Wrinkles

Wrinkles, also known as rhytids are the unwanted result of the ageing process. They may be classified as static or dynamic and contribute to an aged appearance most on the forehead, around the eyes (periocular), the mouth (perioral) as well as the neck, decolletage and back of the hands. A complex interplay of age, gravity, facial expressions and muscle tension, genetic predisposition and skin phototype all play a role in determining the location and severity of wrinkles. The inevitable progression of this interplay may be slowed down with a healthy diet, exercise and not smoking. Moisturising creams containing sorbolene, glycerin and ceramides also help, together with adequate sun protection using clothing and broad-spectrum UVA UVB and SPF 50 sunscreens. Sunscreens containing nicotinamide have been shown to confer additional benefits against ultraviolet radiation. Multifactorial concerns such as rhytids require a blended integrated approach. A range of treatment options are available here at Main Street depending on the type of wrinkle and its location. Each individual face is different and individual results vary.

For dynamic wrinkles in the upper third of the face, including the forehead, glabella and periocular regions, botulinum toxin (and its variants) has been shown to be particularly effective, though it is temporary and treatment needs to take place every 3 months to maintain results. The procedure is very well tolerated with minimal transient side effects including bruising and asymmetry and more rarely, lid ptosis (levator palpebrae superioris) and oral commissural ptosis (zygomaticus major). Static lines in the upper face respond best to deep intradermal rejuvenation with superficial laser resurfacing technologies.

Lines involving the mid face are typically more static in nature and include wrinkles over the pre septal and pretarsal lower lid, the nasojugal groove, the melolabial fold and fine rhytids over the medial and lateral cheek. An integrated approach is recommended here, employing a combination of subdermal volume restoration with hyaluronic acid (HA) products, deep intradermal rejuvenation as well as non ablative fractional laser resurfacing.

Lines involving the lower face include the melomental fold, the labiomental sulcus and superficial peri-oral rhytids. Subdermal fillers are not as effective in this region of the face as elsewhere, due to movements of the mouth displacing products from there intended location. For these areas a combination of deep intradermal rejuvenation and superficial resurfacing laser options are ideal. Smokers are advised to quit smoking (always).