Wrinkle Treatment

As the years go by, our skin ages. The first signs to appear are fine lines around the eyes and cheeks, which become more pronounced when we smile or laugh. These lines gradually deepen, and new ones appear. Before deciding on a specific treatment for wrinkles, it’s important to understand the difference between the types of wrinkles and the factors that cause them. Only by understanding the cause of a particular wrinkle can you choose the right treatment.

 

There are three types of wrinkles: dynamic, static, and so-called “fold wrinkles.”

 

Dynamic wrinkles are caused by the contraction of muscles located immediately beneath the skin. Each muscle contraction causes the skin to tighten and form lines that run perpendicular to the direction of the muscle fibers. Dynamic wrinkles most commonly appear between the eyebrows, horizontally across the forehead, and at the outer corners of the eyes—the so-called “crow’s feet.” It can thus be deduced that paralyzing or at least reducing muscle strength will diminish the appearance of wrinkles or even prevent their formation if the muscles are paralyzed before the initial wrinkles form. Some muscles can be permanently paralyzed through surgery or in combination with blepharoplasty, a brow lift, or a forehead lift. Another method involves injecting botulinum toxin, which reduces muscle activity for 3–6 months, during which time wrinkles are diminished or do not form at all.

 

Static wrinkles are caused by a loss of skin elasticity. The breakdown of elastic fibers is caused by prolonged sun exposure, smoking, a poor diet, genetic factors (weak or abnormally developed elastic fibers), or prolonged contraction of muscle fibers that causes dynamic wrinkles to become permanent. Static wrinkles are visible regardless of muscle contraction—even when the muscle is not contracting. They appear as numerous wrinkles on the face, extending in almost all directions around the eyes and on the cheeks. Effective treatment for these types of wrinkles involves either removing damaged skin or increasing skin thickness. Lasers and chemical peels remove damaged skin and stimulate the formation of new collagen, improving skin elasticity. Creams and ointments containing vitamin A (tretinoin), vitamin C, or collagen growth factors are helpful for maintaining skin elasticity and tone. Of course, avoiding direct exposure to ultraviolet rays and using sunscreen are essential for preventing skin aging and the development of skin cancer. Intense pulsed light (IPL) treatments are based on increasing skin thickness and stimulating the synthesis of new collagen.

 

The third type of wrinkles, known as fold-like wrinkles, is caused by the sagging of facial structures due to gravity, leading to the formation of deep wrinkles, such as those in the nasolabial folds. For these types of wrinkles, the only corrective treatment is a facelift or cervico-facial lift. Alternative, but non-permanent, treatments involve filling these deep wrinkles with substances based on hyaluronic acid or collagen, or with the patient’s own fat.

 

Most people develop a combination of these three types of wrinkles as they age. Regardless of the types of wrinkles you have, there are solutions for almost all of them—solutions you can explore together with your specialist.

 

Many of the products available on the market today promise to reduce wrinkles. Some of them have limited success, but many actually have no effect at all.

 

The skin ages all over the body, but most noticeably in areas exposed to the sun. Sun-induced changes include dry skin, pigmentation, and atrophy of the subcutaneous tissue, which leads to excess skin and wrinkles.

 

Most wrinkles appear on the parts of the body most exposed to the sun: the face, neck, and the backs of the hands.

 

Wrinkles are divided into two categories: fine wrinkles and deep wrinkles.

 

Factors that contribute to the formation of wrinkles:

• sun exposure

• smoking

• fair skin, which burns easily in the sun

• heredity (in some families, wrinkles are more common)

Today, there are so many treatments available to those who want to improve the appearance of their skin—so many, in fact, that it becomes very difficult to choose between them, and especially confusing. It’s best to schedule a consultation with a specialist to determine which treatment is best for you.

Below is a list of the most important treatments available today for reducing wrinkles

Vitamin A-based creams can reduce fine lines, moisturize the skin, and stimulate collagen synthesis. They must be applied as prescribed by a doctor, since simultaneous sun exposure can cause unwanted pigmentation. Over-the-counter creams containing retinoic acid, alpha-hydroxy acids, antioxidants, and coenzyme Q10 provide only limited improvement for wrinkles because they have a low concentration of active ingredients. Results, if any, are limited and short-term.

There are quick, non-invasive treatments offered by various cosmetologists, including microdermabrasion (fewer layers of skin are removed than in dermabrasion; recovery is faster, but repeated treatments are needed to maintain the achieved results), chemical peels (the application of creams based on various acids that break down the superficial layers of the skin; the regenerating skin is smoother and has fewer wrinkles, though recovery takes several weeks), and mesotherapy. These are useful for achieving a more rested appearance; however, they do not significantly alter anything beyond the appearance of very, very fine wrinkles.

Dermabrasion

This is a surgical procedure in which the superficial layers of the skin are removed using a stiff brush rotated by a motor. Immediately after the procedure, the skin will be red and may ooze. Recovery takes about 2 weeks, until the newly formed skin looks normal.

Laser Treatment

Laser treatment helps reduce fine facial wrinkles, brown spots, and telangiectasias, as well as slightly firm the skin. There are many types of lasers that can be used, each with a specific indication for a particular condition. The mechanism of action involves destroying the epidermis and stimulating the synthesis of collagen and elastin fibers in the dermis. The resulting skin is smoother and has improved tone. Intensive pulsed light (IPL) and radiofrequency treatments are based on the same principle; they are less invasive, but the results are more limited, requiring multiple sessions.

Facelift / Cervico-Facial Lift / Forehead Lift

It is the only effective treatment for deep forehead wrinkles, as well as deep wrinkles on the cheeks and nasolabial folds. Recovery does indeed take longer, but the results are the best and most long-lasting (the effects of a cervico-facial lift last between 5 and 10 years).

These consist either of botulinum toxin injections for fine expression lines on the forehead, between the eyebrows, or around the eyes, or of injections with various fillers for deeper wrinkles on the face.

Here are some of the injectable substances used to improve the appearance of wrinkles:

The most commonly used and popular dermal fillers

These are hyaluronic acid-based fillers (Restylane, Perlane, Hylaform, Juvederm, Puragen). Hyaluronic acid is a substance found throughout our bodies. In these products, it is synthetically produced, and once injected, it absorbs a large amount of water, leading to the filling of wrinkles or lips where it was injected. It is the most widely used because side effects are very rare (swelling, redness at the injection site); it is easy to administer, easily moldable and controllable, and non-toxic.

Collagen-based fillers

These are also used to reduce wrinkles. The collagen can be bovine or human and is highly purified.

For deep wrinkles

Radiesse or Sculptra are used, and their effects can last up to 2 years.

CROSS-LINKED
HYALURONIC ACID Cross-linked hyaluronic acid has greater persistence in tissues and therefore a longer-lasting effect. This result is due to the synthesis of natural collagen and the formation of a dermal matrix that ensures a lasting effect after injection of this product.

It can be used to correct facial wrinkles—such as nasolabial folds and vertical lines between the eyebrows—as well as to correct minor facial imperfections (filling in small defects).
The product is well tolerated by the body, is slowly absorbed, and provides results lasting between 9 and 18 months.

The product is injected under local anesthesia; recovery is immediate, and hospitalization is not required.

After injection, moderate localized swelling and slight redness may occur, which subside within the next 24–48 hours.

The time interval before a repeat injection is necessary depends on several factors: skin texture, lifestyle, age, injection site, and, of course, the amount of filler injected.
The results of the injection are immediate, and normal activities can be resumed after the procedure.

FAT
INJECTION Fat injection is used to treat deeper wrinkles (glabellar lines, nasolabial folds).
It involves harvesting fat from another part of the body, making it a more labor-intensive procedure. However, the results are longer-lasting.

BOTULINUM
TOXIN INJECTIONS Botulinum toxin injections are used to smooth out forehead wrinkles and wrinkles around the eyes (crow’s feet). The effects last up to 6 months.

GENERAL
INFORMATION Dysport is a medication that has been used successfully for many years in neurology, pediatrics, and ophthalmology; it is based on a biological product for human use marketed as an injectable solution. In cosmetic corrective treatment, it is injected in very small amounts into areas affected by wrinkles, particularly on the face and neck.
Muscle activity—the main cause of facial wrinkles—is blocked, and the affected muscle can no longer contract as usual. All other nervous system functions (such as skin tactile sensitivity) in the treated area remain unaffected.

WHAT DOES DYSPORT TREAT?

Dynamic expression lines on the forehead, around the eyes, the glabella (the area between the eyebrows), and the lower eyelid

• Minor facial asymmetries

• Excessive sweating of the palms, soles, and underarms

THE
PROCEDURE The procedure is quick and well-tolerated by the patient. Using a very fine needle, Dysport is injected directly into several sites in the target muscles. The treatment is performed on an outpatient basis and requires no prior medical preparation by the patient.

WHAT IS THE EFFECT OF DYSPORT TREATMENT?
By injecting a very small amount of Dysport, muscle contraction is inhibited, thereby preventing the formation or deepening of wrinkles. The effect appears 2–7 days after injection and lasts 3–6 months. Repeating the procedure can extend the effect to nearly one year. The results of Dysport treatment can be enhanced by combining it with other wrinkle-reduction methods (such as chemical peels, laser treatments, etc.).

WHAT ARE THE BENEFITS OF DYSPORT TREATMENT?

• Prior to the procedure, the patient does not need to undergo any tests, so treatment can be administered immediately.

• After treatment, the patient does not need to take time off work and can resume all normal activities (with the exception of exercise and deep facial massage for three weeks).

• The final result is not permanent, although it can be long-lasting, so the patient can decide whether to continue receiving Dysport treatments.

• Once the effect wears off, the face returns to its original appearance.

CONCLUSIONS
Adverse effects are rare. The most common adverse effect is bruising at the injection site. This occurs in approximately 3 to 10% of patients and resolves after a few days. Relaxation of the surrounding muscles may occur, which resolves after a few weeks. In very rare cases, the treatment has no effect.