Lines on our face can begin at almost any age and even be seen in our teens. The reason we get lines on our face can be complex and due to several different factors. Most commonly we see lines on our face from exposure to the elements. This largely is the sun but can be from the cold and wind when the proper protection is not utilized. Smoking can also cause skin lines. We call these types of lines “static” lines because they are always present. Conversely, lines that form when we animate are termed “dynamic” lines. They form perpendicular to our underlying muscles. Examples include our “11” lines and our crow’s feet. We can also get “static” lines from repetitive compression particularly when we sleep. “Sleep lines” form in atypical areas and may be seen as vertical lines outside of our eyes or on the cheek and are most often seen in side or stomach sleepers.
For static lines we have several different options:
Filler products – We can use some filler products with very small needles to directly inject lines on our face. This softens them and makes them less noticeable. In some cases, for deeper dynamic lines, fillers may be used in combination with BTX to achieve a synergistic improvement in those lines. Areas where this may be done include the forehead, 11 lines and lines around the mouth. This requires an advanced “injector” so it is important to make sure your doctor is well trained and experienced in “line chasing”.
Skin care – I am a very big advocate of skin care. While skin care alone does not usually result in significant improvement of lines in our skin, it does help make our skin more homogenous and improve the texture of the skin. In many cases, it can help some of the other treatments we do result in better outcomes when paired with skin care. Color and texture may also be enhanced by light based treatments (IPL/BBL) which like skin care, can improve the color and texture of the skin, but a bit more rapidly than traditional skin care.
Intermediate treatments such as peeling agents, HALO and microneedling can make more of an impact on mild skin lines we have. Chemical peels are done in the office by our aesthetician team and may require a series of treatments to address lines. They can be associated with a few days of peeling and irritation. HALO is a laser that also improves texture and mild lines of the face. Most patients undergo two treatments over 2-3 months to achieve the desired result. Each treatment requires 2-5 days of peeling and swelling. Lastly, microneedling is a procedure performed by our aestheticians and uses a motorized handpiece with very tiny needles that treat the skin superficially to stimulate collagen production (the premise of just about all the treatments we do). Most patients undergo a a series of 3 treatments spaced over 3-4 months. Each treatment has a day or two of light peeling and swelling.
The most aggressive treatment that I perform for moderate to deeper facial lines is the Erbium laser. The treatment “sands” the skin down in a controlled manner to allow it to re-heal without the wrinkles. It is not a skin tightening device but rather a specific treatment for the skin. It is associated with a more significant downtime but in the case of more advanced lines, it is the best and preferred treatment.
Finally, some of the treatments described above can be performed on areas off the face. This includes the neck, chest, arms and hands. Because these areas do not have the healing capacity of our face, we must be more conservative with our treatments to keep the procedures safe. Despite that, we can still achieve good outcomes with “off face” treatments.
Lines on our face can be complex. It is important to assess where they are and what the likely cause is to determine what may be the best treatment options. The final decision will also be guided by the potential downtime associated with the procedures and its impact on work and lifestyle. I would encourage you to come in for a consultation with myself and our aesthetician team if you would like us to examine you and help your skin look as good as you feel!