Relfydess: A New Era in Wrinkle Relaxing Treatments in 2025

After six years as a cardiac nurse, I thought I understood precision. I'd spent countless shifts at KIMS Hospital where every measurement mattered, where knowing the exact path of coronary vessels could mean the difference between life and death. But here's what I've learned since transitioning to aesthetics: that same anatomical precision, that same respect for evidence-based protocols, that same demand for consistency... it all applies here too. And in 2025, we're witnessing something genuinely exciting in the neuromodulator space: the arrival of Relfydess (RelabotulinumtoxinA), the first ready-to-use liquid botulinum toxin that's challenging everything we thought we knew about wrinkle relaxing treatments.

Let me explain why this matters to you as a patient, and why it's got someone like me, who lives and breathes anatomical precision, genuinely excited about the science.

What makes Relfydess different from traditional botulinum toxins?

I'll be direct with you. Traditional botulinum toxins require reconstitution. That means practitioners receive a freeze-dried powder that must be mixed with saline before injection. Now, in cardiac nursing, we had strict protocols for medication preparation because consistency matters. Variation in mixing technique, dilution ratios, or storage conditions can affect potency and outcomes.

Relfydess changes this completely.

It's the first and only ready-to-use liquid neuromodulator, created using something called PEARL (Precipitation-free Extraction and Activity-preserving Refined Liquid) Technology. This isn't just marketing language. It's a fundamentally different manufacturing approach that produces what researchers describe as a "complex-free" formulation. What does that mean? Traditional botulinum toxins contain complexing proteins that don't contribute to therapeutic effect but can potentially trigger immune responses. Relfydess eliminates these.

From a nursing perspective, this innovation addresses something I've thought about for years: standardization. Every vial comes ready to use. No mixing. No variation in dilution technique between practitioners or even between treatments with the same practitioner. Just consistent, volumetric dosing every single time.

For someone who spent years following cardiac protocols where precision wasn't optional, this appeals to me enormously.

The evidence: What the READY clinical trials actually show

Here's the thing about aesthetic medicine that drew me in after my cardiac days: when it's practiced properly, it's grounded in robust clinical evidence. And Relfydess has some impressive data behind it.

The Phase 3 READY clinical trial program enrolled more than 1,900 participants across four separate studies examining both glabellar lines (those vertical frown lines between your eyebrows) and lateral canthal lines (crow's feet). Let me walk you through what the research actually demonstrated.

Efficacy that speaks to precision

In the READY-1 trial, published in the Aesthetic Surgery Journal, researchers examined 297 adults with moderate to severe glabellar lines. The study used a randomized, double-blind, placebo-controlled design (the gold standard for clinical research) with participants receiving either Relfydess (50 units) or placebo in a 3:1 ratio.

The results? Remarkable.

At one month post-treatment, 82.9% of Relfydess-treated participants achieved at least a 2-grade improvement on both investigator and patient severity scales, compared to 0% in the placebo group. But here's what really caught my attention as someone who values precision: 96.3% of Relfydess participants were rated as having none or mild frown lines at maximum frown after one month, versus just 4.5% with placebo.

Those aren't marginal differences. That's clinically significant improvement that patients can actually see and feel.

Onset that changes patient expectations

In my cardiac days, timing mattered. When you're treating acute coronary syndrome, every minute counts. Aesthetic medicine operates on a different timeline, obviously, but patients still care about when they'll see results. Traditional neuromodulators typically show effects around 3 to 7 days post-treatment.

The READY trials demonstrated something different: 39% of patients reported improvements in glabellar lines from day one, with 34% seeing improvements in crow's feet that quickly.

Let me be clear. This doesn't mean maximum effect at day one. Neuromodulators work by blocking acetylcholine release at the neuromuscular junction, and that process takes time to reach full clinical effect. But early onset matters to patients, and the evidence shows it happens with Relfydess.

Duration that impressed even this protocol-focused nurse

Here's where the data really shines. In Kaplan-Meier analysis (a statistical method that accounts for the timing of outcomes), 75% of patients still showed improvements from baseline at 169 days, essentially the end of the six-month study period.

Think about what that means clinically. Most neuromodulators are positioned as 3 to 4 month treatments. With Relfydess, up to 75% of patients maintained improvements for six months, and almost a quarter of patients sustained none-or-mild frown lines and crow's feet through that entire duration.

Safety profile that meets nursing standards

After years in cardiac care, I take adverse events incredibly seriously. Every medical procedure carries risk. The question is whether those risks are appropriate given the benefits, and whether they're properly managed.

In the READY-1 trial, Relfydess-related treatment-emergent adverse events occurred in just 3.6% of participants and were typically mild. That's reassuring, but let me put it in context: the READY program included more than 1,900 participants across multiple studies. That's substantial safety data, and it demonstrated a favorable profile.

What I tell patients in clinic is this: any injectable treatment carries inherent risks related to the injection process itself. Bruising, swelling, temporary discomfort. These are expected and transient. Serious adverse events with properly administered neuromodulators in appropriate anatomical locations by trained practitioners are rare. The evidence supports that statement, and Relfydess appears to continue that safety profile.

Patient-reported outcomes: What actually matters to the people in my treatment room

Clinical measurements matter, but so does patient experience. The second major publication from the READY trials, also in the Aesthetic Surgery Journal, focused specifically on patient-reported outcomes. This is where we see whether the clinical improvements translate to satisfaction and wellbeing.

Satisfaction that sustained through six months

Using the Facial Lines Treatment Satisfaction Questionnaire (a validated instrument that transforms raw scores for statistical analysis), Relfydess-treated patients scored significantly higher than placebo on both the Appearance Module (≥62.5 versus ≤49.8) and Treatment Satisfaction Module (≥83.0 versus ≤36.8).

But here's what resonates with me professionally: patient satisfaction was maintained through the entire six-month study period. That's not just an initial honeymoon effect. That's sustained improvement that continued to benefit patients.

Natural-looking results that patients valued

One concern I hear constantly in clinic: "Will I still look like myself? Will people know I've had something done?" These questions reflect legitimate anxiety about aesthetic treatments, and they deserve honest answers.

In the READY trials, at least 83.3% of Relfydess-treated patients reported looking natural following treatment. Moreover, at least 75.7% felt confident making facial expressions.

That second statistic particularly matters. Effective neuromodulator treatment shouldn't freeze your face. It should soften dynamic lines while preserving natural movement and expression. The patient-reported data suggests Relfydess achieved that balance.

Psychological wellbeing that extended beyond appearance

Here's something I've learned since transitioning from cardiac nursing: aesthetic treatments aren't about vanity. They're about how we feel in our own skin. Using the FACE-Q Psychological Function Questionnaire (another validated tool), the mean change in wellbeing scores was substantially higher with Relfydess (11.0 to 13.7) compared to placebo (0.6 to 4.5).

Those numbers represent real improvements in how patients felt about themselves. And that matters. Physical health and psychological wellbeing aren't separate domains. They're interconnected aspects of overall health.

What this means for aesthetic practice in 2025

Relfydess received marketing authorization through Europe's decentralized procedure in July 2024, with approvals finalized across 16 countries. It also gained approval from Australia's Therapeutic Goods Administration. The product launched in multiple European markets in early 2025, representing the first neuromodulator to receive initial approval for two indications (frown lines and crow's feet) simultaneously in Europe.

From a nursing perspective, here's what excites me about this development:

Standardization in a field that desperately needs it. The ready-to-use liquid formulation eliminates reconstitution variability. Every treatment uses the same preparation. That consistency matters for outcomes and safety.

Evidence-based innovation. Relfydess isn't just another "me-too" product. The PEARL Technology represents genuinely different manufacturing, and the clinical trial program was substantial. Over 1,900 participants with robust, peer-reviewed publications demonstrating efficacy and safety.

Anatomical precision. The volumetric dosing allows for precise placement. In aesthetic medicine, as in cardiac nursing, millimeters matter. We're working around facial vasculature, targeting specific muscle groups, creating symmetrical results. Precision tools enable precision outcomes.

Patient-centered outcomes. The READY trials didn't just measure investigator assessments. They prioritized patient-reported outcomes, satisfaction scores, psychological wellbeing measures. That's the kind of comprehensive evidence aesthetic medicine needs.

What patients need to know before considering Relfydess

If you're contemplating wrinkle relaxing treatment in 2025, whether with Relfydess or any neuromodulator, here's my maternal nursing guidance:

Choose qualified practitioners with proper anatomical knowledge. This cannot be overstated. Neuromodulators are prescription-only medicines that must be administered by appropriately trained medical professionals. In the UK, that means doctors, dentists, pharmacist prescribers, or nurses working under appropriate prescriber direction. Your practitioner should understand facial anatomy intimately. The vascular supply, the muscle groups, the danger zones. Ask about their training. Ask about their experience. Don't be shy about these questions.

Understand realistic expectations. Relfydess, like all neuromodulators, temporarily improves the appearance of dynamic wrinkles (those formed by muscle movement). It works brilliantly for frown lines, crow's feet, forehead lines. It doesn't address volume loss, skin texture, or static wrinkles that exist even at rest. Knowing what any treatment can and cannot achieve prevents disappointment.

Consider the evidence. The READY trials provide robust data on efficacy and safety through six months. That's valuable information. However, individual responses vary. Your anatomy is unique. Your muscle strength differs from the research participants. Your aesthetic goals are personal. Evidence informs decisions. It doesn't dictate individual outcomes.

Discuss safety comprehensively. Any injectable treatment carries risks. Bruising and temporary swelling are common and expected. More serious complications, while rare with appropriate technique and anatomical knowledge, include eyelid ptosis (drooping), unwanted spread to adjacent muscles, or vascular complications if injected into vessels. Your practitioner should discuss these risks candidly before treatment.

Value consistency and follow-up. The ready-to-use formulation provides consistency, but technique still matters enormously. Find a practitioner you trust, who takes time to assess your anatomy, who discusses realistic outcomes, who provides appropriate follow-up. Aesthetic medicine is medical practice. It requires the same professional standards as any healthcare encounter.

My perspective after years in cardiac nursing and aesthetics

When I first transitioned from cardiac care to aesthetic medicine, I struggled with something fundamental: where were the protocols? Where was the hard data? How do you measure beauty?

What I've learned is this: aesthetic medicine, when practiced properly, is evidence-based. It does require anatomical precision. It does follow protocols. The science is there. In understanding facial anatomy, in precise product placement, in appropriate dosing, in complication management.

Relfydess represents the kind of innovation that appeals to someone with my background. It's grounded in substantial clinical research. It addresses a real clinical need (standardization and consistency). It demonstrates statistically significant, clinically meaningful outcomes. And it does so with a favorable safety profile.

But here's what I tell every patient who sits in my treatment room: the product matters less than the person using it. The most innovative neuromodulator in the world won't deliver good outcomes if your practitioner doesn't understand facial anatomy, doesn't take time to assess your unique features, doesn't discuss realistic expectations, or doesn't prioritize your safety above all else.

In my cardiac days, I learned that precision saves lives. In aesthetics, I've learned that the same precision (combined with genuine care for patient wellbeing and respect for anatomical complexity) creates outcomes that enhance lives. That's not vanity. That's medicine applied with both science and heart.

And in 2025, with innovations like Relfydess backed by rigorous clinical evidence, aesthetic medicine continues evolving into the sophisticated, evidence-based medical specialty it should be.

References:

1. Shridharani SM, Moradi A, Donofrio L, et al. Efficacy and Safety of RelabotulinumtoxinA, a New Ready-to-Use Liquid Formulation Botulinum Toxin: Results From the READY-1 Double-Blind, Randomized, Placebo-Controlled Phase 3 Trial in Glabellar Lines. Aesthetic Surgery Journal. 2024. PMID: 38913088. https://pubmed.ncbi.nlm.nih.gov/38913088/

2. Gold MH, Donofrio L, Shridharani S, et al. Patient-Reported Outcomes for Glabellar Line Improvement and Satisfaction With the RelabotulinumtoxinA Ready-to-Use Liquid Formulation: Data From the Phase 3 READY-1 Trial. Aesthetic Surgery Journal. 2025. PMID: 40242960.

3. Galderma. Galderma Completes European Decentralized Procedure (DCP) for Relfydess (RelabotulinumtoxinA). Press Release. July 30, 2024.

Nurse Marina is a BACN member, NMC Registered Nurse, JCCP Verified, ACE Group Registered, Royal College of Nursing Member, ICO Registered, and Professional Standards Authority registered practitioner with 8 years of aesthetic medicine experience and 6 years of cardiac nursing at KIMS Hospital.