Dynamic wrinkles: These are caused by muscle activity moving and bunching up the skin. The thicker the skin is the less it can be wrinkled. A small child has very thick and plump skin that greatly resists wrinkles while adult skin is thinner and wrinkles easier as the skin is "scrunched". About the only way of effectively dealing with dynamic wrinkles is to prevent them from forming. This involves somehow stopping the muscles from moving the skin around. Older techniques involve cutting the muscles surgically to stop their motion. This is an extreme solution and frequently doesn't work. If it does work it is permanent which could lead to other problems.

(As you age your skin looses much of its collagen leaving it thin and prone to wrinkling. New technologies stimulate the production of collagen to keep your skin plump and strong.)

Botox effectively stops wrinkles by paralyzing the muscles that constantly crease the skin. Botox last three to four months at first and usually takes effect within 72 hours of the treatment. The most popular treatment areas are between the eyebrows (globellar region) and wrinkles by the eyes (crows feet). Lower face wrinkles can also be treated with success. Repeated injections progressively weaken the targeted muscles and can lead to more prolonged effects and less frequent treatments.

Static wrinkles. If the skin is creased by prolonged muscle activity the wrinkles that form become permanent. Sleeping on the face night-after-night in the same position can also create permanent "sleep wrinkles". These static wrinkles stay even when the muscles are relaxed as in deep sleep and Botox doesn't do much here. The only way to know if the wrinkles are responsive to Botox is to try it and see if the wrinkles go away.

If the wrinkles do not respond to Botox, other treatments are available to help correct or minimize them. The most natural way to eliminate these wrinkles is to grow new dermis or deep skin tissue under the wrinkle. Forming new collagen under the wrinkle fills the wrinkle from below, flattening it and improving its appearance. Certain lasers heat the deep skin layers in a way that stimulates this growth without burning or scarring. The Cooltouch II laser stimulates new collagen growth and "pushes up" the wrinkled skin from below. This technique usually requires three treatments spaced a few weeks apart. For deeper wrinkles and skin creases a combination of technologies may work best.

Wrinkles that are not treatable with Botox can still be treated with filler injections of collagen or the semi-permanent fillers, Radiance or Silikon. Micro-droplets of these fillers are injected along the wrinkle and "puff up" the skin from below, "filling in" wrinkles and furrows.

Collagen materials were the first popular fillers in the US and were made from bovine (cow) collagen. Allergies were a problem and the time period from testing for cow collagen allergies to treatment could be two months. The newest collagen is of human origin (not from people) and doesn't require skin testing since there are no allergies to worry about. This material comes in several forms depending on the area being treated. It is commonly used to treat facial wrinkles and lips and lasts from three to six months. Collagen fillers can also be very helpful in "trying out" the correction for individual wrinkles or furrows before semi- permanent filler injections are used.

	Botox is now the most commonly performed cosmetic procedure in the United States.

Radiance and Silikon 1000 are the only two fillers currently approved for use in the US. Both of these semi-permanent fillers are made up of inert sugars and last up to seven years. This length of time is ideal since we can continue to treat these wrinkles as they change over time rather than using truly permanent fillers that can’t be altered. Surface uses Radiance exclusively due to its safety and clinical trial results.)

Wrinkles respond best to a combination of surface and deep skin treatments. Botox, filler injections, microdermabrasion, collagen lasers, chemical peels, Thermage, and FotoFacials all work together effectively. Consulting a specialist will help you decide upon the best treatment regimen for your individual needs.

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