Recharge Medical Blog

Philippe T. Nguyen, MD

Philippe T. Nguyen, MD
Chief Medical Officer

The Definitive Guide to Preventing and Reducing Wrinkles in a Post-pandemic World

January 17, 2022

closeup of wrinkles around a woman's eye

An inevitable effect of aging is the development of wrinkles. This occurs for a variety of reasons:

sun and environmental exposure
skin thinning
diminishing collagen production
prolonged muscle contractions
changes in muscle, fat, and bone density
habits and behaviors

For example, is working from home giving you Zoom fatigue? This new norm seems to contribute much of our screen time. Squinting caused by ongoing screen usage can contribute to the formation of new wrinkles and deepen old ones.

Basic prevention

Here are some things you can do to delay the onset of wrinkles:

Use sunscreen when you can’t avoid the sun. I recommend SPF 30 or greater.
Keep your skin moisturized by drinking plenty of water and using hypoallergenic skin moisturizers.
Get enough sleep to feel well-rested upon waking.
Cut down on screen time. Now more than ever we spend lots of time with screens. It’s important to reserve time without screens.
Stop smoking. See Slideshow: Surprising Ways Smoking Affects Your Looks and Life.
Maintain good nutrition. Including fresh fish in your diet is a great way to add protein and omega-3 fatty acids that improve the ability for your skin cells to retain moisture and nutrients to help your skin look healthier. See Want Healthy Skin? Feed It Well.

Prevention begins at the first sign of wrinkles

Consider starting anti-wrinkle treatment at the first sign of troublesome wrinkles. For many people wrinkles are a sign of wisdom and longevity—the visible remnant of life battles fought and won. They don’t mind those lines on their face. Other people prefer their wisdom and history to be told through their stories and not their face. These people prefer the aesthetic of smooth skin. If you know you are in the latter group, the earlier you start to treat the signs of aging the easier it will be to keep those wrinkles at bay. More: 4 reasons why people in their 20s or 30s should get botulinum toxin (Botox/Xeomin)

Prevention can help delay wrinkles and reduce their severity, but wrinkles will still eventually form. Fortunately, a wide variety of treatments are available.

Wrinkles are not skin deep

Causes of wrinkles run deeper than just the surface of your skin: diminishing collagen production, prolonged muscle contractions, and changes in muscle and fat density are all contributors to wrinkles. Consequently, treating wrinkles often requires more than just botulinum toxin or topical creams. Often multiple treatment modalities are required to address the many contributing factors of wrinkle development.

What to do if you can’t limit your screen time

At home, switch from a phone to a tablet or computer to view your emails and texts on a bigger screen. If you wear glasses, ask your optometrist about light-sensitive glasses to decrease eye strain. It’s easier said than done, but being cautious of how close you are to your screen can reduce constant eye muscle contractions that contribute to wrinkles around the eyes. With or without screens, ensure that your corrective lenses are the right prescription.

Treatments

Botulinum toxin

Sold under brand names Xeomin, Botox, and Dysport, botulinum toxin injection is neurotoxin that locally and temporarily paralyzes small muscles in the face, thus diminishing the appearance of wrinkles. This is a good method to address the effects of prolonged and repetitive muscle contractions. Botulinum is safe, quick, inexpensive, has minimal discomfort, and the effects can last for four months.* Botulinum is even more effective when you start treatments while your wrinkles are still relatively small and fine. By using botulinum early and keeping those muscles relaxed, you reduce the wrinkling effect on your skin. However, botulinum can do only so much. It cannot address deep issues like bone and fat changes, and it does not stimulate collagen production. Botulinum is often a good first treatment. It is great for fine lines, and it is a wonderful component of a treatment plan that includes other procedures.

Topicals

Collagen-stimulating topical medications such as fibroblast growth factors, retinoids, and vitamin C serums can help, but they are best used for maintenance in conjunction with other treatments. Topicals do not address other factors in wrinkle development such as prolonged muscle contractions or changes in muscle, fat, and bone density.

Laser treatments

Laser treatments like laser facelift and laser hair removal are a more aggressive and more effective option to address loss of collagen. The process activates skin cells to stimulate collagen production in a mechanical way. Medical lasers emit different types of energies which trick the skin into producing more collagen. Lasers are also very effective in treating sun damage by stripping away the damaged skin. Laser treatments do not address other factors in wrinkle development such as prolonged muscle contractions or changes in muscle, fat, and bone density.

Microneedling

Microneedling treatments (also known as collagen induction therapy (CIT)) involve hundreds of little needle pokes to stimulate mechanical collagen production by producing minor trauma to skin tissue. Microneedling does not address other factors in wrinkle development such as prolonged muscle contractions or changes in muscle, fat, and bone density.

Microthreading

Microthreading is similar to microneedling, but microthreading uses only a few pokes. During this procedure your physician will use a cannula needle to inject absorbable surgical threads under your skin. Fewer pokes means less pain, less bruising, and less chance of infection. Microthreading does not address other factors in wrinkle development such as prolonged muscle contractions or changes in muscle, fat, and bone density.

Dermal fillers

Dermal fillers (aka injectable fillers) replace lost skin volume with safe, biodegradable materials like hyaluronic acids or hydroxyapatite. Fillers can last from six months to a few years, depending on which you choose.* Fillers are great to lift areas of skin that appear saggy, tired, or gaunt. Dermal fillers combat the effects of diminished collagen production and changes in muscle, fat, and body density. Dermal fillers do not address other factors in wrinkle development such as environmental damage or collagen production.

Thread lift

In a thread lift treatment absorbable sutures lift sagging skin and pull underlying tissues up. This treatment is great for drooping marionette lines and jowls and is a great median between fillers and cosmetic surgery. This treatment can provide much more pronounced results in a shorter time, compared to many other non-surgical treatments.* However, the procedure requires great physician skill. This treatment addresses many causes of wrinkles, including loss of collagen, prolonged muscle contraction, and changes in bone and tissue density. Thread lift will not address any environmental damage.

Platelet-rich fibrin treatment (PRF)

This treatment injects you with your own blood platelets to stimulate the growth of healthy collagen cells which reduces fine lines and wrinkles. PRF treatments are best used in conjunction with botulinum injections, fillers, and laser treatments. Some providers will also offer this treatment in conjunction with microneedling or peels. These topical applications of PRF are often called “vampire facials.” However, we have found that topical application of PRF is not effective and only recommend PRF injections.

The top 4 things to consider when choosing a physician

With so many options available, you need a cosmetic medical physician who can help you understand them all in the context of your situation, even if you aren’t ready to commit to treatment. Here are my recommendations on what to look for.

1. Experience

Choose a physician that has at least three years of experience with these procedures. In wrinkle treatment, practice does make perfect.

2. Rapport

Choose a physician that takes their time with you to make you feel comfortable enough that you can imagine yourself returning over a series of many treatments.

3. Versatility

Be wary of physicians that recommend only one treatment. Those that offer many forms of treatment are more likely to help you determine the best treatment plan for you.

4. You get what you pay for

As with other medical treatments, you pay for:

time with a physician with years of education, skill, and experience
advanced technology: for example, a medical laser can cost $90,000, which is amortized across the patients it serves over its lifetime
materials: the cost of botulinum toxin and fillers are largely dictated by how much pharmaceutical companies charge.

Everyone likes a bargain, but deep discounts on cosmetic medical treatments can be a warning that the treatment or physician is not the highest quality. In order to offer deep discounts, quality has to be cut somewhere: diluted or counterfeit pharmaceuticals, out-of-date laser technology, an inexperienced physician, or no physician at all. Cheap deals for botulinum toxin or laser treatments are widely offered, but they will likely cost you more in the long run if the results are ineffective or unsafe.

Everything you need to know about your first visit

Before your first visit

Think: spend some time seriously thinking about:
- what you like about your appearance
- where you see yourself aging gracefully
- what parts of your appearance you want to change.
Perhaps you don’t mind “think lines” on your forehead or “smile lines” around your mouth but reducing a drooping jowl or crow’s feet will make you much less self-conscious about your appearance. The answers are different for everyone. Your physician will be better equipped to help you the more certain you are about your answers to these questions.
Talk to people that have had these procedures, since hearing about others’ experiences can help you understand what to expect. However, remember:
- Treatment advances all the time. For example, a facelift today is not the same as one from several years ago.
- Reactions to treatments can vary; your friend’s experience will not necessarily be identical to your experience.
- Physician experience is paramount. It’s possible to have vastly different results when a treatment is performed by a nurse practitioner with one year of experience than by a cosmetic medical physician with 10 years of experience.

During your first visit

Your physician should review some or all of the options above, helping you understand realistic outcomes and decide on a treatment plan. For example, a thread lift might be the best option to achieve what you seek, but maybe dermal fillers are a better fit for your life right now.

Plan to consider and discuss all of the following:

Goals: the current state of your wrinkles and your ideal image
Cost: how much you can afford
Time:
- how quickly you want results
- how much time you are willing to spend getting results
- how long-lasting you want results
- how frequently you’re willing to have follow-up visits
Other:
- how much discomfort you are willing to endure
- what human biology and current science will allow
- each treatment’s risks, benefits, downtime, and costs.

2 musts for getting meaningful results

Use more than one kind of treatment

In my experience, most patients’ goals are best met with a treatment plan that involves more than one strategy. Using two or more treatments that address multiple causes of wrinkles has a far better chance of getting you the results you want. If you have been regularly using only one kind of treatment and are not seeing the changes you desire, add another kind of treatment in consultation with your physician to improve your odds for success.

Visit your physician regularly

Whereas some goals can be met in just one or two treatments, often meaningful change happens over a series of treatments. Wrinkles don’t appear or disappear overnight. You need to be comfortable visiting your physician regularly to achieve those results.

Contact us

Are you in the San Francisco Bay Area? Book an appointment with one of our skilled physicians to learn more and develop a treatment plan that is right for your goals, budget, and timeframe. See appointments or call us at 415-409-3456.

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