David A. Hecht, M.D., P.C.
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Various Treatments of Facial Wrinkles - Facial Rejuvenation in Scottsdale Arizona

The gradual development of facial wrinkles, whether fine surface lines or deeper creases and folds, is the classic early sign of accumulated skin damage and inevitable aging. Premature aging and wrinkling of the skin may be accelerated by excessive exposure to the sun and other elements, overactive facial expression muscles, the frequent use of tobacco products, poor nutrition, or skin disorders. Fine surface wrinkles that progress to deeper creases, deepening facial expression due to repeated skin folding, and deep folds which develop with one's maturity are obvious changes which may combine to portray a less desirable appearance. Persistent facial lines, especially those involved in negative emotional expressions, may mistakenly portray to others, the look of worry, anger, anxiety, disgust or sadness, despite one's own positive internal feelings. Regardless of the cause of facial creases or folds, safe and successful treatments for reduction or elimination of these problems are now available with the help of a Facial Plastic Surgeon. Injecting or implanting substances which either temporarily weaken the muscles or act as skin volume fillers serve to soften or eliminate the appearance of wrinkles and produce a more youthful, rejuvenated appearance.

Treatments for facial wrinkles are usually performed in the office setting which is convenient, private, and safe for persons who desire therapy. Your health, in conjunction with the appropriate therapy to achieve your goals, is given full consideration by your Facial Plastic Surgeon prior to the any decision to undertake specific treatment. However, very few individual health problems would limit the use of these therapies due to their minimally-invasive methods of application. Your concerns and any medical requirements for each facial wrinkle therapy will be part of the consultation with your surgeon.

Understanding types of treatments for facial wrinkles?

Prominent forehead creases, brow furrows or eye lines (crow's feet) produced by specific facial expression muscles repeatedly creasing the skin may be effectively treated by reducing the function of specific facial muscles. Botulinum toxin (Botox) is a sterile, purified protein produced from the bacteria, Clostridium botulinum, in the laboratory. Botox injected in small amounts into facial muscles binds to the nerve endings supplying the muscle and prevents nerve impulses from traveling to the muscle. When injected into muscle, it weakens or paralyzes the muscle around the area injected for a typical period of several months. The resultant weakening or paralyzing effect on the facial muscle temporarily reduces or eliminates previous skin creasing and new skin creasing is avoided. Botox may take several days to have its effect, and the effect typically lasts 3-6 months, in most individuals, before full muscle movement returns. At that point further treatment may be elected.

Injectable collagen is an animal protein filler material formulated for safe use in nearly all areas of the face, including the lips and crow's feet. Fine wrinkles are filled in by the material to reduce their visibility. Other prominent facial creases and folds around the forehead, cheeks and chin can be treated as well with this material. Initial collagen allergy testing must be performed, and repeated treatments every 2-4 months are typically needed to sustain the desired result. The treatments are easily performed in the office and usually have minimal side effects.

Human collagen matrix, is an implant used for the reconstruction of soft tissue defects. It may be threaded beneath the deep creases of the brow or cheek folds or placed within the upper and lower lips, to flatten and reduce wrinkle visibility. Typically, this material maintains the majority of its volume correction similar to injectable collagen.

Another type of implant is a nonresorbable synthetic polymer material, ePTFE which may likewise be used in the forehead, cheek folds, and lips to produce volume enhancement and effacement of deep facial creases. This material does not incorporate into surrounding tissue, but it does not lose volume either. It provides more lasting change and may be placed during an office procedure using local anesthetic and small incisions with a relatively short recovery period.

Fat grafting creates a natural augmentation for the face, especially for the lips and mouth region. Fat is usually harvested from the abdomen and about one third of the volume remains after the treatment. Fat grafting can be repeated for additional fullness

Making the decision for a specific therapy

Expectations of any facial wrinkle therapy must be realistic. While an expectation for the complete and permanent removal of facial wrinkles for those persons considering treatment may be attractive, it is unrealistic, due to the ongoing nature of wrinkle formation and the currently available methods for treatment. The patterns and severity of facial wrinkle formation are highly individual. Therefore, after consultation with your surgeon, the appropriate therapy for your specific problems must be tailored to meet your needs. Management of many facial wrinkles may require repeated treatments or the use of combinations of treatments to achieve optimal results. The goal is to improve or reduce the appearance of the wrinkle or crease. This can be accomplished by reducing skin folding caused by underlying facial muscle action, as in botulinum toxin therapy. Alternatively, the skin beneath the wrinkle can be augmented to efface the wrinkle with injected or inserted filler material. The choice of a type of therapy depends on the location and extent of the wrinkles, the desired duration of the effects, and the tolerance for potential side effects. All of these treatments provide additional and complimentary aesthetic benefits when combined with another facial rejuvenation procedure such as facelift, browlift, blepharoplasty or skin resurfacing.

What to expect after each treatment

In comparison to typical cosmetic surgical procedures, the office time for these procedures and the subsequent recovery period until one returns to normal function are minimal. Botulinum toxin therapy typically takes a few minutes to perform, and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. Likewise, collagen or human dermal injection therapy can be accomplished with a 5-15 minute procedure with similar attendant side effects. Some mild irritation at the injection sites is unavoidable but can easily be camouflaged with standard make-up, if necessary.

Filler implant insertions typically take up to an hour to perform in the office, depending upon the number and extent of treatment locations. Several sutures are used to close the insertion site. More swelling redness, and discomfort may accompany these procedures, which require the use of a local anesthetic. Local application of cold compresses may feel comforting. Most early swelling subsides within a day or two, though minor swelling and irritation may last for several weeks during the implant healing phase. Your activity level and medication for pain after the procedure are dependent upon your doctor's recommendations.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve facial scars or contour deformities resulting from injury may be covered. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

What to expect after the surgery

Immediately following a chemical peel or dermabrasion, the surgeon may apply a dressing to your skin. Swelling and “crusting” of the skin are normal, and ointments to keep the skin supple will be applied for seven to 10 days following surgery. The redness of skin that persists after the initial healing phase will usually fade in about 4 weeks. The surgeon often recommends a soft diet, avoidance of extremes in temperature and any activity that would cause stress to healing skin. It is imperative that you follow the post-operative instructions of your surgeon to the letter. Should you experience any increase in redness or itching in the days after surgery, notify your surgeon immediately.

In one to two weeks after surgery, new skin will emerge that is pinkish, finer, and free of many wrinkles. But it will take several weeks for all the redness to vanish. Follow-up care involves using sunblock in order to protect the skin while new pigment is created. Patients will notice that the skin remains lighter for a long time after surgery, but that condition will usually subside when the skin's pigment level has been restored.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve major deformities or accidental skin injuries may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

For facial rejuvenation in Scottsdale Arizona contact this board certified facial plastic surgeon serving the Phoenix area.

Content provided by the American Academy of Facial Plastic and Reconstructive Surgery

       
  20201 N. Scottsdale Healthcare Dr., Suite 250, Scottsdale, Arizona 85255    NEW LOCATION
Phone: 480-374-2935   Fax: 480-374-2940
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