In looking into treatment options for the improvement of facial wrinkles the most important thing to realize is that some wrinkling is going to stay. Wrinkles are areas of weakening in the skin and show areas where skin may fold over itself. Understanding how a particular wrinkle is created helps the doctor assemble a treatment program to minimize it. Improvement here depends upon a multi-faceted approach. Often combinations of the below methods are much more effective than any one alone. There are things the patient herself can do to start us here too.

Wrinkling and Aging - Get Rid of the Bad Stuff

Current studies indicate that cigarette smoking and sun exposure contribute enormously to the development of the signs of aging including facial wrinkling. Eliminating these as much as possible almost always improves skin texture and wrinkling. Patients that smoke often have much decreased success with cosmetic treatments relative to their non-smoking counterparts.

To help decrease wrinkling and the other signs of previous smoking and sun exposure, we will start with the simple and move toward the surgical.

Home Skin Care

Starting a regular regimen of skin care just like eliminating smoking makes a difference. It can also make improvements achieved through additional care last longer and get you farther. Most patients benefit from Retin A or another topical retinoid. These do not have to be used daily to offer benefit. Sometimes every other or third day is enough.

Office Skin Care - Facial Peels

The next thing "up the ladder" is Facial Peeling. Facial chemical peels are reliable and tend to be less expensive than light treatments like Fraxel. Each of these methods has different Pros and Cons. Contrary to popular belief, lasers are not always the best thing to do. They are amongst the most expensive things. Look for a doctor honest enough to offer you what you need and not what makes him the most $$$$. Light and Light Medium Chemical peels can be performed in the office. Deeper peeling requires anesthesia and an operating room.

Office Skin Care - Injectable Fillers

Soft Tissue Fillers work by "pumping up" the tissue to decrease the prominence of some wrinkles. They help compensate for the natural tendency over the years for tissues in the face to atrophy. Lips are commonly treated. The original fillers were fat. No filler has been found to last very long. The safest fillers are the newer hyaluronic acid compounds (Restylane, Captique, Juvederm, Prevelle and Hylaform). They do not have the allergy problem that was seen often with Collagen. They dissolve in 2-4 months in the average patient.

Office Skin Care - Botulinum toxin

Botulinum toxin (Botox, Myobloc) is an often-sensationalized injectable compound that partially paralyzes some of the muscles in the face that cause wrinkling. Certain facial muscles are better treated than others such as those of the base of the nose (to decrease the "Look of Consternation") and the "Crow's Feet." Botox cannot eliminate facial wrinkles altogether and only lasts a few months in the average patient. Overuse can make people look pretty strange. Conservative use is best.

"When We Need To Go To The Operating Room"

Patients with more than fine wrinkling of the face sometimes benefit from Full Face Laser Re-surfacing. Redundancy of skin and fatty tissues can also make Facelift surgery beneficial. Facelifts are a group of operations in which different procedures can improve different features.

The key is that there are a many treatments that can be performed dependent upon that which you actually seek to correct. Some treatments work better for some areas than others. Focusing upon that which you want to correct is important in helping choose the methods best for your case.