Wrinkle treatments

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Wrinkles can be a combination of both intrinsic and extrinsic factors.

Intrinsic aging- this term refers to the universal  age related change that occurs with everyone. With age, gravity takes effect, deepening lines, and increasing skin laxity. There is a steady decrease in dermal collagen and elastin- the building blocks of the skin. Fine wrinkles are early signs of intrinsic aging.

Extrinsic aging- UV damage is the major cause of wrinkling especially in Queensland. Years of accumulated solar exposure will predispose to uneven texture, pigmentation, and fine wrinkling of exposed areas. With time, wrinkles deepen and intensify.  UV radiation decreases the thickness of the upper layers of the skin and also fragment collagen and elastin. Both these structures form the scaffolding of the skin, and help prevent wrinkles. The is a gradual loss of skin tone over time, correlating to a reduction in collagen and elastin.

Smoking may also contribute to wrinkling, especially on the upper lip area – smoker’s lines.

The initial step in wrinkle management is careful clinical examination by a Dermatologist to ascertain which type of wrinkling the skin exhibits. By observing muscle movements and assessing skin tone and texture, we would be able to accurately assess the contribution of both dynamic and static wrinkles.

The aims of wrinkle treatments are threefold-

1. Treat dynamic wrinkling
2. Address static wrinkles and replace loss of dermal volume.
3. Prevent further UV damage, reduce future extrinsic aging and slow down intrinsic aging.

Dymanic wrinkles are due to muscle movement which in turn gives rise to wrinkles. In many cases wrinkles maybe exaggerated by dynamic muscle movements. Examples of this include frown lines, forehead  lines ( look up ) and crows feet ( smile to reveal lines radiating from the eye area). The aim of treatment is to reduce muscle tone in the groups of muscles exaggerating the expression. Antiwrinkle treatments such as BTX can dramatically reduce dynamic wrinkling.

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The use of BTX injections can dramatically reduce dynamic wrinkles around the frown lines (wrinkles between the eyebrows), crow’s feet(wrinkles around the eyes) and smokers lines (wrinkles around the mouth). This treatment is effective with a safety record spanning 20 years.

What is BTX?

BTX is a natural, purified protein that relaxes wrinkle-causing muscles creating an improved cosmetic appearance. The active ingredient is a muscle relaxant obtained from the bacterium Clostridium botulinium and is manufactured in sterile laboratory conditions. Botox is a prescription only medicine.

How does BTX work?

Botulinum toxin binds to nerve endings and prevents the release of chemical transmitters that activate muscles. This way, the natural, purified protein relaxes the muscles that cause wrinkles.

This process may take upto 2 weeks for the maximal effect to be seen. After a few months the nerve endings usually grow new connections to the muscles and the effect wears off. The injections are typically repeated about two to three times a year, as directed by your Dermatologist.

What does treatment with BTX involve?

The first step is to have a consultation with a consultant dermatologist. They will evaluate whether BTX therapy is appropriate for you, discuss the expected outcome, and answer any questions you may have.

BTX is a non-surgical treatment for wrinkles. A small amount of Botox is injected into the selected facial muscles with a very fine needle. Discomfort from injections is minimal and brief and comparable to an ant bite.  Ice application or anaesthetic cream can be applied ½ hour prior to the procedure to minimize discomfort.

Slight redness at the injection site is frequently seen, but this usually fades within a few hours. Makeup, if desired can be worn after the BTX procedure. Results are usually seen after a week, however may take upto 2 weeks for the full effect to become apparent.

How long does BTX last?

Botox lasts, on average, three months to four months in most patients. With repeat Botox treatments the effect tends to last longer as muscles weaken over time.

Is BTX safe?

The use of BTX is safe, with a track record of over 20 years. In fact BTX injections are commonly used in much higher doses to treat children with cerebral palsy to reduce muscle spasms and lazy eye syndrome.

Are there any precautions that I need to take after being treated with BTX?

Normal activities can be resumed soon after treatment, however, there are some basic precautions that should be taken to reduce risks of side effects and obtain the best results from your treatment.

• Ice may be applied to the treated area to help reduce discomfort, swelling and bruising
• Try to exercise your treated muscles for the first hour after treatment. If you forget, it will not impact on your treatment negatively
• Do not lie down or do strenuous exercise for 4 hours after treatment
• Do not have a facial, nor rub or massage the treated areas for 24 hours after treatment

As this is a cosmetic procedure there is no claimable Medicare rebate for this treatment.

More information on BTX  wrinkle relaxers

More information on BTX safety

Fillers can be helpful for wrinkles and creases in the lower half of the face, particularly the crease running down from each side of the nose to the corners of the mouth. They are a safe, non-surgical and effective method of lifting, rejuvenating and shaping the face.

What are dermal fillers?

Dermal fillers are used to fill or replace loss volume due to the reduction in skin collagen and elastin. Fillers provide an immediate dose of collagen and ground substance, instantly filling hollows, furrows, wrinkles and lines. Westside Dermatology use fillers consisting of a natural substance called hyaluronans and is allergy free.

What areas can be treated?

• Lips
• Smile creases
• Cheeks
• Frown lines, creases and wrinkles
• Acne scars and chickpox scars

What does the procedure involve?

After a consultation with our Filler Specialist, we will discuss and advise on how fillers may benefit you, including what filler to use, what area to treat, and most importantly discuss the expected outcome, duration of results and costs.

Filler procedure involves multiple fine injections to the treatment area. We often use a combination of ice and a numbing cream prior to the injections, reducing the discomfort to a manageable level. The procedure takes between 20 to 40 minutes depending on the treated area

What will I look like after the treatment and how long will the results last?

Immediately after the filler procedure, you can expect slight redness and swelling- this is absolutely normal. This inconvenience is temporary and settles within a day or two. Light make up maybe applied if desired. The majority of patients feel comfortable enough to resume their work and normal activities after treatment. Bruising may develop a day or two after fillers, but will settle over 3-5 days.

The longevity of fillers will depend on the areas treated, and the type of fillers used. On average, they last 6-8 months, however, much like one’s metabolic rate, there is also an individual variation in the longevity of fillers in different people.

What is the best dermal filler for me?

Westside Dermatology offers a variety of temporary fillers, each suited to different applications. Our Specialist Injector will advise you on which dermal filler is best, depending on the location, longevity and results you desire.

**Westside Dermatology do not perform Permanent Fillers due to the increased risks of serious side effects and complications.

Can dermal fillers be combined with other treatments?

Absolutely! Fillers are only one arm of the rejuvenation process. Fillers are frequently combined with BTX Anti -Wrinkle injections, which relax the underlying muscles. Balance is the key to natural facial rejuvenation. Apart from treating loss volume, the use of Fractional laser and TCA peels can improve skin texture, tone and clarity.

More on dermal fillers

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The technical advances in laser and refinements in technique have made laser treatment a standout treatment of fine thru to deep wrinkling. With laser treatment other visible signs of aging are also treated – including uneven texture and pigmentation and loss of skin tone.

What types of lasers can be used for wrinkles?

Laser maybe performed as full resurfacing – a combination of Erbium and CO2, or as fractionated laser resurfacing (Fraxel/ ProFractional). Fractional laser resurfacing has the added advantage of reducing recovery times, however several treatments are often needed.

Treatment parameters and technique will depend on the degree of photodamage, the extent of wrinkling and the recovery time allowed. A detailed examination and discussion of treatment options is essential for optimal results.

Fractional laser has provided a revolution in the treatment of facial rejuvenation. Fractional lasering induces thousands of micro-punctures whilst leaving surrounding tissues intact. This allows the skin to heal much faster than if the entire skin was treat at once (old school laser resurfacing). Fractionation stimulates collagen production in addition vaporizing both superficial and deep pigmentation. It promotes the skin’s healing process to create new, tighter tissue, with improved skin texture.

What are the main advantages of  Fraxel/ Fractionated Laser Therapy?

ProFractional has the unique ability to penetrate very deep into the skin, but with very little heat damage to surrounding tissue.  This combination allows for efficacious collagen remodeling (due to the deep treatments) and a high safety margin (due to low thermal damage) on all skin types.  This combination makes ProFractional one of the safest, yet most effective resurfacing lasers available today.

What areas of the body can be treated?

Most skin areas can be treated.  Popular treatment areasare the face and neck, although many people also treat thechest and hands.  Your laser dermatologist can adjust the laser settings appropriately for the specific area being treated.

How long will it take to recover?

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Complete healing typically occurs within a few daysand most patients usually feel comfortable enough toget back to normal activities and apply makeup a day or two afterthe treatment.  There may be some swelling that willsubside within several days following the treatment.

When should I expect results?

As your skin heals in the days following your treatment,you may notice a general tightening effect. However, thetrue benefit of ProFractional is the collagen remodeling thatoccurs during the 4 to 6 months following your treatment.  It may therefore take several months to see maximum benefit from your treatment.

More on Fractionated laser treatments

TCA peeling is an effective method of treating sundamage, pigmentation, freckling and wrinkles. Chemical peels such as TCA remove the upper layers of the skin, but also induce collagen remodelling- improving both skin texture and skin tone.

What is TCA peeling?

TCA (Trichloroacetic acid) peels are a time tested method of treating sundamage, uneven skin texture, and decreased skin tone. Peeling with TCA gives a predictable response and result.  The procedure takes approximately 10-15 minutes to perform and is conducted in one of our operating theatres.   Generally one to three peels are conducted over six to ten weeks.

What is the recovery of TCA peels?

Recovery from TCA peels depends on two important factors- the concentration of TCA used and also the site of treatment.  The most common concentration used is between 20-25% for the face, with a typical recovery time of 6-8 days.  TCA peels of the chest area generally take longer to heal- 10-12 days in total.

What conditions can be treated with TCA peels?

TCA peels can be an excellent method of treating skin pigmentation and uneven skin texture.  Conditions such asfreckles, sun damage, and melasma can be successfully treated by TCA peeling. In addition higher strength TCA peels can improve wrinkles and increase skin tone. In higher concentrations of TCA , dermal collagen is stimulated – which accounts for the improvement in tone and wrinkle reduction.

This treatment is ideal for heavy sun-damaged skin and stubborn pigmentation

More on TCA peels

More on Chemical peels

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Glycolic acid / AHA peels can reduce fine wrinkling.  Peels conducted on site typically start from 20% Glycolic acid, thru to 70%. A home kit contains 15% Glycolic acid, and this can be combined with Tretinoin for superior results.  Glycolic acid/ Alpha Hydroxy Acids increase dermal collagen by stimulation of fibroblasts ( cell.s which produce collagen).

What are Glycolic acid peels (AHA peels)?

This peeling agent is the most commonly used chemical peel and is frequently referred to as the ‘lunch time peel’. Side effects are uncommon, recovery is quick (within an hour or two), and the procedure is affordable ($85 per peel.)  Our peel concentration starts at 20% and typically ends at 70%.  We recommend a series of peels spaced between 2-3 weeks apart.

How do Glycolic Acid peels differ from TCA peels?

Glycolic acid peels are gentle peels with little or no downtime and is ideal for superfical pigmentation and correction of very fine wrinkles. TCA (Trichloroacetic acid) peels are aimed at reaching the deeper layers of the skin. Depending on the concentration, a downtime of upto 6-8 days can be expected for TCA peels on the face. This peel is ideal for deeper and more severe pigmentation and more severe wrinkling.

How are chemical peels performed?

All forms of chemical peeling are conducted on site at Westside Dermatology. Patients are assessed by a specialist dermatologist prior to any peel to determine the skin type and the best agent/concentration. Glycolic acid peels are conducted by experienced nurses, TCA peels are conduced by consultant dermatologist.

How will I know what chemical peel is right for my condition?

Several important factors come into consideration as to what treatment is best for you.  Dermatologists consider factors such as the patient’s skin condition, the degree and depth of pigmentation/ acne/ sun-damage/ aging, skin type, and the recovery or downtime allowable.  Additionally we may provide other options apart from chemical peels to best treat your condition.

What is the difference between chemical peels conducted at other centers and peels prescribed at Westside Dermatology?

Chemical peels at Westside Dermatology are performed by experienced nurses and specialist dermatologists. All patients are carefully assessed by dermatologist prior to prescription of a peel. Our selection of 3 types of chemical peels with varying concentrations enables us to prescribe an accurate regime for your condition.  Chemical peels conducted at Westside Dermatology can be far stronger than that conducted at beauty therapist or day spas. Our accessibility and experience treatments such asFractional lasers, BBL lasers and PDT will also provide patients with the best treatment options for their condition.

More on chemical peels

Prevention of wrinkle can be achieved by reducing extrinsic factors such as UV exposure and smoking.  Sunscreen forms the basis of UV protection, additionally anti-oxidants such as Vitamin C may act as antioxidants.  

Dermatologist often prescribe topical retinoids such as Tretinoin. Retinoids can stimulate collagen production as well as increase the thickness of the epidermal layers, in turn diminishing fine visible wrinkles.  Unless there are contraindications, we suggest the nightly use of retinoids in your skin care regime. Prescription retinoids are approximately 100-1000 times higher in concentration then over the counter products.  A prescription cost less than $30 to fill, and lasts upto 4 months!

The treatment of wrinkles is only one aspect of aging - preventing wrinkling and photodamage is the foundation for the future.  A dermatologist can guide you in regards to sensible product use and provide an unbiased assessment of your daily regime.  Winkles rarely occur in isolation - professional assessement of your skin tone and texture with appropriate treatments will give a natural, balanced and harmonious outcome for our patients.

Enquire about wrinkle treatment

moreDr. Davin S. Lim

Dr Davin Lim, Dermatologist

Dermatologist have an array of treatment options to treat wrinkles at Westside Dermatology.  The progress of Fractionated lasers  over the past few years has given patients a new modality to treat wrinkles and address rejuvenation, providing consistently excellent results with minimal down time.

Addressing winkling is only one part in treating the ageing skin. The treatment of photodamage, skin texture, and pigmentation will give clients a better outcome.