SKIN PROBLEMS AND TREATMENT

5.13 WRINKLES

RESURFACING, FILLERS & BOTOX.

As age increases skin loses its elasticity & becomes loose. So wrinkles are common problem. Now a days most of the persons shows wrinkles around eyes & on the forehead after the age 20 years. Wrinkles are of two types: Static or non-movement wrinkles & dynamic or movement wrinkles: Static wrinkles are seen on the on the skin of face when expressions are not done. Movement or dynamic wrinkles are present on the face during emotional expressions and speech. Movement or dynamic wrinkles are caused by same frequent or continuous movements of expressions frequently e.g. frequent frowning, raising eye brows, excess smiling, frequent other emotional expressions. These expressions keep certain muscles under the skin active and strong. Superficial muscles of the face are attached to the skin and so we can express variety of emotions and body talk.

Treatment: Depending upon possible causative factors treatment is advised.

Static wrinkles: Skin can be tightened with Ultra-Pulse® fractional Co2 laser skin resurfacing, microneedling with R.f, Non ablative RF (radiofrequency)

(2) Depressions created by static wrinkles can be filled with fillers which are available the form of fat graft or dermal graft or readymade fillers. Fat graft is suggested in 3-4 sessions to create permanent benefit. For detail see chapter on fat graft in liposuction.

Artificial fillers Hyaluronic acid (Perlane/Restylane): When person do not want to remove fat for body contouring or filling depression then readymade filler or cross linked hyaluronic acid is used. Artificial readymade filler provide benefit which lasts from 6 months few years depending upon type of substance used. Hyaluronic acid is highly stable and very biocompatible. It is available as 'Perlane' or 'Restylane'. After applying topical anaesthesia or local anaesthesia, hyaluronic acid is injected with small needle just like insulin syringe. No skin test is required. The procedure takes fifteen to forty minutes depending on size of area. No dressings are required afterwards. One may need a touch up procedure after about two to four weeks. Results are immediately visible. Swelling and bruising may be mild or none at all. Pain is absent. No rest is required after the procedure. Result lasts up to six months. Results are appreciated in all cases. Contour and wrinkles improve. It has natural and presentable results.

Dynamic wrinkles: Botulinum toxin/Botox: Botox can reduce or disappear wrinkle for about 6 months

Dynamic wrinkles means wrinkles which appear during facial expressions. These wrinkles are due to over contraction of some muscles on the face. So to treat such wrinkles, one needs to reduce activity of some muscles on the face. Other muscles are not affected at all. Skin sensations are also not affected. Botox is safe and simple non-surgical way to minimize wrinkles which are caused by contractions of underlying facial muscles. Results last for 3-6 months. Duration of results increases on repetition. Botox is injected by micro needles. It takes few minutes. The injection shows result in 3-5 days. Do not massage after injection. It can also be used in axillary and palmer hyperhydrosis, excess sweating.

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