Wrinkles and fine lines, an inevitable part of aging, can make a person look old, sad, angry, or tired. To look younger and/or more refreshed, many people who have wrinkles and fine lines seek treatment. Fortunately, there are countless options, including creams, dermal fillers, peels, laser treatments, botox, and surgery, for improving the look of the skin.
The skin is made up of three layers: the epidermis, dermis, and subcutaneous tissue, each of which contributes to the full, strong, and smooth skin that we are born with. The epidermis, which is the outer layer, protects the skin from environmental toxins with special cells called keratinocytes. Underneath the epidermis is the dermis layer, which contains connective tissue, including collagen, elastin, and other proteins, that provide strength and flexibility to the skin. The subcutaneous tissue at the bottom layer is made up of fat cells that insulate the body and is what makes the skin look full and plump.
Each of these layers is affected by aging, genetics, and environmental factors, which can make the skin sag and look more wrinkled. The skin’s layers tend to thin as the production of tissue slows down, making skin more susceptible to damage and changes because it lacks its previous support and fast-repair abilities. The result is thinner skin with visible lines and wrinkles that can no longer be filled in by collagen and fat cells.
Wrinkles and fine lines are the results of several factors, some of which are beyond a person’s control. During aging, the skin naturally thins and loses elasticity, which allows lines and creases to form, usually around the eyes, on the forehead, and at the corners of the mouth. Through years of repeated muscle contraction, lines and wrinkles tend to develop in these areas. Certain people may be genetically prone to getting wrinkles.
Many people also develop wrinkles and other unwanted skin changes as a result of excessive exposure to harmful substances over a long period of time. Ultraviolet light from the sun or artificial tanning is the leading cause of premature aging; it causes collagen and elastin fibers to break down, resulting in sagging, weakened skin that can more easily develop wrinkles and other signs of aging. Smoking also affects the skin; it can result in early aging by triggering changes in the skin’s blood supply. These factors lead to photoaging, which accounts for up to 90 percent of premature skin aging.
Our facial skin develops two types of wrinkles: dynamic wrinkles and static wrinkles. Here’s the difference.
When we make expressions such as frowning, squinting, showing surprise, and others, muscles around our eyes, between our eyebrows, and on our forehead engage. Over time these contractions begin to create wrinkles on the surface skin above the muscle. These wrinkles are known as “dynamic wrinkles.” These are crow’s feet on the outside of the eyes, the 11s between the eyebrows, and forehead lines. When Botox (or another neuromodulator) is injected into the muscles that create these wrinkles, it blocks the nerve messages from the muscle to the brain. Since the brain doesn’t receive the message to contract the muscle it stays relaxed and the wrinkle on the surface skin doesn’t form. This lasts for a period of around four months. At that point, the muscle will begin to contract again, and the wrinkle will return, but another injection session will maintain your results.
Dermal fillers treat the other kind of wrinkles, known as “static wrinkles.” Unlike wrinkles formed by muscle contractions, these wrinkles are due to sun damage, declining collagen production, personal habits, and simple aging. Static wrinkles show themselves at all times and have nothing to do with muscle contractions. These are all static wrinkles: smile and laugh lines, marionette lines, parentheses lines, and barcode lines. These are areas of volume loss that dermal fillers treat: the cheeks, the under-eye areas, the lips, and the backs of the hands.
There are many treatments, including the following, designed to improve skin and make the patient look younger:
The treatment chosen depends on the cause and severity of wrinkles, as well as the age and personal preference of the patient.
Laser treatments can be classified as ablative or non-ablative. Ablative procedures remove some of the outer epidermis layers of the skin, decreasing sun-damaged skin, lines, and other skin issues. This older skin is replaced with healthier, younger-looking skin.
Non-ablative laser treatments work on the skin in two ways. Some target the age spots and other areas of pigmentation due to sun damage. The melanin in these damaged skin cells absorbs the laser energy and it breaks down the melanin. The age spot will usually peel away and become less noticeable.
Other treatments use laser energy to penetrate the epidermis and enter the dermis, the skin’s second layer. Once in the dermis, the light energy converts to heat. When the body senses heat in the dermis, it assumes there has been a wound. It responds by remodeling the existing collagen in the skin, and then it ramps up the production of new amounts of collagen. Since collagen is the protein that provides the structural framework that keeps our skin firm and thick, this improves the skin’s texture and tone, erasing wrinkles and improving the skin quality.
Dermal fillers such as Juvéderm are true to their name — when injected beneath a wrinkle, crease, or area of volume loss they simply “fill” in the area, pushing the skin back upward and erasing the wrinkle or returning volume.
The most popular fillers, the filler families of Juvéderm and Restylane, are known as “natural” fillers because they are made primarily of hyaluronic acid, a naturally occurring substance in the human body that is responsible for plumping, firming, and hydrating the skin. When injected beneath a wrinkle, the hyaluronic acid in a filler like Juvéderm binds with nearby water molecules, instantly hydrating and firming the skin.
Dermal fillers, Botox, and most laser skin rejuvenation treatments have only been around for less than two decades. Before that, the only way a person could do anything about their aging facial skin was to have surgery, namely a facelift, brow lift, or eyelid surgery. Those procedures are all still around, but facelifts have changed dramatically. Where the procedure formerly pulled and stretched skin to remove wrinkles, today the focus is more on the underlying support muscles and other tissues. By elevating these support tissues, rather than stretching the skin, the results are more natural-looking. Also, new methods have been developed to address more specific areas. There is now a mid-face lift, a limited incision facelift, a neck lift, and other options. Otherwise, brow lifts target lines and wrinkles on the upper third of the face from brows to the hairline. Eyelid surgery addresses the eyelids and skin beneath the eyes.
It’s usually the degree of elasticity in a person’s skin. If aging, loss of collagen, and sun damage have worked to make the skin less elastic, then it won’t respond well to skin tightening treatments using laser or radiofrequency energy. That’s when surgery is necessary to remove the excess skin and tighten the aging face.
No. Eventually, your body absorbs the hyaluronic acid or other filler ingredients, and the wrinkle or crease returns. The duration of results from different dermal fillers lasts from six months up to 18 months.
There are many ways to prevent or reduce the effects of photoaging. If avoiding the sun is not possible, it is essential to use sunscreen with an adequate SPF, and wear a hat and/or protective clothing. Avoiding smoking, eating a balanced diet, and minimizing stress also help the skin to look its best.
If you have questions about Botox, Dermal fillers, Microdermabrasion or any of the wrinkle and fine line treatment options discussed, please contact our office by calling (201) 836-9696 or simply fill out the contact form here. One of our staff members will be happy to assist you.