The fight against wrinkles is the most common reason patients seek facial cosmetic procedures. Advances in medicine have made available several new non-surgical choices for treating unwanted wrinkles. While these non-surgical, non-invasive options are particularly effective in treating early wrinkles and fine lines, deeper wrinkles and sagging skin still require a lift procedure or a combination of non-surgical and surgical procedures to get the best result.
In general wrinkles are produced by repetitive facial expressions, known as dynamic wrinkles, or by aging, sun exposure, and other external factors like cigarette smoking, called resting wrinkles. Dynamic wrinkles caused by facial movement, like the ‘crow’s feet’ around the eyes with smiling, can be treated with BOTOX® Cosmetic in St. Louis. Whereas the resting wrinkles produced by aging and the sun call for approaches different than BOTOX Cosmetic.
Wrinkles present at rest can be dealt with by a number of approaches, both non-surgical and surgical. Often a combination of approaches will give the most improvement. One approach is to smooth the raised edges of the wrinkle. Resurfacing procedures work in this manner. Another approach is to elevate the depressed part of the wrinkle by placing ‘filler’ material underneath the depressed part of the wrinkles. And finally, tightening the skin with a lift procedure can improve wrinkles dramatically. To know which options are best for you, we recommend you schedule a consultation with one of our board certified plastic surgeons. Resurfacing procedures include:
Wrinkles caused by muscle use, known as dynamic wrinkles, can benefit from BOTOX Cosmetic treatments. Wrinkles produced by aging skin and the sun do not improve with BOTOX Cosmetic treatments. Wrinkles most effectively treated include:
BOTOX Cosmetic is also used in a variety of medical conditions, including treatment of migraine and tension headache, chronic muscular pain, abnormal facial movements, tremors, and excessive sweating of the palms, soles of the feet and underarms.
BOTOX Cosmetic treatments are a temporary solution for wrinkles created by muscle contraction. A more permanent treatment can be obtained with surgical procedures that remove or partially remove the muscle that cause the wrinkle. A forehead lift is an alternative for treating the horizontal forehead wrinkles and the vertical wrinkles between the eyes. Laser resurfacing, peels, and surgery can be used to improve the crow’s feet lines. Some wrinkles are so deep that ‘filler’ may be necessary to further correct the furrow. The Alma Pixel Laser has also been shown to dramatically improve wrinkles around the eyes.
What can I expect after the BOTOX Cosmetic Injection?
There is no pain after the injection. Immediately after the procedure, you should stay upright for two or three hours and avoid rubbing the injection sites. You can continue with all of your activities the day following the injection. It takes three to five days for the effects of BOTOX Cosmetic to be visible. The full effect may not be evident for two weeks.
What is the long-term outcome for most people?
The degree of improvement varies from person to person, but the results last for three to five months. With subsequent treatments, the results tend to last longer. The treatment will need to be repeated to maintain the result. Repeat treatment is recommended in 4 months.
What are ‘fillers’?
While BOTOX Cosmetic is a popular and effective treatment for wrinkles produced by muscle activity, other deep facial lines and wrinkles caused by sun damage and aging require wrinkle fillers to correct. ‘Fillers’ are materials that are injected directly under the wrinkle or deep facial line to push the wrinkle outward, thereby, making it fuller and less noticeable.
First, there was just collagen and fat used to correct wrinkles and fine lines. However, over the past several years there has been a remarkable increase in the number of FDA approved fillers. Every filler has its own characteristics and indicated use. Some fillers last 6 months whereas other fillers are long-lasting or permanent. Schedule a consultation with one of our board certified plastics surgeons to learn which filler is best for you.
This procedure involves injecting a substance under the wrinkle or deep facial line to push the wrinkle outward, thereby, making it fuller and less noticeable. There are several fillers that are FDA approved and available for use. Some fillers work better in certain areas of the face than others. The most common fillers used currently include:
Hyaluronic Acid Gels. Over recent years, hyaluronic acid, a complex sugar already found naturally in the body, has become a favored compound for replenishing the areas of the face where the skin’s volume and fullness has been lost. In the body, hyaluronic acid fills the space between collagen and elastin fibers of the skin. The hyaluronic gels used at Genesis are biosynthetic and of non-animal origin. Since it is not created from an animal source, there is little chance of allergic reaction. The formula is highly biocompatible, and no testing is required prior to administration. The following hyaluronic acid gels are available:
JUVÉDERM® Ultra & Ultra Plus – is the latest advance in hyaluronic acid cosmetic filler technology. The main difference between JUVÉDERM Injectable Gel and other popular hyaluronic acid fillers is that JUVÉDERM has the highest concentration of hyaluronic acid, and is produced with a special formulation process that makes it smoother than that of other popular gels. JUVÉDERM’s solutions to facial wrinkles and folds are its two density formulations: Ultra for average-depth depressions/wrinkles such as nasolabial folds, forehead wrinkles, glabella lines, mild-to-moderate nasal and cheek furrows, and to plump up thin lips or Ultra Plus where deeper correction is needed; used for volume filling of cheeks, lips and deep nasolabial folds.
Restylane® & Perlane® – is a biosynthetic hyaluronic acid gel. For the treatment of wrinkles, Restylane is injected in the deep dermis in small amounts with a very fine needle. The injected gel gives natural volume under the wrinkle, which is lifted up and smoothed out. The results can be seen immediately and last 6-12 months. Perlane is a larger hyaluronic particle and used when more volume is needed.
Radiesse® – is an FDA-approved, next-generation dermal filler used for the correction of facial lines and wrinkles, such as smile lines and wrinkles on the upper lip. Made of calcium-based microspheres suspended in a water-based gel, the effects of Radiesse may last a year or more. Offering clinically proven safety and longevity, Radiesse is a convenient treatment that stimulates the body to produce new collagen — often with just one or two office visits.
Sculptra® – (poly-L-lactic acid) is a FDA approved treatment for restoration and/or correction of the signs of facial fat loss. Facial fat loss, or lipoatrophy, is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. Sculptra is a safe, synthetic, and biocompatible material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas. No skin testing is required.
Fat (Your own) – your own fat is the safest, longest-lasting filler available. Fat from your abdomen, thigh, or buttocks is injected into areas on the face to correct volume loss. Fat grafting is commonly used to enhance facial shape, add fullness to the lips, correct smile lines and sunken cheeks.
How is a Wrinkle Filler procedure performed?
Wrinkle correction treatments are performed in the office. Routinely, a prescribed cream can is applied to the skin 45 minutes before to numb the skin. Local anesthesia is then injected to completely anesthetize the area being treated. Using a very thin needle and syringe, small amounts of filler are injected in the desired wrinkles. Results can be seen immediately.
What can I expect after Wrinkle Correction?
Immediately after the treatment, we recommend you apply a cold pack to the treated area. There is no pain after the injection. You can expect slight redness and swelling. Light bruising happens occasionally. To reduce the chance of bruising, we have patients stop aspirin and ibuprofen prior to the procedure. We recommend the use of supplements that have been showed to minimize bruising and swelling. Any discomfort is minor and temporary and generally disappears within a few days. Initially, the filler material may feel firm under the tissues. This resolves within 2 weeks and the area becomes softer like your normal skin, but with the wrinkle gone or improved.
What is the long-term outcome for most people?
The length of time of wrinkle correction varies depending upon the filler used and the severity of the wrinkle. For the most severe wrinkles, surgery is necessary to get the best and longest-lasting improvement.