A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 1]

July 15th, 2013 by Dr. Robert J. Troell, M.D., F.A.C.S.
Blog

Patients frequently ask me “What is the best treatment for wrinkles?” This has a complex response; however, to simplify matters…the optimal treatment depends on the cause of the wrinkle.

The best situation is prevention of wrinkle formation. This prevention centers on avoidance of sun exposure or frequent application of sun block creams as well as the avoidance of tobacco use.

Let’s examine the adult face from the hairline down to the chin and identify all the lines of the face:

♦ horizontal lines of the forehead
♦ vertical lines at the root of the nose and between the eyebrows (glabellar area)
♦ lateral aspect of the eyes extending down onto the superior aspect of the cheek bones (crow’s feet)
♦ hollowness below the eyes (tear trough)
♦ hollowness extending from the nose down to the area below the cheek bone (nasojugal groove)
♦ the folds extending from the nose lateral to the corners of the mouth (nasolabial fold) ¨ the folds from the corners of the mouth to the lateral chin area (mesolabial fold)
♦ vertical lines above the upper lip
♦ horizontal line below the lower lip (mental crease)
♦ depression under the cheek bone (submalar area)
♦ fullness at the jowl area with creases in front and behind
♦ vertical lines on the lips themselves
♦ small lines of the skin throughout the face

“Laugh lines” are actually created by laughing…what a surprise! Laughing has shown to change one’s affect, decrease stress and even heighten our longevity. Repeat emotional facial expressions or animation, no matter happy or sad, can change your appearance for the rest of your life. Facial wrinkles, created by the action of the facial muscles of animation, can be treated by attenuating the muscle contraction through the use of botulinum toxin injections (Botox, Dysport, Xeomin).

Botulinum toxin prevents the propagation of the nerve impulse from the nerve ending to the muscle side of the connection, called a synapse. The medication is delivered by an injection that can be performed without any anesthesia with the procedure taking one to two minutes to complete with minimal risks and possible complications. The procedure usually needs to be repeated every 3-4 months to continue the aesthetic effect of wrinkle effacement.

Cosmetic facial services in Las Vegas, NV, and Laguna Beach, CA: http://www.drtroell.com/procedures/facial-cosmetics/

The following are the lines that can be improved and even resolved (in younger patients):

♦ horizontal lines of the forehead
♦vertical lines at the root of the nose and between the eyebrows (glabellar area)
♦ lateral aspect of the eyes extending down onto the superior aspect of the cheek bones (crow’s feet)

Volume replacement or facial enhancement can be achieved through a variety of methods to include dermal fillers, sculptra, fat transfer, or silastic implants, such as the following areas: Each method has its benefits and limitations, the most important of which is temporary versus permanent changes.

♦ hollowness below the eyes (tear trough)
♦ hollowness extending from the nose down to the area below the cheek bone (nasojugal groove)
♦ the folds extending from the nose lateral to the corners of the mouth (nasolabial fold) ¨ the folds from the corners of the mouth to the lateral chin area (mesolabial fold)
♦ depression under the cheek bone (submalar area)

Related posts:

A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 2]
A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 3]

Facial Plastic Surgery American College of Surgeons American academy of cosmetic surgery American society of liposuction surgery American academy of otolaryngology head and neck surgery