Non-Invasive Procedures To Treat Facial Aging
There are three main signs of aging in the face: the development of lines and
wrinkles, sagging and relaxation of the tissues of the face, and changes in the
quality of the skin (increased pore size, increased thickness, pigmentary
changes, flaking, etc.).
We can pull on the skin as in a rhytidectomy; we can correct the muscles causing
the wrinkle if it is a dynamic wrinkle, or we can fill up the groove, thereby
making the wrinkle disappear.
If the forces causing the wrinkles are due to underlying muscle contraction,
then paralysis or weakening of that muscle results in fading or lessening of the
wrinkle. This can be accomplished by Botox injections.
Botox is produced from the fermentation of a strain of bacteria. It works by
blocking the release of acethylcholine from the end of the nerve which is the
chemical released from the nerve to produce muscle contraction. Botox is very
successful in the glabellar area (frown lines between the eyebrows) in crow’s
feet area; sometimes in the forehead. Botox is occasionally used for neck bands
and for the corners of the mouth.
If the wrinkle is not entirely due to muscle contraction, or if complete
paralysis of the underlying muscle(s) is contraindicated, a variety of
substances can be used to fill the wrinkle. The materials used for filling
wrinkles can include human collagen (injection or sheets) or synthetic
substances. Some are manufactured substances similar to tissues normally present
in the body (Restylane, Radiance) some are substances that are completely
foreign to the human body (Silicone, Acrylic beads).
As the skin loses volume and wrinkles start to appear due to the loss of the
ability to produce enough of a naturally occurring substance called hyaluronic
acid (HA) we can replace that substance with Restylane which is made of
molecules of the same chemical attached together (polymerized)
The treatments are quick and easy and they are cost effective. Allergy testing
is not required and the side-effects are minimal. Restylane is a clear
non-animal biodegradable hyaluronic acid gel (HA) with an excellent safety
profile. The gel is injected into the skin with a very fine needle to minimize
discomfort. The effect of Restylane generally lasts about six months, but this
varies depending on the area injected. It will last longest in an area which has
very little motion and little circulation.
Another option for tissue replacement is Radiance, made of calcium
hydroxyapatite, a molecule found in bone and coral, the particles are small
enough to be injected. I reserve the use of Radiance to defects over bony areas
and the naso-labial folds.
Although one may want filler that will be permanent in nature, the disadvantage
of such filler is that, if any irregularity were to occur, it would be very
difficult to correct. Any long- lasting filler will induce scar tissue formation
and the amount of scar tissue and the quality of the scar tissue will vary
according to the patient and, therefore, is not a controllable variable. The
other advantage of using non permanent filler is that, since the aging will vary
over time and over the areas of the face, adjustments are possible with
subsequent treatments as the changes of aging are occurring.
If the changes are mainly in the form of pigmentary changes and in the quality
of the skin I recommend the Nu-Derm program.It will replenish the collagen,
correct the pigmentation and get rid of the pre-malignant cells. Nu-Derm is a
series of products applied by the patient morning and evening and adjustments
with regards to individual needs are made. It is useful in the treatment as well
as maintenance for healthy skin.