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What Causes Facial Wrinkles
by Dr Gavin Chan - Victorian Cosmetic Institute

Facial wrinkles are caused by a number of factors;

Expression lines – these are wrinkles that are caused by contraction of the muscles of facial expression. This leads to the compression of skin that results in wrinkle formation. Initially, these wrinkles can only be seen when the muscles contract e.g when you smile/frown, however, as the skin becomes progressively creased, the lines may often appear at rest.

Loss of facial volume – When we are younger, our face is more plump and full like a beach ball, and as time passes, this volume is lost making it more like a sultana. fat around the eyes, cheeks, and forehead are depleted. This loss of volume leads to some laxity of skin and the formation of wrinkles.

Gravity – the inescapable pull of gravity pulls the skin downwards on the face. This leads to drooping of the cheeks and formation of nasolabial lines (the lines from the corners of the mouth to the nose) and jowls, drooping of the eye skin and formation of upper and lower lid laxity and wrinkles.

Sleep lines – this is caused by the compression of the skin from contact of the pillow to the face when sleeping. Their location is determined by the underlying anatomical attachments of the superficial musculoaponeurotic system (SMAS). Pillow contact puts pressure on these attachments and causes sleep lines. Sleep lines include those on the forehead, around the eyes, cheeks and upper lip.

How can wrinkles be treated?
Expression lines are generally treated with anti-wrinkle injections (Botox) that relax the muscles causing the compression of the skin . This is most commonly performed in the muscles between the brows and the around the eyes. Anti-wrinkle injections generally last for 3 to 4 months. By stopping the movement/expressions that cause wrinkles, anti-wrinkle injections can also prevent static lines from becoming deeper by stopping the compression of skin. If static lines or lines at rest are already present, then anti-wrinkle injections generally do not reverse these. However, the application of anti-wrinkle injections at regular intervals gives the skin a rest from compression, and often static wrinkles may improve slightly over time.

A common method of treating static lines or lines at rest is with dermal fillers. Dermal fillers add volume to the area that has lost volume due to expression formation, gravity, sleep or just aging. Mostly, dermal fillers are temporary in their effect and last from 4 to 18 months.

A more permanent solution to wrinkles is skin resurfacing. This can be done with laser, deep chemical peels, or plasma skin regeneration. Traditional laser resurfacing techniques, although effective, often require a large amount of downtime or recovery. At The Victorian Cosmetic Institute, we recommend plasma skin regeneration for the treatment of wrinkles as it offers results whilst minimising downtime.

Volume loss is usually addressed by using thicker dermal fillers such as Radiesse, Perlane, or Restylane Sub-Q. These can add volume to the cheeks, chin, and eye areas to replace the fat lost over time. A more permanent alternative is fat grafting which is performed by plastic surgeons.

Dr. Gavin Chan (MBBS)
The Victorian Cosmetic Institute
Level 6, 200 High St
Lower Templestowe 3107
(03)88500655
www.thevictoriancosmeticinstitute.com.au

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