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You may have noticed that one of the very first
signs of aging are the tiny lines on the cheeks and eyelids that
are accentuated with smiling. With each passing year, these facial
wrinkles become progressively deeper and new lines begin to appear.
Before deciding on the ideal wrinkle treatment, it is important
to understand the difference among facial wrinkles, and their various
causes. Once the underlying cause is identified then the appropriate
wrinkle treatment can be applied, virtually turning back time on
your skin.
There are three types of wrinkles: dynamic wrinkles,
static wrinkles, and wrinkle folds. Dynamic wrinkles are caused
by contraction of muscles that are attached to the overlying skin.
Each muscle contraction causes the skin to bunch together, forming
lines between the bulk of the muscle. The most common locations
for dynamic wrinkles are between the eyebrows, across the forehead,
and on the cheeks near the outer corners of the eyes, referred to
as “crow’s feet”. It follows, then, that weakening
these muscles will cause a reduction in the severity of the facial
wrinkles, or can prevent them altogether when muscle weakening is
done before wrinkles form. Some of the muscles can be weakened permanently
through surgery alone, or in combination with eyelid
surgery (blepharoplasty), a brow
lift or forehead lift.
An alternative dynamic wrinkle treatment is injection of Botox
into specifically targeted muscles to temporarily decrease the muscle
action for approximately 3-4 months, preventing wrinkle formation.
Static wrinkles are due to lack of elasticity of
the skin caused from sun damage, smoking, genetics, poor nutrition,
or from prolonged dynamic wrinkling. Static facial wrinkles are
visible regardless of muscle contraction; they stay (hence the name
“static”) even when the muscles are not contracting. This
leads to the classic “crepiness” and multiple cross-hatching
as is often seen in wrinkles on the cheeks and around the eyes.
Techniques that increase the thickness of the skin or that remove
the damaged skin are effective wrinkle treatments. Laser
skin resurfacing and deeper chemical
peels remove the damaged skin and stimulate new collagen formation
to improve the skin’s appearance, elasticity and thickness.
Topical creams and ointments such as Tretinoin (Retin-A), Vitamin
C serum, and new collagen growth factor formulas are good maintenance
systems to restore and maintain the skin’s youthfulness. Of
course, daily sun protection is essential in preventing further
sun damage and skin cancer.
Multiple treatments of intense pulsed
light or light chemical peels and other non-ablative lasers
can increase the thickness of the skin and collagen level without
significant downtime.
The third type of wrinkles, called wrinkle folds,
is often due to sagging of the underlying facial structures, most
notably causing the deep grooves between the nose and mouth known
as the naso-labial groove. Surgical procedures such as midface
lifts, cheek lifts, and neck
lifts offer the best corrective measures for these problems.
Alternatively, the folds can be camouflaged temporarily by plumping
up the groove from beneath with substances like collagen or soon
to be FDA-approved hyaluronic acid derivatives like Restylane
and Perlane. These materials typically last for anywhere from
3 to 9 months, depending on the material used and the location of
the injection. Fat transfer,
whereby your own fat is removed from one area and then injected
into the area where fullness is desired, is an excellent alternative
to fillers from outside sources, and is one of the more permanent
wrinkle treatments.
Most people have a combination of all three types
of facial wrinkles, especially with advanced age. Regardless of
your wrinkle type and your desired degree of correction, there is
a solution available for you.
Dr. Jonathan Hoenig provides the most advanced and innovative techniques
in facial plastic surgery and facial rejuvenation today. To learn
more about facial plastic and reconstructive surgery, visit us on
the web at http://www.la-plastic-surgery.com,
email info@drhoenig.com,
or phone toll free 866-HOENIG9.
dr. hoenig
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