Why do we get wrinkles?
As we age-wrinkles start to form on our faces, hands and elsewhere. Most of the wrinkles are formed because of three reasons – the sun damage, the repeated use of facial muscles and the degradation of those skin substances that keep the skin tight during the youth (like collagen and elastin proteins among others).
There are many options available in today’s advanced medical world. With the latest developments in the medical sciences, lasers can repair a lot of the sun damage by taking away the dead layer of the skin that the body replaces with the fresher new skin – giving you the youthful appearance. Similarly, Botox® and skin fillers can get rid of different kinds of wrinkles without having to go through any surgery. The good news is that most of these procedures are non-surgical, take only a few minutes to perform and you can resume your regular activities immediately after the procedure. Moreover, almost no pain is involved as local anesthesia (in the form of very effective creams) can be applied to make the skin anesthetized before the procedure.
Following are a few options used for wrinkle removal / reduction. During your consultation, our doctors will guide you about different options and the best treatments in your particular situation.
What is Botox®?
Botox is a nonsurgical therapy that can make a remarkable difference in softening and virtually eliminating deep furrows and wrinkles between your brows, creases on your forehead, and crow's feet around your eyes.
Botox® is a medicine that is injected with a very fine needle in the skin with very little or no discomfort to the patient. It is used very safely, simply and effectively. By relaxing the underlying muscles, Botox® reduces wrinkles. Botox® is a remarkable treatment for dynamic wrinkles resulting from repeated use of facial muscles.
How does the Botox® work?
BOTOX® acts as a nerve impulse blocker. Botox® actually prevents wrinkles from appearing by relaxing the underlying muscles so they don't contract. Botox® binds to the nerve endings and blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing your normal facial expression to be unaffected.
What is the Botox® treatment like?
BOTOX® therapy is a simple and safe procedure performed by our doctors in our clinic. The injection takes just minutes, and there is no significant pain, as we use extremely fine needles. No sedation or local anesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to the office. Usually makeup can be reapplied before patients leave the clinic, and normal activities can be resumed immediately after the procedure. Some results from BOTOX® therapy will be seen in the first few hours, but it generally takes one to two weeks for the full effect to become apparent. BOTOX® treatment may be repeated a couple of times a year to maintain the desired effects.
What is a skin filler or dermal filler?
Natural proteins like collagen and elastin, and a special substance called ‘hyaluronic acid’ form the support structure or the “filling material” of your skin. When these substances degrade with advancing age, wrinkles begin to appear. This loss is mostly attributed to aging, but smoking, exposure to the sun, pollution, health, heredity, and lifestyle also play major roles. Several “filler” products that contain one of these filling materials are available to fill the wrinkles. These include collagen injections and hyaluronic acid filler injections. Different brands of hyaluronic acid injections like Restylane®, Perlane®, Juvederm®, Puragen™,and Prevel® – are available to restore fullness and remove wrinkles appearing on the face.
Various options – different brands.
Hyaluronic Acid or HA like Restylane® treatment has been used for years in the smile lines and marionette lines that develop around the mouth area, and to create fullness in the lips. Perlane® and Juvederm® are slightly more concentrated products that have been a popular treatment in Europe for deeper lines and wrinkles. Restylane®, Perlane® and Juvederm® are made up of non-animal based hyaluronic acid, a substance found naturally in the body, so no allergy testing is required. Hyaluronic acid binds to water, gradually causing the body’s own moisture to add volume in the treated area. These products are injected with a tiny needle just under the surface of the skin. Like your own “natural hyaluronic acid”, your body eventually breaks down and absorbs this injected material slowly in the next few months… so ongoing treatments are necessary to maintain results.
Semi-permanent options include Aquamid® and Radiesse® which can last from 3 -5 years and are called the ‘semi-permanent’ fillers. These fillers are relatively newer addition to the anti-wrinkle therapy.
What is the treatment like? - Effects and expectations………….
Treatment takes only 15-20 minutes. To make the injection painless, a topical numbing cream can be applied 1 hour prior to treatment, but normally there is minimal discomfort. Applying ice to the site after treatment helps minimize any swelling or bruising. Results of these products are immediate. Because people absorb these materials at varying rates, repeat treatments may be required between 3 months to 12-month intervals.
Are there any permanent fillers?
Yes, there are some permanent fillers available but most of them are not FDA approved. FDA stands for Food and Drug Administration of USA. It is a government regulatory body to ensure the safety and efficacy of medicines and materials used for patients.
Radiesse® is one of the long term fillers approved by FDA in certain cases.
Why not use permanent fillers in every case?
Permanent may mean permanent correction / improvement but may also result in some permanent problems as well. Some of permanent fillers like silicone injection on the face can be extremely dangerous in some cases and should usually be avoided.
It is, therefore not recommended in every case especially when much safer and extensively used Hyaluronic Acid fillers like Restylane® are available and have long safety record. These fillers have been used in millions of people with out any significant problem. But in certain cases long-term filler may need to be used and that can be determined during consultation with Dr. Azim.
What is the fat transfer?
We can take fat out from where it is not needed like the bulging abdomen and can put it where it is needed like a depressed wrinkle, hollow cheeks or depressed cheek bones to make cheek bones higher. Since fat comes free of cost and is natural from your own body it is cheep and safe.
As we age, our muscles and skin lose some of their elasticity, and the cushion of fat, which provide the foundation for smooth and creaseless skin, dissipates.
The resulting facial creases and depressions can be corrected by implanting some material to take the place of the lost fatty cushion. When one's own fat is used for implanting, the possibility of allergic reaction or rejection is eliminated.
Fat transfer is an effective procedure in minimizing creases and grooves. It also can be used to augment lips, cheeks, the chin or earlobes (to help minimize tearing from wearing large earrings), recontour the face, and even adjust some body contours.
Fat transfer is performed in our outpatient surgery center by our skilled doctors. A donor site is chosen based upon patient preference. The hips, buttocks, thighs or lower abdomen are areas in women where fat can easily be harvested. In men, the donor area is often the flank area above the hips. During the procedure, both the donor site and the recipient site (site where the fat will be transferred to) are treated with local anesthesia, to minimize discomfort. The duration of the procedure depends on the number and size of the locations being treated. A small amount of bruising may occur. Patients usually resume normal activities immediately or within a day, and return to strenuous sports or activities within a week.
Where can the fat transfer be used?
It can be used at any area which is depressed and needs to be filled. It can be deep laugh lines on the face or a depressed scar of an accident, low cheek bones or small breast. It can also be used to rejuvenate the hands and feet where emptiness can give them an aged look.
How long will the fat last in new location?
Once transferred about 50-70% of the fat is absorbed by the body and 30-50% will stay for a long time and maybe for life. It means that additional procedure may keep on adding volume to the pre-existing fat.
Is fat transfer a safe procedure?
Absolutely yes. It is as safe as it can get, because it is your own fat being transferred from one place to another. Since no foreign material is used, no reactions are seen.
Laser Peel & Resurfacing Treatments
Laser peel and laser resurfacing treatments may also be used to minimize the appearance of wrinkles and uneven skin tone and pigmentation on the face and other parts of the body. Many kinds of lasers are available to repair the time-damaged skin. As we age, the skin loses the elasticity and the lasers like Er: YAG laser, especially in Pakistani population, can do a remarkable job of eliminating the outer dead layer of skin and can get rid of the fine lines. If done aggressively, it can even eliminate the deep wrinkles but in darker skin, can cause the pigmentation, so it should be avoided.
To fight the wrinkles in Pakistani population, the safest approach is the “Fractional Laser Resurfacing”, in which only a “fraction” of the total skin is treated at a time. This “fractional” approach to get rid of the damaged skin, gives the skin enough time to replace the ‘fraction’ of the skin with the new vibrant skin, before we can go ahead with the next fraction that needs treatment. In 3-5 treatment sessions the damaged wrinkled skin is replaced completely with the young new glowing skin. The best part is that the procedure is completely painless and takes only 20-30 minutes to complete. The skin may stay slightly pink for the next 24-48 hours and there is no other downtime. You can apply the makeup the next day and continue with your daily routine activities.
We use the most advanced lasers like Fraxel® or Mosaic® to treat the fine wrinkles and pigmentation to give your face a brand new refreshed look without any side effects.