Deep wrinkles
Understanding Various Treatments Of Facial Wrinkles
The gradual development of facial wrinkles, whether fine surface lines or deeper creases and folds, is the classic early sign of accumulated skin damage and inevitable aging. Premature aging and wrinkling of the skin may be accelerated by excessive exposure to the sun and other elements, overactive facial expression muscles, the frequent use of tobacco products, poor nutrition, or skin disorders. Fine surface wrinkles progresses to deeper creases, deepening facial expression due to repeated skin folding, and deep folds which develop with one’s maturity are obvious changes which may combine to portray a less desirable appearance. Persistent facial lines, especially those involved in negative emotional expressions, may mistakenly portray to others, the look of worry, anger, anxiety, disgust or sadness, despite one’s own positive internal feelings. Regardless of the cause of facial creases or folds, safe and successful treatments for reduction or elimination of these problems is available. Injecting or implanting substances which either temporarily weaken the muscles or act as skin volume fillers serve to soften or eliminate the appearance of wrinkles and produce a more youthful, rejuvenated appearance. Likewise, other non-surgical procedures are available.
Cosmetic procedures
- Glycolic acid peels. These superficial peels can make a very slight difference in the intensity of fine wrinkles.
- Deeper peels. These peels use ingredients like salicylic acid and trichloroacetic acid and penetrate somewhat deeper into the skin. These deeper peels do a better job of smoothing fine lines. In general, however, the deeper the peel, the greater the risk of side effects, such as long-lasting pigment changes (changes in skin color) and scarring. Such peels do not require anesthesia.
- Dermabrasion. Often performed under general anesthesia, this procedure involves the use of a rotating instrument to sand the skin down. Depending a great deal on the skill and experience of the operator, dermabrasion can result in excellent improvement, but can also produce significant side effects, including scarring and permanent changes in skin color.
- Laser resurfacing. Using instruments such as the carbon dioxide and erbium lasers, aestheticians can achieve results similar to those of dermabrasion with greater reliability and precision. The laser is passed several times over the area to be treated until the peel reaches the middle of the dermis, the skin’s second layer. This helps stimulate the body’s natural collagen synthesis (production), which plumps up sagging skin and wrinkles. Some aestheticians perform laser resurfacing under “conscious sedation,” in which the patient remains awake and receives intravenous medications to calm and ease pain. This sedation is combined with the application of topical anesthetic creams such as EMLA or Ela-Max, as well as injections of local anesthetics like lidocaine. Procedures may need to be repeated once or twice at 6 to12 month intervals to maximize improvement. They are, however, associated with pain, lengthy healing times, and potential for permanent pigment changes and scarring.
- Non-ablative laser resurfacing. Newer lasers attempt to stimulate collagen synthesis under the skin without peeling or damaging the epidermis. Data on their effectiveness are still preliminary at this point, but suggest that results for fine lines and wrinkles may approach those of invasive laser resurfacing. Treatment is almost painless and there is little or no redness, peeling, or “down-time” afterward. Noticeable improvement may involve several repeated procedures over a period of months.
- Plastic surgical procedures. Surgical facelifts, brow lifts, and similar operations can be very helpful for selected patients under direction of an MD.
- Botox. Injection of botulinum toxin, the muscle poison, can paralyze muscles that produce the “frown lines” on the forehead, fine lines around the eyes, and other wrinkles. Improvement lasts several months and must be repeated to sustain improvement. Safety depends again on the experience of the aesthetician.
Anyone considering any of these solutions should contact an aesthetician experience in one or several of these techniques. Call Radiant Medspa at 206-402-3063 in Seattle or 425-640-5900 in Lynnwood for a complimentary consultation.
Understanding Types Of Treatments For Deep Facial Wrinkles
Prominent forehead creases, brow furrows or eye lines (crow’s feet) produced by specific facial expression muscles repeatedly creasing the skin may be effectively treated by reducing the function of specific facial muscles. Botulinum toxin, Botox, is a sterile, purified protein produced from the bacteria, Clostridium botulinum, in the laboratory. Botox injected in small amounts into facial muscles binds to the nerve endings supplying the muscle and prevents nerve impulses from traveling to the muscle. When injected into muscle, it weakens or paralyzes the muscle around the area injected for a typical period of several months. The resultant weakening or paralyzing effect on the facial muscle temporarily reduces or eliminates previous skin creasing and new skin creasing is avoided. Botox may take several days to have its effect, and the effect typically lasts 3-6 months, in most individuals, before full muscle movement returns. At that point further treatment may be elected.
Injectable collagen is an animal protein filler material formulated for safe use in nearly all areas of the face, including the lips and crow’s feet. Fine wrinkles are filled in by the material to reduce their visibility. Other prominent facial creases and folds around the forehead, cheeks and chin can be treated as well with this material. Initial collagen allergy testing must be performed, and repeated treatments every 2-4 months are typically needed to sustain the desired result. The treatments are easily performed in the office and usually have minimal side effects.
Human collagen matrix, is an implant used for the reconstruction of soft tissue defects. It may be threaded beneath the deep creases of the brow or cheek folds or placed within the upper and lower lips, to flatten and reduce wrinkle visibility. Typically, this material maintains the majority of its volume correction similar to injectable collagen.
Another type of implant is a nonresorbable synthetic polymer material, ePTFE which may likewise be used in the forehead, cheek folds, and lips to produce volume enhancement and effacement of deep facial creases. This material does not incorporate into surrounding tissue, but it does not lose volume either. It provides more lasting change and may be placed during an office procedure using local anesthetic and small incisions with a relatively short recovery period.
Fat grafting creates a natural augmentation for the face, especially for the lips and mouth region. Fat is usually harvested from the abdomen and about one third of the volume remains after the treatment. Fat grafting can be repeated for additional fullness.
Making The Decision For A Specific Therapy
Expectations of any facial wrinkle therapy must be realistic. While an expectation for the complete and permanent removal of facial wrinkles for those persons considering treatment may be attractive, it is unrealistic, due to the ongoing nature of aging and wrinkle formation, and the currently available methods for treatment. The patterns and severity of facial wrinkle formation are highly individual. Therefore, after consultation with your surgeon, the appropriate therapy for your specific problems must be tailored to meet your needs. Management of many facial wrinkles may require repeated treatments or the use of combinations of treatments to achieve optimal results. The goal is to improve or reduce the appearance of the wrinkle or crease. This can be accomplished by reducing skin folding caused by underlying facial muscle action, as in botulinum toxin therapy. Alternatively, the skin beneath the wrinkle can be augmented to efface the wrinkle with injected or inserted filler material. The choice of a type of therapy depends on the location and extent of the wrinkles, the desired duration of the effects, and the tolerance for potential side effects. All of these treatments provide additional and complimentary aesthetic benefits when combined with another facial rejuvenation procedure such as facelift, browlift, blepharoplasty or skin resurfacing.
What To Expect After Each Treatment
In comparison to typical cosmetic surgical procedures, the office time for these procedures and the subsequent recovery period until one returns to normal function are minimal. Botulinum toxin therapy typically takes a few minutes to perform, and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. Likewise, collagen or human dermal injection therapy can be accomplished with a 5-15 minute procedure with similar attendant side effects. Some mild irritation at the injection sites is unavoidable but can easily be camouflaged with standard make-up, if necessary.
Filler implant insertions typically take up to an hour to perform in the office, depending upon the number and extent of treatment locations. Several sutures are used to close the insertion site. More swelling redness, and discomfort may accompany these procedures, which require the use of a local anesthetic. Local application of cold compresses may feel comforting. Most early swelling subsides within a day or two, though minor swelling and irritation may last for several weeks during the implant healing phase. Your activity level and medication for pain after the procedure are dependent upon your doctor’s recommendations.






