Ask an Expert – Non-surgical Removal of Facial Wrinkles

Q: I would like to get rid of facial wrinkles without undergoing surgery. What are my options?

Dr. Juliet Porch, Plastic Surgeon, gives her answer…

Although facial aging is associated with the development of wrinkles in the skin, the process is actually more than skin-deep. Lines and folds on the face can occur due to the loss of structural support in the lips, cheeks, and around the eyes, as well as due to the repeated action of the muscles of facial expression, which gradually overwhelms the skin’s elasticity.

A group of medications commonly referred to as “injectables” aims to address these underlying causes without surgery. Botox works by relaxing the muscles that create frown lines and creases. Soft-tissue fillers are used to augment or replace underlying facial volume.

These office-based nonsurgical procedures for facial rejuvenation have become quite popular over the past several years. According to the latest statistics from the American Society of Plastic Surgeons, Botox injection was the most commonly performed nonsurgical procedure in the United States in 2013, with over 6 million injections performed. Soft-tissue fillers were second in line, with 2.2 million injections performed. Why has there been such an increase in popularity for these procedures?

Tailored to the individual

Nonsurgical procedures are usually performed as part of a treatment plan tailored to the individual, taking into account the person’s goals, anatomy, prior treatments, and general aging process. The spectrum of injectable treatments available today enables the physician to provide truly customized therapy with the goal of rejuvenation, rather than simple wrinkle correction.

Suited to a full schedule

It may be challenging to set aside time for surgery and recuperation from a surgical procedure, especially when considering work schedules, family obligations, and vacation plans. Nonsurgical procedures involving Botox and soft tissue fillers can be scheduled conveniently as an office visit, with results apparent within a few days of the procedure.

Pro-active

Early treatment with Botox may prevent expression and frown lines from forming in the first place. To varying extents, soft-tissue fillers not only replace volume loss but also stimulate collagen formation. These findings suggest that injectables may actually slow down the process of facial aging.

A way to test the waters

Injectables are temporary in their effect and represent a good way to evaluate a change in appearance before committing to it with surgery. Furthermore, these products are based on substances that the body produces naturally, so there is minimal risk of adverse reaction. Of course, you should always do your homework, and make sure to insist on the 3 P’s: that the product, the practitioner, and the place where you do the procedure are all of the highest quality. Ultimately, these factors are critical in achieving a great outcome.

First line of defense

Sun exposure is recognized to be a significant contributor to skin aging. There is growing concern, of particular relevance to urban residents in China, that air pollution may contribute to skin damage. Along with sun protection and a skin care regimen that includes a prescription retinoid cream such as Retin-A, nonsurgical rejuvenation represents a first line of treatment for age-related changes of the face.

Reference:

Carruthers, Jean, et al. “Advances in Facial Rejuvenation: Botulinum Toxin Type A, Hyaluronic Acid Dermal Fillers, and Cobination Therapies – Consensus Recommendations. Plastic & Reconstructive Surgery.May 2008; Vol 121 Issue 5: pp 5S-30S.