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As far as correction of fine lines & wrinkles in the face is concerned, there are 2 basic approaches:
1. To fill in the area under the wrinkle with a suitable biocompatible soft substance such as dermal filler.
2. To inject the underlying muscle (whose activity and contraction causes the wrinkle) with a medicine to relax and deactivate it (Botulinum Toxin).
In general, we can divide strategy de-
UPPER FACE WRINKLES
Upper face wrinkles are almost entirely caused by 3 muscle groups:
• FOREHEAD LINES
Caused by the large flat forehead muscle that (frontalis) raises the eyebrows.
• FROWN LINES
Caused by the muscles which furrow the eyebrows to produce a frown (procerus & corrugator supercilii muscles).
• CROWS FEET
Caused by the muscles (orbicularis oculi) that narrows and creases the eyes during a powerful smile.
All three of these “wrinkle categories” can therefore be treated very effectively with muscle relaxing injections (in suitable patients). They can also be treated in certain cases effectively with dermal filler injections using either a needle or cannula.
Your clinician will guide you through the options most suitable for you.
LOWER FACE WRINKLES
Lower face wrinkles and the ageing process that creates them, can be slightly more complex.
Usually ageing lines of the lower face are caused by a combination of sagging fat compartments in the cheek, overactivity of muscles (such as those that furrow the mouth and lower the mouth corners), fine lines around that mouth caused by smoking, and changes in skin quality & elasticity.
The basics are as follows:
• NASOLABIAL (NOSE-
From the corners of the nose to the corners of the mouth, exaggerated when smiling. Corrected in simple cases using dermal filler injections to these lines and perhaps to the cheeks. More advanced cases will need treatments that specifically target mid-
• MARIONETTE LINES
Lines leading downwards and outwards from the mouth corners: can be corrected with dermal filler to support volume loss in this area, but in many cases muscle relaxing injections can maximise this result.
• SMOKER’S LINES
Fine vertical wrinkles above top lip, accentuated by pouting, usually but not always found in smokers. Corrected with dermal filler injections.
• THE WRINKLED CHIN
The famed “Gordon Ramsay chin” is not uncommon, and can be seen in both men and women. Caused exclusively by overactivity of the chin muscle (mentalis), this condition is best and most simply treated by muscle relaxing injections to this muscle.
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