 weeks) because muscle bulk has not yet reduced from consistent treatment. With consistent treatment over 12 to 24 months, the interval typically extends as muscle bulk reduces and the relative duration of effect lengthens. This pattern is documented and tracked.
When the Review Suggests Dose Reduction Next Time
Some reviews reveal that the dose was higher than necessary for the patient’s anatomy or preference. The clinical effect is appropriate, but the patient prefers more movement preservation, or specific muscles were treated when a more targeted approach would be sufficient.
This is documented as a planning note for the next treatment. The next session uses a reduced or more targeted dose. The 2-week review of the next treatment confirms whether the adjustment achieved the patient’s preference.
This iterative refinement across appointments is part of conservative practice. The treatment plan adapts to the patient’s individual response and preference rather than applying a fixed protocol regardless of outcome.
What Happens if You Miss the Review
Missing the 2-week review is not a clinical disaster, but it does mean: any unintended effect is not formally assessed and managed, the documentation of the settled effect is incomplete, and the treatment plan for the next appointment is based on patient self-report rather than clinical assessment.
Where the review is missed, the next treatment appointment serves as a delayed review. The practitioner assesses the current state, asks about the experience of the previous treatment, and adjusts the new dose accordingly. This is workable but less precise than the structured 2-week review.
Where the review is missed and an unintended effect is suspected, the patient should contact the clinic before the standard rebooking interval. Time-limited unintended effects benefit from documentation and discussion even after they have resolved.
How This Operates at Core Aesthetics
The 2-week review is part of the standard treatment plan at Core Aesthetics. The review fee is included in the original treatment, with the structure explained at the consultation that precedes the original treatment.
Reviews are scheduled at the time of treatment, typically at 14 days. Where a longer interval is appropriate (such as masseter treatment), the timing is adjusted accordingly. The review takes 15 to 30 minutes depending on the assessment and any adjustment required.
All reviews are conducted by Corey Anderson, AHPRA registered nurse, who delivered the original treatment. This continuity supports accurate clinical reasoning across the treatment plan.
Is this for you?
Consider booking a consultation if
- Patients who have had anti-wrinkle treatment and want to understand what the 2-week review covers
- First-time patients preparing for their first 2-week review
- Patients considering anti-wrinkle treatment and assessing what review structure to look for in a clinic
- Patients curious about what the practitioner is looking for at this stage of the treatment plan
This may not be for you if
- Anyone under 18 years of age
- Patients who are pregnant or breastfeeding
- Patients seeking specific clinical advice about an individual review concern, this requires individual consultation
- Patients who have not yet had treatment, the consultation guide is more relevant
- Patients seeking guarantees of treatment outcome, results vary between individuals
Suitability is confirmed at consultation. This list is general guidance, not a substitute for clinical assessment.
Frequently asked questions
How long does the 2-week review appointment take?
Typically 15 to 30 minutes, depending on the area treated and any adjustment required. The appointment includes the clinical assessment, photography, discussion of the result, and any small top-up dosing if appropriate. Top-ups, if any, are administered at the same appointment when clinically indicated.
Is the 2-week review charged separately?
No. The review fee is included in the original treatment fee. This is part of the standard treatment plan structure. The fee is explained at the consultation that precedes the original treatment.
What if I cannot attend at exactly 2 weeks?
The review can be scheduled within a window of approximately 12 to 18 days after treatment. Earlier than 12 days risks assessing an incomplete effect. Later than 18 days delays the opportunity for adjustment if the treatment outcome is not optimal. Within the window, the timing is flexible.
Can the review identify problems I have not noticed?
Yes. Subtle asymmetry, mild brow position changes, or specific muscle effects may not be obvious to the patient but can be identified through structured clinical assessment and photographic comparison. This is one of the reasons the review is part of standard practice rather than left to patient self-assessment.
If a top-up is needed, will it cost extra?
Top-up dosing at the 2-week review is included in the original treatment plan when it is calibrating the effect of the recent treatment. Where a top-up represents a new treatment (such as adding a previously untreated area), this is a separate clinical decision and a separate fee structure applies.
What if I want more movement than the current effect allows?
This is a useful conversation at the review. Anti-wrinkle dosing can be adjusted at each appointment to match the patient’s preference for movement preservation. Some patients prefer a softer effect with more expression range. Future appointments can use a reduced or more targeted dose to achieve this. The review documents the preference for the next session.
Will my treatment work for as long if I do not attend the review?
The duration of effect is not directly dependent on attending the review. The duration is determined by the dose, muscle activity, metabolism, and individual response. The review supports the quality of the treatment plan over time but does not affect the duration of any single treatment. Attending the review is recommended for the reasons described above.