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

August 20th, 2013 by Dr. Robert J. Troell, M.D., F.A.C.S.
Blog

Facial liposuction to remove excess fatty tissue or a facelift to suspend the soft tissues may improve the following:

♦ fullness at the jowl area often with creases in front and behind the fullness

The fine lines of the face can be treated with dermal fillers or laser skin resurfacing:

♦horizontal line below the lower lip (mental crease)
♦vertical lines on the lips themselves
♦small lines of the skin throughout the face, often along with pigmentation spots, such as freckles and “age spots”, and decreased skin elasticity. All these skin changes are caused by sun exposure.

The dermal fillers most commonly used for filling facial lines and wrinkles are hyaluronic acid (HLA) fillers, such as Restylane, Perlane and Juvaderm. The benefit of these fillers is that the procedure is minimally invasive, with only a small needle placed in the skin to deliver the dermal filler. The procedure can be made more comfortable using anesthetic techniques, such as ice, topical anesthetic solutions or nerve blocks. All of these substances are designed to make the procedure minimally uncomfortable and limit the potential for bruising. These HLA fillers last about 6 months, before a repeat injection is indicated.

Vascular and skin pigmentation lines, lesions and blemishes, such as fine and medium blood vessels, freckles and age spots are best treated with an intense pulse light (IPL) device. The energy delivered in the visual light spectrum (blue, red, brown) is absorbed by different colored pigments within our skin, which creates changes in the tissue, often permanently.

Superficial lines or wrinkles can be treated using dermal needling, such as the Dermapen, and Micropen, or Erbium-YAG lasers, such as Fraxel, as well as IPL machines.

However, moderate to deep wrinkles and acne scarring are best treated with a fractionated carbon dioxide (CO2) resurfacing laser. DEKA’s Smartxide DOT fractional CO2 laser was determined to be the best resurfacing laser in a peer-reviewed published scientific study (Waibel J, J Drugs in Derm May 2009). Dr. Troell is a physician trainer for the DEKA laser and according to the president of DEKA North America, has the largest outcome study in the US.

Additionally, by adding platelet rich plasma (PRP) topically to the laser treated area, the PRP decreasing redness post-treatment, decreases the risk of darkening of the skin (hyperpigmentation) and accelerates healing of the skin. Also, optimal skin tightening and skin rejuvenation can be achieved by using a CO2 laser.

Despite all these skin treatments, it is essential to use a home regimen of skin care products to include a sun block, moisturizer, and mild cleanser. Consultation with a skin care specialist is something all of us can benefit from to keep our skin looking young. Future avenues: research since 2007 has been investigating the topical application of botulinum toxin for alleviation of wrinkles caused by the muscles of animation and it soon will be available for public use.

Related posts:

A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 1]
A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 2]

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