Lines and Wrinkles Treatment in Singapore with Botox, Fillers, Collagen Stimulators, HIFU and EMFACE

Written by Dr Gerard Ee, MBBS (UK), MRCS (Edinburgh), Postgraduate Diploma in Practical Dermatology (Cardiff), sole author. Founder and Medical Director, The Clifford Clinic and The Clifford Surgery, Singapore. Last medically reviewed and updated September 2026.

“Wrinkles” is one word for three different problems, and disappointment with wrinkle treatment in Singapore usually follows from matching the tool to the wrong one of them. Lines that appear only on frowning or smiling are produced by muscle. Creases visible at rest arise from dermal collagen loss and from volume that has shifted. Folds and jowls arise from skin and deeper tissue that has descended. Each has its own treatment, and most faces over forty need two of the three. This page sets out how I decide.

Expression lines, static wrinkles and sagging skin, three problems and three tools

What is visible	What causes it	First-line treatment	Support
Forehead lines, frown lines, crow’s feet that appear with expression	Repeated muscle movement	Botulinum toxin (Botox)	Skin boosters for the fine crepe above them
Lines still there at rest. Crepey, thin, dull skin. Fine lines under the eyes	Collagen loss in the dermis	Skin boosters (PDLLA skin booster, Rejuran, hybrid HA), or superficial PLLA	Fraxel or gentle HIFU
Deep creases such as nasolabial folds, marionette lines, plus flattened cheeks and temples	Volume loss and descent	Collagen stimulators (PLLA, Loviselle) or fillers (HA, PCL)	HIFU first if the face has dropped
Loose skin, jowls, a softened jawline	Skin and deeper tissue laxity	HIFU (Tightan 2 deep, Sygmalift gentle), Thermage or EMFACE	Collagen stimulator after the lift

Forehead lines, frown lines and crow’s feet treated with Botox

Lines made by muscle need the muscle relaxed, not filled. A small, precise dose of botulinum toxin placed in the frown muscles, across the forehead or at the outer corner of the eyes softens the movement that folds the skin, and the line fades over two weeks. The objective is not immobility. A careful plan softens excessive movement while preserving natural expression. Asian faces generally require lower doses and fewer points than the Western dosing charts suggest. Published Asian consensus dosing is as low as 8 units over three points for the frown lines and 7 units a side for crow’s feet. Placement above the brow is critical in the twenties and thirties, when a strong frontalis will drop the brow if it is over-treated. Results last three to four months. Details, areas and prices are on the Botox page.

Static wrinkles and crepey skin treated with skin boosters and superficial collagen stimulation

A line that persists with the face at rest indicates that the dermis itself has thinned. Hyaluronic acid skin boosters, polynucleotide (Rejuran) and poly-D,L-lactic acid boosters (PDLLA skin booster) hydrate and thicken the dermis over a course of about three sessions a month apart. The collagen-stimulating boosters produce the more durable change, because the new collagen persists after the injected material has resorbed. For fine lines beneath the eyes I compare the options in under-eye skin boosters compared. For surface texture and fine lines across the cheeks, the Fraxel 1550 nm laser resurfaces gently over three to five sessions.

Deep creases and flattened cheeks treated with fillers and collagen stimulators

Nasolabial folds and marionette lines are usually a cheek problem, not a fold problem. The cheek has deflated and the overlying skin has descended into the fold. Filling the fold alone can flatten the face. Restoring the cheek with a collagen stimulator such as PLLA or Loviselle, or with a filler that gives shape on the day such as PCL or hyaluronic acid, lifts the fold from above. A small amount of hyaluronic acid filler in the fold itself completes the correction. My collagen biostimulator guide explains which product suits which face. Neither poly-L-lactic acid nor polycaprolactone is placed in the lips, the thin skin under the eyes, the glabella or the nose.

Loose skin and jowls treated with HIFU, Thermage and EMFACE

When the face has dropped, no injectable can be expected to lift it convincingly, and adding volume to a descended face tends to make it heavier. Deep HIFU with Tightan 2 lifts the brow, cheek and jawline in one session a year, whereas gentle fractional HIFU with Sygmalift firms and smooths over a course of five and suits the eye area, including crow’s feet. In a split-face trial, microfocused ultrasound and monopolar radiofrequency improved facial and upper-neck laxity to a comparable degree at six months, so the choice is made on the depth of tissue to be treated rather than on a claimed superiority. Thermage tightens the skin layer, EMFACE tones the muscle layer beneath, and I maintain my own face with yearly Thermage FLX and HIFU. The lift is done first, with volume rebuilt two to four weeks later if it is still required. The HIFU guide compares the machines and prices.

Wrinkle treatment by decade

• Twenties: sunscreen, retinoid, a skin booster course, with low-dose Botox only when expression lines are already forming.
• Thirties: Botox for frown and crow’s feet, a skin booster course, gentle HIFU for early laxity around the eyes.
• Forties: Botox, a collagen stimulator for the cheeks and temples over two to three sessions, deep HIFU once a year.
• Fifties and beyond: HIFU or Thermage first, then collagen stimulator or filler, then Botox for the lines that remain. Surgery is discussed honestly where the descent is beyond what devices can lift.

The decade-by-decade version, with the treatments I would not do at each age, is in tweakments by decade.

Wrinkle treatment cost in Singapore

Treatment	Price at this clinic (before GST)	How often
Botox, facial lines	S$16 a unit (frown lines, forehead, crow’s feet), and S$10 a unit for masseter, trapezius and underarms	Every 3 to 4 months
Skin booster course (PDLLA skin booster combination)	S$1,500	3 sessions a month apart, then maintenance yearly
Collagen stimulator	PLLA S$1,800 a vial, Loviselle S$2,000 a vial	2 to 3 sessions 4 to 8 weeks apart, then maintenance every 12 to 18 months
PCL filler	S$1,400 a syringe	Single session, lasting about two years
Hyaluronic acid filler (cheek, chin, nasolabial, temple)	S$800 a syringe, under eye S$1,200	Every 9 to 18 months
Deep HIFU, Tightan 2	S$3,500 full face, neck, under the chin and eyes	Once a year
Gentle HIFU, Sygmalift	S$1,200 a session, or S$4,500 for five	Course of five, then a top-up every six months
Fraxel Dual	From S$1,000 a session	3 to 5 sessions

Wrinkle treatment FAQ

Which is the best treatment for wrinkles?

The effective treatment is the one matched to the cause. Botox addresses lines made by movement, collagen stimulation or filler addresses creases at rest and lost volume, and HIFU or Thermage addresses loose skin. A face in its forties usually requires two of these rather than one applied more aggressively.

How much does wrinkle treatment cost in Singapore?

Costs run from under S$200 for Botox in one small area to S$3,500 for a full-face deep HIFU. A realistic yearly plan for a face in its forties at this clinic is a Botox visit every three to four months, one collagen stimulator course, and one HIFU session.

Can wrinkles be removed permanently?

No treatment stops the face from ageing. Botox wears off in months, collagen stimulators last one to two years, HIFU about a year. What changes permanently is the trajectory. Skin that is maintained ages more slowly than skin that is not.

Does Botox or filler work better for forehead lines?

Botox is the better tool. Forehead lines are made by the muscle that lifts the brows. Filler placed in a mobile forehead can look lumpy and can occlude a vessel. Filler has a role only for a deep static line that remains after the muscle is relaxed, and even then a skin booster is usually the safer choice.

What is the best anti-wrinkle procedure without needles?

HIFU lifts, Thermage tightens, EMFACE tones the muscle layer and Fraxel improves texture. None of them treats an expression line as well as Botox does.

At what age should I start?

Treatment is worth starting when a line is visible at rest, not before. Prevention in the twenties is sunscreen, a retinoid and sleep, and injectables are introduced once a line has begun to persist.

Published evidence on wrinkle treatment

Show the 9 references

1. Carruthers JA, Lowe NJ, Menter MA, Gibson J, Nordquist M, Mordaunt J et al. A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol. 2002;46(6):840-9. doi:10.1067/mjd.2002.121356. PMID 12063480. OnabotulinumtoxinA 20 U into 5 glabellar sites reduced glabellar line severity significantly more than placebo at every visit to day 120 (P<0.022), with mild blepharoptosis in 5.4%.
2. Carruthers A, Bruce S, de Coninck A, Connolly S, Cox SE, Davis PG et al. Efficacy and safety of onabotulinumtoxinA for the treatment of crows feet lines: a multicenter, randomized, controlled trial. Dermatol Surg. 2014;40(11):1181-90. doi:10.1097/DSS.0000000000000128. PMID 25347451. OnabotulinumtoxinA 24 U for crow’s feet achieved investigator-rated none/mild at maximum smile in 66.7% versus 6.7% with placebo at day 30 (P<0.001).
3. Ahn BK, Kim YS, Kim HJ, Rho NK, Kim HS. Consensus recommendations on the aesthetic usage of botulinum toxin type A in Asians. Dermatol Surg. 2013;39(12):1843-60. doi:10.1111/dsu.12317. PMID 24118218. The Asian consensus recommends lower doses than Western protocols, e.g. 8 U total over three points for glabellar lines, 7 U per side for crow’s feet and 1 U per point over nine frontalis points for forehead lines.
4. Zhou SB, Xie Y, Chiang CA, Liu K, Li QF. A Randomized Clinical Trial of Comparing Monophasic Monodensified and Biphasic Nonanimal Stabilized Hyaluronic Acid Dermal Fillers in Treatment of Asian Nasolabial Folds. Dermatol Surg. 2016;42(9):1061-8. doi:10.1097/DSS.0000000000000843. PMID 27560289. In Asian nasolabial folds, monophasic and biphasic hyaluronic acid fillers both maintained correction at 24 weeks, with the monophasic product needing significantly less volume for a similar result (P<0.01).
5. Narins RS, Baumann L, Brandt FS, Fagien S, Glazer S, Lowe NJ et al. A randomized study of the efficacy and safety of injectable poly-L-lactic acid versus human-based collagen implant in the treatment of nasolabial fold wrinkles. J Am Acad Dermatol. 2010;62(3):448-62. doi:10.1016/j.jaad.2009.07.040. PMID 20159311. Injectable poly-L-lactic acid improved nasolabial fold Wrinkle Assessment Scale scores significantly more than collagen from months 3 to 13 (P<0.001), with improvement sustained up to 25 months after the last treatment.
6. Alhaddad M, Wu DC, Bolton J, Wilson MJ, Jones IT, Boen M et al. A Randomized, Split-Face, Evaluator-Blind Clinical Trial Comparing Monopolar Radiofrequency Versus Microfocused Ultrasound With Visualization for Lifting and Tightening of the Face and Upper Neck. Dermatol Surg. 2019;45(1):131-139. doi:10.1097/DSS.0000000000001653. PMID 30531187. Microfocused ultrasound with visualization and monopolar radiofrequency both significantly improved face and upper-neck laxity from day 30 through 180 days, with no significant difference between the two sides in laxity scores, satisfaction or adverse events.
7. Cartier H, Hedén P, Delmar H, Bergentz P, Skoglund C, Edwartz C et al. Repeated Full-Face Aesthetic Combination Treatment With AbobotulinumtoxinA, Hyaluronic Acid Filler, and Skin-Boosting Hyaluronic Acid After Monotherapy With AbobotulinumtoxinA or Hyaluronic Acid Filler. Dermatol Surg. 2020;46(4):475-482. doi:10.1097/DSS.0000000000002165. PMID 31592825. Repeated full-face combination treatment with abobotulinumtoxinA, hyaluronic acid filler and skin-booster HA at months 6 and 12 produced considerably greater aesthetic improvement and satisfaction than initial monotherapy, with glabellar response increasing with each treatment.
8. Saffarian Z, Rahimnia A, Ehsani A, Balighi K, Amirhoushang Ehsani, Razavi Z et al. Combined Use of Botulinum Toxin A and Profhilo for Upper Face Rejuvenation: A Randomized Clinical Trial. Health Sci Rep. 2026;9(5):e71973. doi:10.1002/hsr2.71973. PMID 42063688.
9. Neves MLBB, Thome C, da Silva Junior SV, Machado T, Sánchez-Ayala A, Câmara-Souza MB et al. Efficacy and Durability of the Association of Botox and Skinvive in the Treatment of Moderate/Severe Wrinkles in the Periorbital Region: A Randomized, Controlled, Double-Blind, Split-Face Clinical Study. J Cosmet Dermatol. 2025;24(8):e70403. doi:10.1111/jocd.70403. PMID 40814769.

The clinic offers the treatments described here. No manufacturer funded this page. This page is general education, not medical advice.

Dr Gerard Ee consults and performs this treatment at The Clifford Clinic, 50 Raffles Place, Singapore.