Wrinkle Treatment

Wrinkle is a sign of aging.  Presently wrinkle treatment with non-surgical ways is a common practice, because there is no downtime.  The material used in non-surgical wrinkle treatment is botulinum toxin and fillers.  What is the difference between them?

Aging sign on skin begins with fine wrinkles (Stage One).  Fine wrinkles are caused by loosing elasticity, decreasing water content and thinning of skin, etc., in aging process.  There are many ways to treat fine wrinkles on face, such as lasers or creams (content retinoid or vitamin C, etc.) that can increase elasticity of skin and thicken skin.

Stage Two is manifested with dynamic wrinkles.  Dynamic wrinkles are expression lines and grooves that appear when person is making facial expression.  Such as Crow's feet is noted when smiling.  Frown wrinkles are noted when angry.  The cause of dynamic wrinkles is hyperactivity of expression facial muscles and loosing elasticity of skin.  Treatment of dynamic wrinkles is local injection of botulinum toxin.  The toxin can paralyze the target muscles.

Below shows facial expression muscles.  To treat Crow's feet, toxin is injected on the lateral side of Orbicularis Oculi to paralyze the over active muscle.  To treat frown wrinkles, toxin is injected into Corrugator and Procerus muscles.

Similarly toxin can be injected into Frontalis muscle to treat wrinkles on forehead.  The effect of botulinum toxin lasts about 4-6 months.

Below showed the result after toxin injection to treat Crow's feet, frown line and forehead wrinkles.

Stage Three is Static Wrinkles.  Static wrinkles are those that are visible all the time.  They exist when person is not making facial expression.  The cause of static wrinkles is long-term effect of dyanamic wrinkle.  Such as static wrinkles of Crow's feet appear earlier on persons who often smile.  The wrinkles are more difficult to treat than dynamic wrinkles because they consist of deep grooves and permanent lines that have taken years to develop.

Thickness of skin is thinner below the groove than adjacent skin.  Filler injection under groove is needed to smoothen static wrinkles.  Below showed the effect of filler .

Presently there are many kinds of filler, such as collagen, hyaluronic acid (abbreviated as HA), Radiesse,etc. The advantage of filler injection is no downtime.  But the effect is temporaty.

Collagen comes from cow or pig's skin.  There is chance of allergic reaction to collagen reaction.  After the introduction of HA, rarely is the usage of collagen. In addition, HA lasts longer than collagen.

HA is kind of polysaccharide.  It distributes widely in human tissues.  Presently HA is made from products of bacteria in the laboratory.  The structure of HA is almost the same as the HA of human.  Rarely will the occurrence of allergy.

There are several kinds of preparation of HA, such as small, median or large particles of HA.  Depending on the severity of wrinkle and location of wrikles, there is more flexible to choose the best HA product  to smooth the wrinkles.

There are many bony small particles in Radiesse.  Radiesse is a tough filler material than HA, so that Radiesse can lift more skin up than HA.  Radiesse is more suitable to augment nose or chin than HA.

Below showed the combination of toxin and HA to smooth static frown lines.  Below left is before picture without frowning.  Below right is before picture with frowning.

Just as explained before, formation of static frown lines is related with contraction of Corrugator and Procerus muscles.  Toxin is needed to paralyze the muscles.  The onset of toxin effect is about 4 days.  Below left is one week picture without frowning after toxin treatment.  Below right is after picture with frowning.  No frown muscle contraction is noted after toxin treatment.  Static frown wrinkle improved, but not enough for her.  HA to smooth the wrinkle is needed.

Below showed the immediate appearance after HA injection on the static frown line.



The benefit of nonsurgical toxin and filler injection includes no down-time, quick recovery. Below is the list of wrinkles and their treatment.