Question: I’m 57 and have crepey facial skin, upper and lower lip wrinkles that cause lipstick bleed and deep nasolabial smile lines. I tried a laser a few years ago but it didn’t help. Are there better wrinkle treatment options?

Answer: Not only is each patient different, but all wrinkles are not the same. For this reason, different wrinkle treatments exist for the different types of wrinkles.

There are 2 types of fine lines. One is crepey skin which is often due to loss of skin elasticity and can be improved with the Infini RF non-surgical facelift to tighten, lift and smooth the skin. Other lines such as those around the upper and lower lips can be improved with superficial injectable fillers such as Restylane Silk specifically formulated to fill superficial lines without development of bumps. Deeper lip wrinkles may require combination treatment with Infini RF, micro-Botox and injectable filler.

Deep smile lines like the nasolabial folds typically require a deeper filler such as Bellafill-the-5-Year filler, Restylane Refyne, Defyne or Juvederm. Such fillers can also work well for marionette lines and droopy mouth corners by using filler techniques to both fill and lift the mouth corner.

When frown lines between the brows cause depressions, a combination of Botox to relax overactive muscle activity between the brows and a deeper filler such as Bellafill to soften the depression can be very effective.

If the wrinkles are solely due to overactive muscles as with glabellar frown lines, horizontal forehead wrinkles, crows feet (laugh lines around the eyes) or lip lines that worsen with pursing, neuromodulators can be quite effective. Current FDA-approved neuromodulators include Dysport, Jeuveau, Xeomin and Botox cosmetic.

Some wrinkles are actually due to aging skin texture and require a medical skin regimen in combination with in-office treatments. Other wrinkles have deep and superficial components and may require filler layering or filler lifting techniques for optimal results.

The most suitable filler and procedure of choice for your unique types of wrinkles depends on whether the cause is loss of skin elasticity, overactive muscle activity, collagen breakdown or volume loss. Whether the wrinkles are superficial, medium or deep is also a key factor. A thorough consultation with a Board Certified Facial Plastic Surgeon who thoroughly understands facial anatomy is the first step.

 
Dr. Anita Mandal is a double Board Certified Facial Plastic Surgeon practicing since 1998. She exclusively specializes in facial rejuvenation and non-invasive body contouring. In addition to being on the medical staff at Jupiter Medical Center, her offices house both surgical and laser suites. Dr. Mandal is committed to giving her patients the most natural looking results.