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Do you ever look into the mirror and think "NOOOOOO! I REFUSE TO LET ANOTHER
WRINKLE APPEAR ON MY FACE!?!" Okay, well maybe not like that, rather "I wish I
didn't have a few of these lines around my eyes or forehead"? Ladies and Gents, face
it, we age and we are going to continue to age until the scientists get on the ball and
create a miracle pill. But, we CAN do it gracefully and prolong the process as well.
They're a quite a few additional wrinkle removing techniques out there. Here
are some facts and my views on the subject:
What
Are Wrinkles & Why Do We Get Them?
Wrinkles (rhytids)
are caused from the break down of your underlying collagen and elastin fibers.
I
don't care what anyone says, you keep making a face: frown, smile, squint, sneer
-- you will eventually develop creases and lines where your skin
"olds repeatedly. Please look at the below diagram to understand
what the skin structure is.
Please
Click Here For a Cross-Section Diagram of the Skin
*loads
in a new window for cross referencing convenience*
These
fissures being to show their ugly heads around 27 years of age, but in some
individuals they may show up in the teens. It depends upon your facial habits, your skin care regimen and your genetics.
They may be fine
lines, deep folds or jagged ravines. All the same though, they aren't welcome
by many of us.
Over
The Counter Lotions, Creams & Potions (OTC)
These are less expensive, easy to get and the first course of therapy people
usually go for. Most wrinkles are because of collagen and elastin break down due
to simple aging or Photo damage. If you would like to learn how to care for your
skin properly please visit the Skin
Care Page. Here are the available products by category and sometimes by
name. For more product reviews, visit the Product
Review Page.
Retinol:
Considered a Cosmetic, these products are available OTC. This are low level
Retin A (Tretinoin) creams. Some brands that I like (in order of favoritism)
are: L'Oreal Line Eraser, RoC and Neutrogena Healthy Skin. Patients who have
trouble with Renova and Retin A can use these with less if any irritation.
Hydroxy Acid Peels
I have had a few of these and I consider the ones you can get at an
esthetician/aesthetician/ facialist to be rather mild. Of
course you may visit a dermatologist and they have access to strengths that are much more
penetrating -- we will cover these as well. These cause a reaction in your skin that makes you peel
a few days later on your own. They increase cell turnover rate and thicken the
dermis as well as correct hyperpigmentation or texture problems. Of course the
amount of improvement depends on the strength or number of treatments you have.
The ones that you can get in a spa by a facialist are not
that strong.
Normally, my esthetician charges just $5.US extra for a glycolic treatment on top of her
normal $65.US fee for a European facial. If you aren't accustomed to it or don't know what
to expect, I think 'sting' would be too harsh a word, rather it is irritating.
*Ladies: I don't recommend any type of glycolic
or similar treatment when you are nearing your menstrual cycle, your skin tends to be more sensitive
around these times and you will be climbing the walls.)
Alpha Hydroxy Acids (AHA):
Water soluble, these products such as 8% Glycolic acid cream can help remove
hyperpigmentations and help with photo damage, thickening of the dermal collagen
and increase cellular turnover. It shows the same type of improvements in other
treatments but offer no neoangiogenesis (blood vessel formation) so that
telangiectasias are not increased or inflamed. Includes Lactic Acids. Higher
concentrations work better, of course. Low PH causes irritation, irritation
represents stimulus BUT one needs to change strengths. You must determine if
your physician knows the difference about high concentration, high free acid
concentration and low ph -- irritation is symptomatic of it working. Although
extreme irritation should be avoided.
BetaHydroxy Acids (BHA):
(Salicylic Acids most common); lipid soluble. It is an exfoliant, an anti-inflammatory
(acetylsalicylic acid - aspirin family), a comedolytic (de-clogging agent
for pores). It is in many products. There are BHAs in Oil of Olay's Age Defying
Series, Pond's Prevent/Correct Neutrogena has products with BHA's and are
recommend by Dermatologists.
Combination Hydroxy Acids (CHA):
Equal concentrations of AHA and BHA. These are not recommended as mixing of the
two different pH's cause the delivery of only one product at the right pH and
the other at a lesser strength. This is a marketing ploy -- don't fall for it.
Triple Hydroxy Acids (THA):
Lactic, malic citric, glycolic acids, usually has three of the aforementioned
acids. It is another marketing ploy. Another not to fall for.
Topical
Vitamin C:
(Ascorbyl Palmitate) First it was thought that the molecules were not small enough to penetrate but
it DOES penetrate, but very irregular and unstable. Different sizes do not work
on different people. Many arguments have
arisen due to this fact and quite frankly some molecules work differently in you
or I. Yet, how do we know? The benefits of a correctly absorbed molecule can
stay in the tissues for up to 3 days and is considered an anti-oxidant and
benefits the skin my seeking out and destroying free radicals. Unfortunately you
may have to go through hundreds of dollars to figure out which works for you.
Topical Vitamin E:
(Tocopheryl Acetate) Considered an antioxidant and has anti cancer and anti sunburn properties but
can cause contact dermatitis and possible worsened scar healing. Just went against everything
you thought, huh?
Topical Vitamin A:
(Retinyl Palmitate) Such as Retinol Products but specifically Vitamin A in OTC
creams/lotions such as, well just about every night cream. One such product is a
product I use but not for its Vitamin A content but more for its Niacin/Niacinamide
-- BeautyControl SPA Organic Enzyme Masque with Niacin and Niacinamide (which
dilates your superficial capillaries) to bring oxygen rich blood to the surface
of the skin. You will appear flushed after use of a Niacinamide/Niacin
containing product. This particular product contains Retinyl Palmitate as well
as papaya and pineapple enzymes and pineapple-derived Bromelain.
Niacin/Niacinamides/Niacinamates:
As I said, I use products with these
additives to flush my facial skin. These products deliver increased oxygen to the
skin, increase circulation and help transport toxins from the epidermis. I find
that I break out less with use of this masque. Although sensitive skins beware
it can irritate and sometimes make your skin feel itchy in addition to the
normal sensation of heat due to the flushing. Niacinamides are making their way to
Dermatologists office more now.
Enzymes:
The enzymes (protein complexes) dissolve the horny layer (stratum corneum) They
are not an irritating product and only digest the dead skin layer. They stimulate cell turnover and allow other products to penetrate better into the
skin. Papaya and Pineapple are the most common. They are unfortunately unstable
and can't be kept fresh for long.
Prescription
or Physician Supplied Lotions, Creams & Potions
Please see our Physician's
Skincare Section for more information. This section is entirely too
large to place here.
Facial
Exercises:
Also known as
isometric exercise programs, I too have fallen for it at one point. Ah, what the desperate will do... I did this for a whole month (which isn't long until you
find out what it CAN do for you -- which is make matters worse). After this I realized that
my face gets enough 'exercise' through the my daily expressions -- too much exercise as I
am getting expression lines. In fact, I believe and have found comments on the web that
this will actually worsen the appearance of lines. Think about it...You basically hold
down areas of skin and use your facial muscles to pull against the resistance, thereby
stretching your already weakening underlying collagen structure (which is actually what
gives your skin its springy, line-free, youthful appearance to begin with).
Unfortunately some people are sold after they notice their face may seem a
little more raised but notice how your muscles seem a little more pumped after exercising them or lifting weights -- same concept but
on a smaller scale. The muscles may be engorged with blood due to exertion.
Update 10/05/00:
I am presently trying these exercises again. I will give it another fair chance as I am presently bothered by a
newly formed pudge of whatever-it-is under my chin.
Update 01/30/02:
Long time to update huh? *sorry* I did a few of these for a long time and
DID notice tautness after the first few weeks but I am not sure of the long term
effects. Just be sure you aren't creasing your skin excessively. You don't
want static wrinkles.
But here are some links
so that you may try it out for yourself, afterall it is far less
expensive than Cosmetic Surgery, isn't it? Maybe you want to try all of your
options before choosing to go under the knife -- I don't blame you.
Cost: Free once you learn the
techniques.
Electronic Muscle
Stimulators (EMS)
I don't quite
know if I believe in this either but hey! this site isn't about what I think
(well not too much anyhow) it's about providing you unbiased information -- so here is some info...
(I have several friends who SWEAR by these). However, damage CAN happen --
caveat emptor.
Although I must say that I used EMS for the first year of my
physical therapy on my back -- it feels really weird but good. It makes your
muscle contract and is supposed to maintain your muscle strength during down
time. I was down for a VERY long time. It was also great for loosening my
muscles before I was adjusted or before I did my physical therapy exercises.
I
wanted one to take home but they are expensive.
Cost: from $30. to $200. to several thousand.
Caution: Nerve damage
is possible from overuse or too high of a setting.
Implants
For Wrinkles
Gore-Tex Implants: Gore-Tex is pretty
well-rounded isn't it? Combat Boots, lip augmentation, raincoats and wrinkle 'removal'.
The deep lines that form from the mouth to the chin, called marionette
lines. Or the lines that run from the nose to the mouth corners, in the Maxillofacial area, sometimes
referred to as the Nasolabial folds or lines can be implanted with very small strips or
strands of Gore S.A.M. (Gore-Tex). The implant used is GORE S.A.M. (Gore Subcutaneous
Augmentation Material) is made from a material called (ePTFE) expanded
polytetrafluoro-ethylene. There are several types: a white flat or tubular
type of rubbery material or comes in
smaller, solid tubular strands. Usually the tubes are used. It is a non-reactive, nontoxic polymer that has been used in
medical implants throughout the body without ill-effects. (ePTFE) has been shown NOT to be
rejected by the body. There are approximately 4 million (ePTFE) implants, in all forms, to
date. The Gore-Tex implant is porous therefore allowing the body's tissue to attach itself
to the implant. It is extremely strong and is not likely to tear or disintegrate.
The implants are meant to and can puff out the lines and viola!
no more wrinkles. Gore-Tex is normally reserved for the larger of the wrinkles such as the
Nasolabial folds. I suggest having your doctor use the GoreTex strings for
facial applications. These implants are more rounded and smaller, more can be used
as a build up and not necessarily limited to 2 to 3 sizes for soft tissue augmentation.
Unfortunately, if not placed well or in thin skinned people -- the Gore-Tex is
palpable (easily seen or felt) especially when the face is animated.
Allergy test: N/A
Longevity: Permanent,
yet reversible (otherwise known as semi-permanent)
Cost: $2,000.US.
But, it may vary from state to state - region to region. Some less, some more.
Lip implants are anywhere from $900.US to $4,500.US.
Softform Implants: Softform is another
choice for this type of procedure. The Softform implant is made from
the same material as Gore-Tex called (ePTFE) expanded tubular
polytetrafluoro-ethylene. Softform hollow and there for not as hard. However, it is
made from the same material and has about the same technique with slightly less
augmentation results. Unfortunately, if not
placed well or in thin skinned people -- the Softform implant is palpable (easily
seen or felt) especially when the face is animated.
Allergy Test: N/A
Longevity: permanent,
yet reversible
Cost: About
$1,000 a lip plus operating room fees, if applicable.
AlloDerm:
(technically:
Acellular cadaveric dermis) Go into the doc's office saying that one! It is
basically donor tissue (cadaver tissue obtained at the time of death). The Tissue Banks
surgically remove a thin layer of skin tissue (an allograft) from the 'donor', place into
an antibiotic solution and transport it to Lifecell
Corp. There, the allograft is 'processed'
by removing the epidermis and all of the cells in the dermis which may cause rejection.
The resulting AlloDerm graft is the protein framework without any human cells. Supposedly,
there is absolutely no way whatsoever to contract any disease or virus from this product.
They do extensive testing and bloodwork on the donors and they even remove DNA (how can
they pull off this trick?). The remaining material is a collagen framework.
There are none
of the donor's components to cause rejection by a recipient's body and there have been no
case reports of ANYONE contacting any disease, not even AIDS, from an AlloDerm graft.
The
donor beforehand, had been tested with FDA licensed tests ruling out AIDS, Hepatitis B
& C, HIV types 1 & 2 and syphilis. After that it is individually checked under a
microscope to insure the safety of a disease free graft. It is used in burn victims,
surgeries and periodontal disease. But, this too, gets absorbed eventually.
The AlloDerm
comes in freezedried sheets and pieces approximate to the size needed are rehydrated in a
sterile solution. After full rehydration the AlloDerm is inserted or "draped"
where needed.
Now, unlike the Gore-Tex which can be removed. AlloDerm,
essentially, cannot be. At least it would be a difficult task. It is softer inside the
lips and the tissue basically becomes 'your own'. So, if you don't mind having cadaver
skin inside your lips maybe this will work for you. I have been told that it can last up
to 2 years, maybe a little over one year, depending upon your body.
Additionally, AlloDerm can be used to augment other areas of the
body that have been subjected to tissue loss or deterioration, i.e. draping
for burn injuries & cancer excisions as well as an implant under the surface of the
skin to correct soft tissue defects. When applied as a surface skin, an extremely thin
allograft of the patient's own skin is placed on top to provide the amount of tissue
needed.
Very small slivers are excised and implanted by using jeweler's
forceps and a needle, "under" the wrinkle. It is performed on a microscopic
level. The use of AlloDerm for wrinkles is not very widespread but is becoming more
popular.
Allergy
Test: Not
necessary.
Cost: approximately
$1,200 per area.
Longevity:
reported to last 12 - 24 months - average. (possibly indefinitely) although one
of our researchers had her nasolabials augmented with AlloDerm and it lasted
under a year. It is essentially a scaffold so it depends upon YOUR
collagenation of the scaffold for permanency.
Threading (not to be confused with
"Aptos Threads"):
This sounds 'hokey' to me. The doctor actually threads suture material (there are many sizes for different
applications) just under the skin, thereby eliminating the wrinkle. Your own
collagen (scar tissue) is supposed to develop around it so that when it
dissolves the augmentation is replaced with your own tissue. The downfall?
You can
actually feel the thread under your skin. Yuk! I don't know who came up with this one.
Allergy Test: N/A
Longevity: permanent,
yet reversible
Cost: unknown
BOTOX:
I have a separate page on BOTOX®.
You can visit the BOTOX® page
now or read this summary. A derivative of the Botulism Toxin
(fatal in large amounts), is being used to literally paralyze the muscles that make the
expressions that create your wrinkles. It works by blocking the receptors
that receive transmissions (orders) from the brain to contract. Originally used as a paralytic for muscle
spasms for conditions such as Strabismus and Blepharospasm. A tiny micro-needle is used to inject
very small amounts of the toxin into the forehead or other areas
to prohibit your ability to frown or look surprised or any other expression
that is creating a furrow or line. Make sure you stay upright to prohibit
migration for about 3 to 4 hours post-injection. You can usually drive
yourself right
home. The toxin has a small chance of leaking down or falling to the eyes
and creating a droopy eye effect for a few weeks. But local
injections of antibiotics can sometimes remedy this. Once you get the shot, you
have the paralysis for about 3 to 4 months. Like I said, my Aesthetician has it done about
every three months and she gets headaches for the first 3 days. (I personally
don't get headaches) She has never had a
problem with it 'falling' and she no longer can make that frown line appear between her
eyes. You can't even see a wrinkle in her forehead skin anymore - nor my own!
WOO HOO!!. Also, BOTOX® finally got approved for use for cosmetic purposes
--
not that it makes a difference considering everyone and their grandmaw had Botox
injections pre-approval.
Allergy Test: N/A
Longevity: 3-4
months
Cost: 1
area: $175. - $500. 2 areas: $275. - $600. 3 or
more areas: $375. - $800.
*incidentally, one
(1) vial (100 units) of BOTOX costs $375.00 (roughly 5 areas can be treated per
vial). It is a considerable mark up although not near as high of a mark up as
Collagen. Very worth it though.
Injectable Fillers:
Please see our Injectable
Fillers Section for more information. This section is entirely too
large to place here.
Chemical Peels:
This procedure supposedly
restores your sun-damaged, wrinkled, blemished, acne scarred or blotchy skin to its
original youthful appearance. I am skeptical though. I have another friend who went this
route and she said her skin turned ghost-white for the first 2 days then pitch-black for 2
weeks; the thick patches of scabby skin (PLEASE DON'T PULL THEM OFF!) naturally fell off
and resulted in a smoother younger appearance. This scares me because there are no
guarantees. You can be scarred worse than before, for life! However, the techniques today
are better than they were years ago. The results are normally a smoother more even toned
textured skin. The skin will look younger, tighter and "fresher" than before
although it cannot remove all facial flaws. Deeper lines, wrinkles and other flaws may
require additional treatments or techniques. The chemicals normally used are
Trichloracetic acid (TCA, for more superficial lines and blemishes) or Phenol (a much
deeper and more dangerous peel) for deeper wrinkles, flaws or discolorations.
Regardless,
the down time is considerable so you better take some time off for this one.
Please see our Chemical Peels Section for more
information.
Laser Resurfacing:
LASER
is an acronym for Light Amplification
by Stimulated Emission
of Radiation.
Light energy is changed into a tight, intense beam of monochromatic
radiation capable of delivering large amounts of power or heat. All
lasers possess a lasing cavity consisting of two mirrors placed parallel
to each other. One of these mirrors is partially reflective and between these
mirrors is a lasing medium or conduit which can be either a gas
(CO2 or Halide), solid (Alexandrite or Ruby) or liquid state. Well
there are ablative lasers which literally remove your top few layers of skin or
there are non-ablative lasers such as NLite which stimulates the collagen in the
dermis which then grows and fills in your wrinkles from the inside
out. Please see the Laser Resurfacing and NLite
Sections for more information.
Sometimes referred to as a Laser Peel, this procedure can help erase fine lines and wrinkles that appear
on the cheeks, forehead, eyes and around the lips. It can also erase facial veins, broken
capillaries, spider veins, age spots and unwanted pigmentation. Lasers can enhance certain
facial procedures that an eyelift or face lift cannot do alone. This procedure removes the
outer layers of damaged skin, allowing newer and tighter skin to appear. Recovery time for
the procedure varies with the degree of the peel. A said before, two friends of mine had
this done and here, years later, the damage is back. Obviously the results aren't
permanent. For more information visit the Laser Resurfacing Page!
Intense
Pulsed Light (IPL):
You may skip
directly to the Intense Pulsed Light Therapy section or read the intro...For
those of you who have not the time to recover from nor the epidermal capacity to
withstand lasers -- High Intensity Pulsed Light Therapy may be for you. This
promising new procedure is also known as Intense Pulsed Light Therapy, computer
controlled light therapy, Light Laser, MultiLight, Photo Laser or by various
trade and service marks, FotoFacial™, PhotoFacial™, PhotoDerm™, EpiLight™,
MultiLight™, PlasmaLight, and I am sure, soon-to-be others.
It is phenomenal new
mini-procedure capable of diminishing or fully ridding one of age/liver spots,
fine wrinkles (rhytids), facial flushing, redness, broken capillaries, telangiectasia
(purple or blue veins on the face), hemangiomas (sacs of red, purple or
blue blood vessels resembling a blister, aka strawberry hemangiomas), freckles,
minor sun damage, port wine stains, tattoos, varicose veins, spider veins, flat
birth marks, hypo-pigmentation and even hair removal! And the best part?
NO
downtime! Intense Pulsed Light Therapy gives you the benefits of a medium depth
laser or chemical peel or other type of resurfacing/rejuvenation procedure
without the blisters, burns and long recovery time. Not only that, it is the only
proven therapy to help with redness
(rosacea, flushing, etc)! And to boot, many patients report a reduction in pore size, smoother skin, and less wrinkles!
Coronal
or Browlift:
Also called a forehead lift. This
procedure corrects dropping or sagging eyebrows that can make you look tired and old.
Coronal lift is the correction of sagging brows, wrinkles of the forehead, and drooping
upper eyelids. Often performed in conjunction with eyelid surgery, a forehead lift is the
surgery of choice when the excess skin of the upper eyelids is caused by low or drooping
eyebrows or when there are deep forehead wrinkles and frown lines between the eyes.
Often,
raising the eyebrows is sufficient and a complete eye lift procedure is not necessary.
Your surgeon will help you determine the procedure or combination of procedures that will
help you achieve your goal. Very fine lines under the eyes and smile lines can often be
corrected with laser resurfacing or a light dermabrasion or skin peel. For more
information, visit the the Brow & Forehead
Lift Section.
Microdermabrasion:
Also known as a
Smartpeel, Parisian peel, Crystal peel, Micro-peel, lunch time peel and the
anything-I-may-have-forgotten-peel. My partner and I have had a few of these.
He swears
by them. They are pricey as well...$150.US for about 20 minutes for just your face. It
feels like windburn or sandburn (literally your skin surface is being mildly sandblasted
with aluminum-oxide crystals). It does work -- slowly, but it is expensive for a series.
For more information visit the Microdermabrasion
Page.
My
Recommendations:
Wear Sunblock! I barely tan my face,
ever! I always have a Sunblock 45 on with Copper Peptide when I leave the
house. I use a self tanning lotion by Jan Tana and I have only one freckle on my entire face
(on my jawline) because of this. If it were genetic (which sometimes it is) I would have
them everywhere (my mom is a freckled redhead). Moisturize with a great product.
Seriously, it is your skin, spend money on it. Drink lots of water. Now, I am being a
hypocrite because I don't drink enough fluids as it is. I think I have that premature
wrinkle on my forehead because as a small child on up to 25 I wrapped my wet hair in a big
heavy towel like a turban. I sincerely believe that the weight has pulled the skin on my
forehead all out of whack. I would leave this towel on for hours (watching cartoons as a
child and whatever as an adult). So, I don't suggest doing this for long periods of time.
Maybe I am being paranoid but why should YOU take chances. Don't tug and pull on your face
unnecessarily. That means no poking and prodding at blemishes. I know we all do this
(including myself) but please, try to refrain. Cleanse your skin with high quality
products, I don't recommend bar soap, even if it is meant for your face. I believe
bacteria can somehow grow on even this and besides it isn't as nice and comfy to lather
up. I like a nice foaming cleanser in a closed container. Don't over wash either.
By doing
that, with harsh chemicals, can throw your sebum (oil) glands out of whack causing them to
produce even more oil to compensate. Believe it or not, you DO need oil on your skin. It
is your body's ally in moisturizing the skin. Do you ever notice that women with oilier
skins have less wrinkles? And drier skins get irritated and flaky and red?
Hmmm... Think
about it; oil isn't all that bad.
References
Rubin, Mark, G. M.D. - Lasky Clinic
Beverly Hills, CA Pharmacology and Use on Contemporary Skin Care Agents (Lecture)
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