Picture by Greg Rosenke at Unsplash
Wrinkles are commonly equated with age itself. There is nothing that bothers patients more than their own wrinkled face. In this respect, it is not surprising that we also focus on this topic in aesthetic treatments. Wrinkles reflect the loss of youth most clearly.
On the other hand, wrinkles certainly have their own attractiveness and aesthetics. There are many pictures of old people who radiate great dignity, precisely because their wrinkles show that they have experienced a lot in their lives. They write stories in people’s faces, stories of hunger and hard work in the fields, stories of suffering and sadness, of happiness and peace.
Nevertheless, it is more than understandable if you want to get rid of or better reduce your wrinkles, because they are first and foremost associated with age.
However, it depends on how much the wrinkles should be reduced. Recently, there has been much discussion in aesthetic medicine about naturalness and wholeness. The background to this are excesses that can be observed primarily in the United States and Brazil, but we can also see these excesses to a lesser extent in Europe. Fully lifted and wrinkle-free faces are seen as mask-like and waxy, especially when they belong to old people. The issue of over-treatment can also be observed more often in stars and especially starlets. In the process, sometimes even the facial features slip away completely and the formerly beautiful faces are no longer recognizable.
We would rather want to advise against completely eliminating wrinkles. A more youthful appearance and vitality, that is a desirable goal for us. No goal should be to erase age completely, because this can not and will not succeed. Therefore, we aim to reduce wrinkles in a dosage that makes the older face appear more vital.
Wrinkles and wrinkles
In our articles about the aging process we had already talked about the different types of wrinkles and what causes them. A too intense facial expression with strong recurring muscle contractions is one cause, the other can be seen in the loss of hyaluronic acid, of elastin and collagen, as well as in a dwindling of blood circulation. The extent to which these natural aging processes are perceived in the face also depends on our genes and also on how we behave towards the environment and ourselves. “Are we sun worshippers and lie on the beach all vacation? Or are we heavy smokers and negatively influence the process of skin aging through continuous intake of nicotine? Do we eat only fast food or do we eat healthy?” are questions that need to be asked in connection with skin aging and that also influence the severity of wrinkles.
The treatment of mimic wrinkles
We have a lot of muscles in the face because they allow us to adopt many different expressions for emotional states and because we speak and act a lot with the whole face. As you know, this muscle activity is called facial expression. In particular, the eye and mouth regions are moved very intensively. In this respect it is not surprising if these two regions are treated with priority. However, the muscle activity radiates far beyond the very narrow area of the eyes and mouth. If you once contract your eyes strained in front of the mirror or produce an angry facial expression, you can notice that very many muscles are involved in these expressions. But not only these, a smile also involves a lot of muscles.
The neuromodulator Botulinum
We definitely have to dedicate a separate section to the active ingredient used, because there is a lot of ignorance here and because it is often described negatively in the press. We are referring to botulinum toxin A, which is probably better known to you under one of its brand names – Botox®. For all of us, the term toxin also expresses something danger signaling, and indeed, in the past, before it was recognized and described in science, this bacterium also led to deaths by botulism many times – but never in aesthetics or medicine, because there we use concentrations that are far beyond any danger.
To the contrary, with correct dosage it can not even lead to a serious complication with permanent damage, because this is the good news: after 6 weeks already its effect diminishes and after 3-6 months any muscle reaction that is not desired can be put to rest. However, this good news is at the same time bad news: the prevention of excessive muscle activity must be renewed approximately every 6-9 months.
So how does the bacterium work? Well, it serves to reduce the automatic muscle contractions. The term neuromodulator means that we dampen the signal transmission by the nerves to the muscles in very specific muscles (neuro = concerning the nerves, modulate here = dampen) and thus influence our automatic reactions to these signals.
In the past, attempts were made to eliminate them completely. Today, with a clearer view of the real needs of patients, we can adjust the dosage so precisely that activity of the muscles is still possible, just not so extremely strong. Without activity, there are no facial expressions – indeed, no facial expression wrinkles – but please ask yourself the question: is this what you want? A face that is no longer able to produce an emotional expression?
The main regions of treatment with neuromodulators
Neuromodulators have been around for more than 25 years in aesthetics. They are therefore well researched. However, the spectrum for their use has continuously expanded. Initially, only the glabella, i.e. our frown line in the center above the eyes, was treated. This indication is still one of the most important treatment options today. However, many doctors have contributed to the fact that in the last decades more and more injection points could be determined that can influence many different mimic wrinkles, be it the muscles that pull our upper eyelids down too much, be it the small wrinkles that form around the eyes, the so-called crow’s feet, be it wrinkles that form on the left and right side of the nose or the wrinkles around the mouth that are influenced by our facial expressions. Even the muscles that create the wrinkles on the neck can be partially quieted today.
Therefore, on the one hand, we can clearly say that treatment with this active ingredient is still one of the most important treatments in aesthetics today, but on the other hand, we do not want to conceal and thus also move on to the next paragraph, that many wrinkles require the combination with a superficial filler in order to produce optimal results.
If you want to read on then click the following link to get to the next part: The nuisance wrinkles – Part 2 Filler