Wrinkle Treatments

Wrinkles are caused by intrinsic and extrinsic factors. Intrinsic aging is the natural aging of the skin which results in loss of collagen. Therefore, the skin appears thin and fragile. Extrinsic factors include UV radiation, smoking, and the environment. The combination of these factors results in uneven skin tone, rough texture, and wrinkles. Wrinkles can be treated in both surgical and non-surgical approaches.

SURGICAL TREATMENTS

For surgical treatment of wrinkles, facelift is by far the most effective solution. Surgical facelift is the traditional form of facelift. It is further classified into:

• Deep plane facelift which involves lifting the layer of tissues at or near the muscles of facial expressions
• Regular facelift which is the less invasive version of deep plane facelift as the surgeon works underneath the skin and none of the muscles or deeper tissues are dissected or manipulated
• Mini-facelift which is the least invasive of the three and only involves small and short incisions

Out of the three types of facelifts the deep plane facelift provides the best and longest-lasting results. However, the recovery period is also the longest.

Recovery from mini-facelift is the shortest but its effects are not as dramatic as a regular or deep plane facelift. That is why deep plane and regular facelifts are recommended for moderate to deep wrinkles while mini-facelift is for mild cases of wrinkles.

NON-SURGICAL TREATMENTS

There are many non-surgical options for those who are hesitant to go under the knife. These treatments include botox, chemical peels, microneedling, dermal filler injections, and lastly laser treatments.  The best treatment option depends on the patient’s age, their desired outcome, their budget, and procedures they have had previously.

Botox can be used as a preventative treatment to minimize wrinkles. Botox relaxes muscles and therefore reduces wrinkles in the area of injection. Chemical peels are a great option to improve texture, wrinkles, and discoloration. They range from superficial to deep peels. Chemical peels are a misnomer because you may not necessarily peel from the treatment. However, the chemicals work underneath the skin to produce collagen and improve signs of aging.

Microneedling is another option to improve texture and diminish wrinkles. This technique works by creating micro-injuries to the skin thereby producing collagen and improving the overall skin tone. Dermal fillers are used to soften fine lines and deep wrinkles as well as enhancing natural beauty. Fillers are made of a variety of substances. Juvederm and Restylane are composed of hyaluronic acid; Radiesse is composed of calcium hydroxyapatite; Sculptra and Bellafill are composed of ploy lactic acid and PMMA respectively. The aforementioned fillers will last from 12 months to 5 years depending on the product. The only permanent filler on the market is Silicone.  In well trained hands, most fillers and even a combination of these products are effective in achieving the aesthetic enhancement.

Lastly, lasers can also improve wrinkles. There are numerous on the market, but the most effective are erbium, CO2, and radiofrequency. Not all lasers are ideal for all skin types. It is imperative to have a thorough evaluation by a physician.

COMPARISON & LIMITATIONS

Surgical treatments will definitely produce more dramatic results but most patients do not want to undergo this option to remove wrinkles. Among the non-surgical wrinkle treatments available today, specialists prefer a multi-modality approach in order to achieve the desired effect. As no single treatment can correct all the signs of aging, a combination of techniques is required. During a consultation, it is recommended to avoid frequent and prolonged sun exposure, cease smoking, and use the right products with ingredients that stimulate collagen and decrease oxidative stress.

RISKS

In terms of complications, it depends on the specialist’s skill, training, and experience. In laser treatment, a provider who is not trained properly to use the machine might burn the patient’s skin and cause discoloration.  When using fillers, if the doctor is not familiar with the anatomy there can be some serious issues like necrosis and blindness. With chemical peels, patient selection is imperative to minimize skin discoloration. Microneedling has no serious side effects and is suitable for all skin types.

RECOVERY

There is usually downtime for all the aforementioned procedures performed. The downtime can include mild redness and minimal swelling to significant bruising and swelling.

FINAL THOUGHTS

In order to prolong the effects of surgical or a non-surgical wrinkle treatment, patients must avoid frequent and prolonged sun exposure and maintain a healthy lifestyle.  A healthy lifestyle includes exercising regularly, eating a low glycemic diet, wearing sunscreen all year round, and using products that enhance collagen production.

Written by Cosmetic Town Editorial Team - AA

Based on an exclusive interview with Dr. Naana Boakye, MD in Englewood Cliffs, NJ