WRINKLE TREATMENTS

As we age, the lines on our skin created by facial expressions become permanently etched as wrinkles. These wrinkles not only give away our age, they also can make us look worried, angry or stressed when we are not. Several treatments are available to smooth wrinkles, including:

BOTOX injections
Chemical peels
Collagen injections
MicroDermabrasion
Laser resurfacing

These treatments may be done alone or in combination with more extensive cosmetic surgery, such as a face-lift or eyelid rejuvenation. Skin care consultations and a variety of skin-care products also are available.

BOTOX FOR WRINKLES

Botox injections have become increasingly popular for reducing wrinkles of the forehead and face. Today, injections of botulinum toxin type A provide a nonsurgical cosmetic technique for treating frown lines, forehead furrows, "crow's feet" and other lines of the face.

Physicians have used Botox safely and extensively for more than 20 years to treat a variety of muscular diseases as well as wrinkles. The injection causes temporary weakness of only those muscles injected. Although the weakness is temporary, the benefits last three to six months.

CHEMICAL PEELS FOR WRINKLES

Chemical peels have been used to treat fine facial wrinkles for 40 years. The art and science of performing chemical peels has changed radically in the past five years. Several mild acid solutions are now available to surgeons, allowing the treatments to be customized for each patient. The new acids and techniques allow us to treat a much wider variety of patients than previously possible.

Chemical peels are classified as superficial, medium and deep peels. Depending on the severity of the wrinkles and the degree of sun damage, your surgeon will suggest the appropriate treatment for you. The chemical peel is done under local anesthesia and intravenous sedation. The peel itself takes 30 to 60 minutes. The patient then usually goes home with supervision or stays in a nearby hotel for 24 to 48 hours. The patient receives careful instruction on how to apply antibiotic ointments, moisturizing creams and gentle facial washes to remove the old superficial skin layer.

The superficial skin layer to which the peel has been applied is usually shed completely in three to seven days. The new skin will be pink, fine and shiny. Superficial and deep wrinkles and pigmentary irregularities around the mouth, cheeks, forehead and eyes will look much better. About 10 to 14 days after the procedure, the skin may still be somewhat pink, but makeup can be used and patients are usually comfortable appearing in public. Four to 12 weeks after the procedure, the skin assumes normal color and texture. Depending upon the acid agent chosen by your surgeon, the peel may last indefinitely or just a few years.

COLLAGEN INJECTIONS FOR WRINKLES

Injectable collagen was developed to treat certain types of wrinkles and minor skin depressions. The material can be used to fill acne and other scars on the face and to fill aging wrinkles on the forehead, cheeks and lips.

Before receiving facial injections, patients are given a skin test in the forearm to check for allergic reactions to the collagen. If the test is negative, the injections can be given.

Several separate treatments are usually necessary to fill the defect. Touch-up injections are required at three- to four-month intervals because the injected collagen is absorbed slowly. Several strengths and types of collagen are now available.

Collagen is approved by the Food and Drug Administration as safe.

MICRODERMABRASION FOR WRINKLES

Microdermabrasion is used for improving scars and fine wrinkles. Essentially, micro dermabrasion removes the top layers of skin to create a new skin surface. A rapidly rotating instrument is used to "sand" the outer layers of skin. The procedure is most often performed on the face to remove tissue damaged by acne scarring. It can also be used to remove wrinkles, scar tissue, and various skin lesions.

LASER RESURFACING FOR WRINKLES

Lasers are widely available to treat many conditions. Laser resurfacing can minimize fine wrinkles on the face, particularly those that form around the mouth and eyes. In laser resurfacing, a carbon dioxide (CO2) or erbium laser is used to remove fine wrinkles and treat facial scars or areas of uneven pigmentation. The procedure can be done on the whole face or only specific regions.

Laser resurfacing rejuvenates the skin through a beam of light energy that removes the upper layers of damaged skin. During the healing process, new cells form, producing a smoother, tighter appearance. Alternative skin resurfacing treatments include dermabrasion and chemical peels.

In general, ideal candidates for laser resurfacing are patients with facial wrinkles or fine wrinkles localized to the region of the eyes or mouth. Individuals with olive skin or those who have taken Accutane within the past 12 to 18 months are at risk for scarring. At your consultation, the surgeon will evaluate your skin and make recommendations, accordingly.

Depending on individuals needs, a pretreatment plan to prepare the skin for resurfacing may be necessary. Patients with darker skin may be treated with a bleaching cream, while other patients may require Retin-A before surgery. All patients with a history of cold sores are given antiviral medication before surgery and two to three days afterward.

Laser resurfacing is an outpatient procedure. When specific areas require resurfacing, local anesthesia with sedation can be used. For the more extensive resurfacing procedures, general anesthesia may be required. Laser resurfacing requires 15 to 90 minutes, depending on areas being treated.

If you have any questions about wrinkle treatments please feel free to schedule a consultation with Board Certified Dermatologist, Board Certified Dermatopathologist, Babar K. Rao, MD, FAAD at his Manhattan, New York or Fresno, California office.
 

Copyright © 2004, Aesthetic Cosmetic Centers, Babar K. Rao, MD, FAAD,
Board Certified Dermatologist, Board Certified Dermatopathologist, Manhattan, New York

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