All about facial wrinkles and their treatment

Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)

Dr. Gavin Chan

Templestowe Lower and Berwick Clinics

Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
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What causes facial wrinkles?

Facial wrinkles are caused by a number of factors;

UV exposure- Chronic UV exposure is the most common cause of premature skin wrinkling. Besides being the cause of skin cancers and skin pigmentation UV radiation causes premature ageing by thinning the epidermis (the top layer of skin) as well as causing breakdown of collagen. A good sunscreen is an imperative in the prevention of premature ageing.

Expression lines – these are wrinkles that are caused by contraction of the muscles of facial expression. This leads to the compression of skin that results in wrinkle formation. Initially, these wrinkles can only be seen when the muscles contract e.g when you smile/frown, however, as the skin becomes progressively creased, the lines may often appear at rest. Anti-wrinkle injections can help reduce expression lines.

Loss of facial volume – When we are younger, our face is more plump and full like a grape, and as time passes, this volume is lost making it more like a sultana. Fat around the eyes, cheeks, and forehead are depleted. This loss of volume leads to some laxity of skin and the formation of wrinkles. Loss of facial volume also results in an older, more gaunt appearance. Non-surgical facial reshaping with dermal fillers can help to replace this lost volume – improving both wrinkles and the overall youthfulness of the face.

Gravity – the inescapable pull of gravity draws the skin downwards on the face. This leads to drooping of the cheeks and formation of nasolabial lines (the lines from the corners of the mouth to the nose) and jowls, drooping of the eye skin and formation of upper and lower lid laxity and wrinkles.

Sleep lines – this is caused by the compression of the skin from contact of the pillow to the face when sleeping. Their location is determined by the underlying anatomical attachments of the superficial musculoaponeurotic system (SMAS). Pillow contact puts pressure on these attachments and causes sleep lines. Sleep lines include those on the forehead, around the eyes, cheeks and upper lip.


How can wrinkles be treated?

Firstly, wrinkles can be prevented by using a good sunscreen. By protecting against UV radiation, it is possible to reduce further premature damage to the skin.

Expression lines are generally treated with anti-wrinkle injections that relax the muscles causing the compression of the skin . This is most commonly performed in the muscles between the brows and around the eyes. Anti-wrinkle injections generally last for 3 to 4 months. By stopping the movement/expressions that cause wrinkles, anti-wrinkle injections can also prevent static lines from becoming deeper by stopping the compression of skin. If static lines or lines at rest  are already present, then anti-wrinkle injections generally do not reverse these. However, the application of anti-wrinkle injections at regular intervals gives the skin a rest from compression, and often static wrinkles may improve slightly over time.

The other cause of wrinkles is facial volume loss. An analogy to this is when we are young, our faces are full , like a grape. As we get older, our faces lose volume and form wrinkles, more like a sultana. Replacing this volume is an effective means of reducing wrinkles and revolumising the face.  Dermal fillers add volume to the area that has lost volume due to expression formation, gravity, sleep or just aging. Mostly, dermal fillers are temporary in their effect and last from 4 to 24 months. Also, by strategically adding volume to certain areas of the face such as the cheeks, under eye hollows (tear troughs), lips, and brows, it is possible to rejuvenate or shape the face non-surgically.

For wrinkles caused by skin laxity and droop, a surgical lift may be required e.g facelift, brow lift, or blepharoplasty (eyelid reduction surgery).

Wrinkles that are etched into the skin and skin textural irregularities can be treated with skin resurfacing. This can be done with lasers such as the Lumenis Ultrapulse fractional carbon dioxide laser,  chemical peels. Laser resurfacing techniques, although effective, often require a period of downtime or recovery.

For more information and a comparison between the various skin resurfacing techniques, click here.

For estimate volumes and costs of anti-wrinkle and/or dermal filler treatments please visit the Cosmetic consultation and treatments pricing page.

The doctors at Victorian Cosmetic Institute are specialised in the area of non-surgical rejuvenation of the skin. We will listen to your concerns and help you to decide what treatments best suit you by considering your goals and the amount of downtime or recovery that can be tolerated. We will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.

Dr. Gavin Chan
Dr. Gavin Chan

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