The Wrinkle in Botox

The Wrinkle in Botox

Why you can still expect to have a Facelift

Botox Birmingham ALWikipedia’s definition for wrinkle “is a fold, ridge or crease in the skin.”   Botox is a wonderful medical break-through that has altered how some women smile, or lack thereof.  Just like many medical breakthrough products, Botox is often over-sold to the general public giving them an unrealistic expectation of results and, often, misconceptions about turning back the clock or stopping the aging process altogether.  Medical technology has yet to advance enough to alter our DNA and stop the aging process, but has given us products such as Botox that can help prevent wrinkles from occurring to some degree.

Botox is a product that paralyzes the muscles in the injected area.  Since most wrinkles are created from the stress of the underlying muscles, paralyzing those muscles helps to prevent the muscles from contracting thus it prevents skin folds from occurring.  When used prior to the appearance of wrinkles, then Botox is preventing those folds from occurring, thus the signs of aging.  When used after the signs of aging are present, then Botox assists those muscles from contracting thus relaxing the fold, or wrinkle.  Most patients can see visible improvement over time after consistent use.  However, the “wrinkle” in Botox is that is does not erase those deep wrinkles once they are formed, but can help minimize their appearance.

Deep wrinkles are the manifestations of muscle contractions over a period of time.  Wrinkles are more than just folds, they are the visible signs of soft tissue having been broken down from the stress of the muscle contracting.  A tissue replacement, such as artificial fillers or fat grafting, is often recommended to achieve the desired result of minimizing the appearance of wrinkles beyond the capabilities of Botox.

Common areas for Botox Cosmetic are the forehead, glabella (between the eyebrows), and the crow’s feet area around the eyes.  Injecting Botox to frown lines is not advisable unless you wish to paralyze your smile for about 4-6 months.  Even if you could obtain some benefit from Botox injections to the frown lines (laugh lines – or the parentheses lines that extend from our nose down to the corners of our mouth), then the manifestations of aging would still exist as gravity is a proven cosmetic disadvantage to our facial structure.  Botox injections cannot prevent gravity from pulling down the soft tissues of our cheeks contributing to those laugh lines and creating those jowls which in turn help create marionette lines from the corner of the mouth extending down the sides of the chin.

Since it is clear no one would want to Botox those frown lines, the aging process in that area will continue thus leading to a more traditional procedure such as a facelift.  Other factors that can help minimize the appearance of wrinkles are skin care, using sun-block protection, drinking plenty of water to keep the skin hydrated, and maintaining a healthy weight.  Botox is a great product for the prevention of forehead wrinkles, but one should understand it isn’t a magic potion for all areas of the face.

The Perfect Facial Filler by Dr. Paul Howard

Botox and Restylane have become the mantra for those seeking facial rejuvenation without the inconvenience of having a “surgical procedure.”  While these off-the-shelf products are enticing, they are expensive, temporary, and can be painful to inject, especially in the lips.  For more Plastic Surgeons, these artificial fillers (Restylane, Juvederm, Strattice) are appropriate only for temporary improvements where there are time constraints and the need to be in public within a couple of days.  Searching for the perfect facial filler had been elusive until recently.  The emergence of fat from your own body (autogenous) has paralleled the refinements in fat harvesting and injection techniques that have elevated the “take” of fat injections to the 80-90% range.  Coupled with improvements in local anesthesia and anesthetic agents make the overall experience with the new fat injection techniques less painful and more likely to give a permanent, elegant improvement in facial contours and rhytids (wrinkles).  Many non-surgical practitioners complain of the donor site for obtaining the fat.  While we must respect the donor site, offering the patient an improvement in body contour by harvesting fat for injection offers the patient the benefits of a liposuction (method of harvesting fat) procedure and cosmetic improvement of the donor site as well as the areas of the face injected with fat.

What does the future hold for facial fillers?  Ongoing research using stem cell and growth factor technology may lead to even further improvements in fat injection techniques while artificial filler research tries to make their artificial substances last longer and the cost with longer lasting substances is naturally higher and will continue to increase over time.

Fat injection techniques have proven to be a vast improvement over foreign-body injections for facial rejuvenation.  Fat is permanent, soft, cannot be rejected by the body, natural, and requires only small (3-4mm) stab wounds for injection.  The patient can request which body area is preferred as a liposuction donor site obtaining body contour improvement at no additional charge.  The well informed patient will usually choose the elegance of fat injection over the expediency of foreign material injected in the face.

As an extension of fat technology, we have begun fat injections in the back of hands for hand rejuvenation.  The injected fat decreases the appearance of prominent veins, knuckles, and tendons that become more pronounced as we age.  No one should let their hand reveal their age when we have the procedures to reduce the signs of the aging hand.

Read more about top fat grafting surgeon Dr. Paul Howard and view fat injection before and after photos.