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Concern: Wrinkles

Procedures:

Fillers (Juvederm, Restylane, Radiesse, Sculptra) , Neuromodulators (Botox, Dysport) , Face lift , Mini Lift , Intense Pulsed Light (IPL) , Skin Care , Laser Skin Rejuvenation

Ages:

20's , 30's , 40's , 50's , 60's+

HA Fillers (Juvederm, Restylane)

Author: Min Ahn

Fillers (Juvederm, Restylane, Radiesse, Sculptra)

Since the introduction of bovine collagen for treating wrinkles, significant advances have been made with soft tissue fillers. Currently the most popular fillers in the United States for skin creases and volume deficient areas are the hyaluronic acid fillers (HA). The two most popular of such fillers are Juvéderm® Ultra and Restylane®. Both fillers have the advantages of being well tolerated by the body, long lasting and natural appearing.


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Radiesse

Author: Min Ahn

Fillers (Juvederm, Restylane, Radiesse, Sculptra)
Radiesse is long lasting soft tissue filler that is a popular choice for facial volumizing treatments. It is FDA approved for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds (laugh lines). Radiesse is composed of Calcium hydroxylapatite microspheres suspended in a gel carrier and high purity water. When Radiesse is injected into tissue it provides an immediate 1:1 level of correction. Over the course of 3-6 months, the gel carrier is degraded and the remaining Radiesse particles act as a scaffold for new collagen formation. This process is thought to account for extended, “semi-permanent” correction.

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Botox- Cosmetic

Author: Min Ahn

Neuromodulators (Botox, Dysport)
In 1987, Dr. Jean Carruthers, a Vancouver oculoplastic surgeon, discovered that she could inject botulinum toxin A into muscles around the eye and temporarily smooth out wrinkles. Four years later, she and her husband Dr. Alastair Carruthers, a dermatologist, published their findings. This report launched what would become the most commonly performed aesthetic treatment.

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Fractional Laser- Ablative

Author: Jay Burns, MD FACS

Laser Skin Rejuvenation
Fractional resurfacing was introduced in 2004 and has become widely popular in the last few years.  The technology stands as a radically different approach from classic standard laser resurfacing which removes the entire upper layer of skin one layer at a time. 

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Face lift

Author: Patrick Byrne, MD FACS

Face lift
A face lift is a procedure which lifts sagging tissues of the lower face and neck. It is a procedure that has been present for decades, and is constantly evolving and improving. The contemporary techniques focus on elevation of the deeper tissues of the face and neck, rather than simply pulling the skin tightly. Thus the results tend to be not only more natural appearing, but also longer lasting. Most patients appear more youthful and rested. This discussion will provide you with the important information you need to understand face lifting procedures.

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Mini Lift

Author: Min Ahn

Mini Lift
The mini lift is a surgical procedure that improves the appearance of the lower face and upper neck. This procedure has recently become more popular because it is less invasive than a traditional face lift, yet has comparable results. Advantages of the mini-lift include shorter, less noticeable incisions, quicker recovery and less chance for complications such as noticeable scars or hairline irregularities. More importantly, the mini lift can look less “plastic” or “pulled” as compared to the traditional facelift.  Most patients prefer results that make one look “refreshed” or “rejuvenated” as opposed to appearing “done”.

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Intense Pulsed Light (IPL)

Author: Joely Kaufman, MD FAAD

Intense Pulsed Light (IPL)
IPL, or intense pulsed light, was introduced to the aesthetic market in the mid 1990’s. IPL is also sometimes referred to as a ‘photofacial’. Though an IPL may look, sound and feel like a laser, it is not classified as a true “laser”. IPL is not a true laser because it uses multiple wavelengths of light, whereas lasers use only one wavelength of light. Just because it is not a true laser, does not mean that IPL is any less effective or less complicated of a treatment. Multiple wavelengths of light can actually be an advantage when used by an experienced operator. Some wavelengths of light are more effective for treating pigmentation, while other wavelengths are better for treating blood vessels or redness. Using an IPL with various wavelengths can allow for treatment of multiple conditions in one session. Even though an IPL is not a laser, it is still important to know who is performing your procedure.

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Skin Care (Cosmeceuticals)

Author: Joely Kaufman, MD FAAD

Skin Care
Aging is an inevitable process that occurs in every cell in every organ in every living thing. Our skin also participates in this process. Recently more focus has been given to methods of aging prevention. Many of these involve procedures that are performed in the doctor’s office, but there are also ways to prevent aging that you can do at home. In the future we will see more products directed to at home users, including peels, topicals and even at home laser systems.

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Dysport

Author: Patrick Byrne, MD FACS

Neuromodulators (Botox, Dysport)
Dysport is an injectable drug used to lesson wrinkles on the face. It is made of botulinum toxin type A.  Dysport can reduce the appearance of lines and wrinkles by constricting the movement of muscles that it is injected into. It is the same active agent as Botox, a very popular wrinkle reducer. Dysport was approved for use in the United States in 2009.

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Fractional Laser- Non Ablative

Author: Joely Kaufman, MD FAAD

Laser Skin Rejuvenation
Since the advent of fractional resurfacing in 2004, the popularity of laser resurfacing has increased dramatically. Classical laser resurfacing, used in the past, involved removing the top layers of the skin (the epidermis and parts of the dermis) in the same treatment. These lasers included the Carbon dioxide (CO2) and erbium yag (Er:Yag) devices. The entire surface area of the skin was treated with each session of classical resurfacing, requiring weeks to heal and sometimes even longer. Many patients had residual redness of the skin that could persist for months. Late complications of these classical procedures also included discoloration of the treated skin, including lightening or darkening from the normal skin color. The results of these classical laser resurfacing procedures could be incredibly positive, with tightening of the skin and a major improvement in wrinkles, but the procedure was often fraught with complications. Because of these side effects, many physicians opted not to perform these procedures in their office and the search for a safer way to treat wrinkles began.

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Laser Skin Therapy- Traditional

Author: Jay Burns, MD FACS

Laser Skin Rejuvenation
Laser resurfacing took the cosmetic world by storm in the mid 90’s with the invention of carbon dioxide (CO2) laser resurfacing.  This treatment involved removing the entire superficial skin layer all at once and is commonly referred to as an ablative (taking away or removing) skin treatment. It significantly improved wrinkles and tightened skin.  In 2000 the Erbium laser was introduced as an alternative ablative laser treatment. Both standard CO2 and Erbium laser resurfacing remain the most effective treatment for significant wrinkles caused by sun damage.

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Sculptra

Author: David W. Kim, MD FACS

Fillers (Juvederm, Restylane, Radiesse, Sculptra)
Commercially available fillers have seen recent increased popularity.  These office based treatments improve the appearance of unwanted wrinkles, folds, and areas of hollowing or deflation in the face.  The most commonly used fillers come in a paste or gel form and are introduced to the desired location under the skin surface through needle injection.   Collagen, hyaluronic acid, or hydroxyapatite are types of fillers available on the market.  These substances, which also naturally exist in the body, create a beneficial effect by direct addition of volume into specific areas.  A disadvantage of these products is the fact that they are reabsorbed by the body within 6-18 months after placement.  Although there are some non-absorbable, permanent products used, these have not gained the popularity of the absorbable fillers, likely due to concerns about the potential for long term or permanent complications.

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