Today’s options for treating wrinkles are numerous and growing. From topical creams and lotions to Dermatologic/and medical spa procedures such as laser skin resurfacing, Botox, Fillers and finally plastic surgery. Today I will briefly discuss the anatomy of a wrinkle and how wrinkles are classified, giving you an overview of treatment options so you can feel great about your appearance at any age.
Characterizing a Wrinkle
When we treat a wrinkle, we first assess its underlying cause. Is it a sleep crease or a line of expression? Was it caused by sun or by smoking? Its depth, whether superficial or deep, also determines the approach to treatment. The following will explain how we classify wrinkles.
FINE (SUPERFICIAL) WRINKLES
WHAT THEY ARE: Typically caused by sun damage and smoking, both of which accelerate the degeneration of collagen and elastin fibers, these lines are superficial in nature and extend only to the upper dermis. The little lines around the mouth that cause lipstick to bleed are the best example of superficial wrinkles.
WHAT WORKS: Treatments directed at fixing superficial wrinkles must target the upper layers of the dermis. Cosmetic ingredients, by definition, target only the uppermost layer of the skin, the epidermis. Today, we have a better understanding of biofeedback mechanisms that enable the cells in the epidermis to “talk to” cells in deeper tissue layers, causing a specific response such as building collagen. We believe this mechanism explains why we are seeing impressive outcomes with topically applied antiaging peptides. Topical treatment is the simplest approach for treating these fine wrinkles and the best place to start preventing new ones from forming. However, for fine lines around the lips, injectables such as juvederm can help restore the t crisp border of the lip.
DEEP WRINKLES
WHAT ARE THEY: Caused by the degradation of the structural components of the skin, including elastin, collagen, and fat, deep wrinkles extend through the upper dermis into the mid dermis and lower dermis The loss of fat cells beneath the wrinkle coupled with lax connective tissue above it means wrinkling and sagging eventually go hand in hand. A droopy mouth is a perfect example.
WHAT WORKS: Deep wrinkles require fillers that are designed to replace the volume that has been lost. Juvederm is volumizing filler that is very effective for lessening the “parenthesis” formed by nasolabial folds.
DYNAMIC WRINKLES
WHAT ARE THEY: A dynamic wrinkle is caused by muscle movement. The forehead frown line, those two parallel creases making the number 11 between your eyebrows, result from the repetitive contraction of three muscles, two corrugators and one procerus, tugging against the skin above and eventually engraving wrinkles.
WHAT WORKS: Botulinum toxin, better known as Botox Cosmetic or Reloxin, inhibits muscle activity, allowing a relaxation of the skin and a disappearance of the wrinkle. It’s truly amazing how erasing these creases can transform your face. It makes you look happier and more relaxed and often changes the way people respond to you.
STATIC WRINKLES
WHAT ARE THEY: In contrast to winkles seen when muscles contract, static wrinkles are evident when the facial muscles are at rest. The most distressing static wrinkles tend to be those that occur where the lower are of the eye socket meets the top of the cheekbone, sometimes known as the “tear troughs.” Static wrinkles are the most difficult to treat, but when they are correctly addressed; the improvement in appearance can be quite impressive.
WHAT WORKS: Not treatable with botulinum toxin, static wrinkles require fillers to replace lost volume. Microdermabrasion procedures may also help to build collagen because the pull of the vacuum on the skin may stimulate collagen growth. But the reality is that if you have significant wrinkling and a hollowed, gaunt face, you will likely need a long –lasting, deep filler to dramatically improve facial wasting.
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