Dermal Fillers: The Basics

In a previous entry I reviewed the two types of facial wrinkles, static and dynamic. Dynamic wrinkles occur when facial muscles contract and static wrinkles are present when the face is at rest.

Botox works well for dynamic wrinkles because it relaxes the muscles that cause them. Botox has no effect on static wrinkles because static wrinkles are not related to muscle contraction.

As we age, certain substances (collagen and elastin) within the deep layer of our skin (dermis) begin to deteriorate. Furrows form within the dermis as collagen and elastin disappear. Static wrinkles form when the overlying skin falls into these furrows.

Dermal fillers like Juvederm, Restylane and Belotero are made of a compound (hyaluronic acid... not really an “acid”) that naturally occurs in the dermis. Dermal fillers smooth out wrinkles by filling the furrows between the overlying skin and underlying dermis.

Deep static wrinkles are commonly found on the lower half of the face. Wrinkles that are particularly amenable to treatment with dermal fillers include wrinkles around and below the nose (nasolabial folds), jaw wrinkles (marionette lines) and the lines around the mouth (cigarette lines.)

Botox: Where it Works Best

Most people know that Botox smoothes facial wrinkles by relaxing the muscles that cause them. Few people, however, are aware of the areas of the face that represent danger zones when it comes to Botox injections.

Botox is routinely used to treat wrinkles involving the upper half of the face. Crow's feet, forehead wrinkles and the lines between the eyebrows (the "11" lines) are prime targets. In trained hands, full doses are given with few complications.

Less frequently, Botox is used to treat wrinkling in the lower half of the face. Wrinkling around the mouth and lips are the most frequent target areas.

Lower doses of Botox are utilized in the lower half of the face due to the increased risk of side effects. Slurred speech, difficulty drinking through a straw and an impaired ability to kiss can occur where muscles around the mouth are relaxed with Botox injections.

Before undergoing any medical procedures, it is important to understand the risks and benefits. If you are contemplating Botox injections to the lower half of your face, be sure to discuss these specific risks with your injector before undergoing treatment.

Wrinkles- The Basics

If you have ever looked at the wrinkles on your face and thought...maybe I'd like to do something about them-here are a few things you should know about wrinkles.

Every adult has two types of wrinkles,dynamic and static. Dynamic wrinkles occur when we contract a certain set of muscles and the skin folds in. When we smile, for example, everyone gets "crow's feet." When we frown, everyone gets the "11 lines" between the eyebrows.

Static wrinkles are lines that remain in the skin after the muscles are relaxed. These wrinkles are due to a breakdown in the underlying tissue that supports the outer layer of the skin. When this happens, the skin folds in on itself, creating a wrinkle that does not disappear.

Dynamic wrinkles are most effectively treated with Botox since Botox relaxes the muscle that creates these types of wrinkles. Static wrinkles are best treated with a dermal filler. The filler "fills in" the area under the skin that has become worn away as a result of age, exposure to the sun, smoking, etc.

Sunglasses: The One Thing You Need to Know

Now that summer is here, it seems like everyone wants to be outside. If you plan to spend any length of time outdoors, it is important to wear sunglasses that maximally protect your eyes from the sun’s harmful rays.

The sun constantly bombards us with invisible UV rays, rain or shine. Studies have shown that that overexposure to UV radiation contributes to the formation of cataracts, macular degeneration and skin cancer.

The best way to protect your eyes from UV radiation is to wear glasses with filters that screen out 99% of it. Prescription glasses are required to have high quality UV filters. Many sunglasses have them too.

Sunglasses with filters that screen out 99% of incident UV radiation are entitled to display stickers that say: “UV absorption up to 400 nm” or “Meets ANSI standards.” Sunglasses with “cosmetic” stickers filter out only 70% of the sun’s UV rays. Sunglasses with no sticker may not block UV radiation at all.

Unfortunately, many sunglasses displayed in kiosks carry no stickers. Before you decide to buy a pair without a sticker, I suggest that you take a moment to visit the manufacturer’s website. Chances are, information regarding UV filters will be described there.

As a test, I inspected the websites of ten popular sunglasses brands. These included: Bolle, Dolce and Gabbana, Fendi, Gucci, Guess, Maui Jim, Oakley, Prada, Ray Ban and Tom Ford. By doing so, I was able to confirm that every one of these manufacturers makes sunglasses that include a UV filter that screens out 99% of incident UV rays.

It’s easy to be distracted by the many different styles of sunglasses. There is only one feature, however, that makes a difference to the health of your eyes, and that is the UV filter.

Last week, I examined a 75-year-old man who had been a sailor before he retired. After examining him, I realized that he must have diligently protected his eyes from the sun since he had no macular degeneration, normal eyelid skin and only mild cataracts that were consistent with his age.

At the end of the exam, he told me his secret. “Doc, I’ve spent more time with skin doctors taking skin cancers off my body than I care to remember. I couldn’t wear sunscreen on the boat because it made my hands slippery. But, I always tried to wear a good pair of sunglasses.”