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“I wanted to talk a little bit about fine line treatments of the face, the little wrinkles, radial lines around the mouth and eyes and the most common areas that some people have them really with sun damage on the entire face and it starts with a real range of options that are available.
The real work course for long lasting results with fine lines is to do some type of resurfacing which I have describe extensively but there’s basically three types of resurfacing. All of which are doing the same thing. There’s stimulating the wound healing mechanisms of the body to rebuilt collagen and repopulate the skin surface giving a nice smooth look to the skin and eliminating those fine lines. The 3ways of doing that or with the mechanical disruption of the skin surface dermabrasion or sanding which is old fashion, we don’t do that very often. Deep chemical peels, not the type you get in a spa or salon but a real peel that goes down to the second layer of the skin called the dermis and includes part of that or laser resurfacing which we subdivide now into two types of laser resurfacing. The older technique which is still very popular and effective which is full laser resurfacing where the entire surface of the skin is gently removed down to the second layer skin level that’s the dermal papillary dermis or the junction of the papillary and reticular dermis. So the deeper layer of the second layer of skin I guess is a simple way to put that and when you mechanically take those away or do that chemically or use light or heat energy like you do with laser the body responds by making new skin cells, reorganizing and remodeling the collagen making new collagen which loose the skin out and it does that really for the long term. People ask me how long does laser resurfacing last or fractional laser last and the answer is really forever, its remodeling the skin for the long term, doesn’t mean that your skin stops aging, we just turn the clock back on the aging process on the skin and we really reset it so that we’re starting with more youthful skin as a result of stimulating the body’s repair mechanisms.
There are other options by the way for fine lines which include injectable fillers and in the old days when we use collagen starting with what is called Bomine or powdered collagen or the ultimately moving to human collagen we really had a great product that we could use because to effectively treat a fine line, to elevate a fine wrinkle in the lip or anywhere on the face we have to place the filler intradermal in the skin it can’t be below the skin where we’re lifting it all up or we just have puffier looking skin with lines in it and as I think a real common hair on with the basic level injectors is the understanding of this concept, the placement in the dermis to lift that fine line up, really an important concept if you want to get them but very effective and there are couple of products in particular that we know work quite well with that, that’s Retylane silk the newer of the Restylane products and Belotero which is a product from Merz so both of those are excellently reduce the concentrations so the jells are not so thick and then with the local anesthesia and they can be injected in what we call a serial point technique to elevate the skin without making it look puffy. And again, I’m not a big fan of what I’ve seen commonly done with this called the poke and plum technique where a little incisions are made or needle is inserted in the entire upper lip has made to look puffy which ultimately does make the lines better but really makes the entire lips that [inaudible [00:03:59] is really not should not be the goal in getting optimal results with fine lines.
So in summary, we’ve got fractional laser resurfacing, laser resurfacing, chemical peels for fine lines and I own exclude dermabrasion is still sometimes used. We do have the fillers that can be used in a very selective way Restylane silk and Belotero in my opinion are the best options in that and then there are few new technologies that are being applied in this area including ultrasound like ultherapy for fine lines which seem to give a benefit, maybe not a long term benefit but as at least initially a benefit and some of the now it’s called non ablative lasers which are used to heat the deeper layers of tissue and create new collagens synthesis. Now what those non ablative lasers lack is that as described with non-ablative names there’s no injury to the skin, that’s visible on the surface and really with that you don’t get repopulation of the surface skin cell but we are stimulating the collagen in a deeper layer. There’s a lot of attention being paid to this right now but I would say in general that there’s some limitations to non-ablative resurfacing in terms of expected outcome. Some people get pretty decent results and others I’ve seen pay a lot of money and not really be satisfied with the outcomes. We have a way to go in developing and improving the technology of non-ablative resurfacing, we’re getting there but it’s not perfect yet.
So that’s a summary of the ways that we can treat fine lines. We have the filler option, we have ablative and non-ablative laser options and then the standard resurfacing, deep chemical peels would be in that category also.
If you have any other questions about techniques for treating fine lines please don’t hesitate to call, you can write us @DrMaas.com or even send in pictures or videos where we can have online or private discussion about what might be best for you in terms of getting fine lines taken care of. This is Dr. Corey Maas on looking your best.”