Wrinkle Treatment

Wrinkle Treatment Information from Dr. Thomas Le in Baltimore, MD, near Washington, DC and Northern Virginia

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The gradual development of facial wrinkles, whether fine surface lines or deeper creases and folds, is the classic early sign of accumulated skin damage and inevitable aging. Premature aging and wrinkling of the skin may be accelerated by excessive exposure to the sun and other elements, overactive facial expression muscles, the frequent use of tobacco products, poor nutrition, or skin disorders. Fine surface wrinkles that progress to deeper creases, deepening facial expression due to repeated skin folding, and deep folds which develop with one's maturity are obvious changes which may combine to portray a less desirable appearance. Persistent facial lines, especially those involved in negative emotional expressions, may mistakenly portray to others, the look of worry, anger, anxiety, disgust or sadness, despite one's own positive internal feelings. Regardless of the cause of facial creases or folds, safe and successful treatments for reduction or elimination of these problems are now available with the help of a Facial Plastic Surgeon. Injecting or implanting substances which either temporarily weaken the muscles or act as skin volume fillers serve to soften or eliminate the appearance of wrinkles and produce a more youthful, rejuvenated appearance.

 

Treatments for facial wrinkles are usually performed in the office setting which is convenient, private, and safe for persons who desire therapy. Your health, in conjunction with the appropriate therapy to achieve your goals, is given full consideration by your Facial Plastic Surgeon prior to the any decision to undertake specific treatment. However, very few individual health problems would limit the use of these therapies due to their minimally-invasive methods of application. Your concerns and any medical requirements for each facial wrinkle therapy will be part of the consultation with your surgeon.

 

Understanding Types of Treatments for Facial Wrinkles

Prominent forehead creases, brow furrows or eye lines (crow's feet) produced by specific facial expression muscles repeatedly creasing the skin may be effectively treated by reducing the function of specific facial muscles. Botulinum toxin is a sterile, purified protein produced from the bacteria, Clostridium botulinum, in the laboratory. Botulinum injected in small amounts into facial muscles binds to the nerve endings supplying the muscle and prevents nerve impulses from traveling to the muscle. When injected into muscle, it weakens or paralyzes the muscle around the area injected for a typical period of several months. The resultant weakening or paralyzing effect on the facial muscle temporarily reduces or eliminates previous skin creasing and new skin creasing is avoided. Botulinum may take several days to have its effect, and the effect typically lasts 3-6 months, in most individuals, before full muscle movement returns. At that point further treatment may be elected.

Injectable fillers are formulated for safe use in nearly all areas of the face, including the cheek laugh lines, lips, and under-eye area. Fine wrinkles are filled in by the material to reduce their visibility. Other prominent facial creases and folds around the forehead, cheeks and chin can be treated as well with this material.  The treatments are easily performed in the office and usually have minimal side effects.

Making the Decision for a Specific Therapy

Expectations of any facial wrinkle therapy must be realistic. While an expectation for the complete and permanent removal of facial wrinkles for those persons considering treatment may be attractive, it is unrealistic, due to the ongoing nature of wrinkle formation and the currently available methods for treatment. The patterns and severity of facial wrinkle formation are highly individual. Therefore, after consultation with your surgeon, the appropriate therapy for your specific problems must be tailored to meet your needs. Management of many facial wrinkles may require repeated treatments or the use of combinations of treatments to achieve optimal results. The goal is to improve or reduce the appearance of the wrinkle or crease. This can be accomplished by reducing skin folding caused by underlying facial muscle action, as in botulinum toxin therapy. Alternatively, the skin beneath the wrinkle can be augmented to efface the wrinkle with injected filler material. The choice of a type of therapy depends on the location and extent of the wrinkles, the desired duration of the effects, and the tolerance for potential side effects. All of these treatments provide additional and synergistic aesthetic benefits when combined with another facial rejuvenation procedure such as facelift, browlift, blepharoplasty or skin resurfacing.

What to Expect After Each Treatment

In comparison to typical cosmetic surgical procedures, the office time for these procedures and the subsequent recovery period until one returns to normal function are minimal. Botulinum toxin therapy typically takes a few minutes to perform, and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours.

Likewise, filler applications can be accomplished under topical anesthesia with similar attendant side effects. Some mild irritation at the injection sites is unavoidable but can usually be camouflaged with standard make-up, if necessary. Most early swelling subsides within a day or two, though minor swelling and irritation may last for several weeks during the implant healing phase. Your activity level and medication for pain after the procedure are dependent upon your doctor's recommendations.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve facial scars or contour deformities resulting from injury may be covered. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

Please contact our office in Baltimore, MD, to schedule an appointment or to ask our team any questions. 

© Copyright 2000 American Academy of Facial Plastic and Reconstructive Surgery