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more articles by Lewis, Jeffrey S. , DMD, MD  |  author's bio

Smoothing Away Wrinkles and Lines

By Jeffrey S. Lewis, MD, DMD


While there are truly enjoyable aspects of aging, such as watching our children grow up, most of us do not appreciate the lines and wrinkles we acquire through the aging process. Fortunately, facial cosmetic surgeons now have an arsenal of tools to help smooth the lines and wrinkles that can make us look tired or older than we feel.


In my experience most patients seeking facial cosmetic work fall into one of two groups: patients who know they want cosmetic surgery to achieve significant change, and those who know they want to improve aspects of their appearance but they absolutely do not want to have surgery.


What are the nonsurgical options for smoothing facial lines and wrinkles?

There are essentially two general categories of injectable treatments to smooth facial creases, lines, and wrinkles. The first category is injectable botox. This is used to treat muscle-induced lines and creases, such as crow’s feet at the outside corners of the eyes, forehead furrows, and lines around the lips. These creases and lines appear when a person is engaged in activities such as laughing, talking, or squinting. The second treatment category includes injectable fillers, which are used to enhance volume in indented areas, such as scars and certain types of skin folds. Fillers are designed to smooth lines and creases that are present when the person is at rest and the face is still.


What’s the major difference between botox and fillers?

Botox is a paralyzing agent that is injected into the muscle fibers, weakening their ability to contract. Botox injections are very successfully used for crow’s feet, for example, where the skin is thin and wrinkles like an accordion when the muscles contract t0 smile. This is quite an effective treatment in the hands of an experienced practitioner. The amount of botox injected for facial aesthetics is completely safe: people can still be very expressive facially, but without their crow’s feet.


Two widely used fillers today are Restylane® and Juvederm®. Unlike the injectable collagen that was used in the past, these new gels are made primarily of hyaluronic acid, which is a carbohydrate polymer that is naturally occurring in all humans and is a major component of connective tissue in skin. As a result, these injectable fillers are quite safe and there have been no reports of allergies, as there were with collagen fillers.


What are some of the pros and cons of injectable treatments?

Unlike cosmetic facial surgery, which requires several days of recovery, injectable treatments have very minimal impact on lifestyle. Injections, which typically take about fifteen minutes, are performed in the office of a cosmetic surgeon. Patients can resume regular activities right away: you can come from work, have the injection, and go out to dinner afterwards. For the overwhelming majority of patients, the resulting look from injectable treatments exceeds their expectations.


The downside of injectables is that the results are not permanent. If you love the results, as most patients do, it will be a recurring expense. We expect the effects of botox to last for about six months and the injectable gels to last for twelve months. Naturally results vary somewhat from patient to patient. However, with no recovery time and no surgical risk, many people prefer this option.


It is very satisfying to offer such a low-risk treatment that provides such a high level of satisfaction and meets patients’ goals. Over 90 percent of patients who visit my practice for botox or injectable gels decide to return for repeat treatment in the future.


Dr. Lewis is board certified in facial cosmetic surgery by the American Board of Cosmetic Surgery. He serves on the medical staff of Cayuga Medical Center, where he is director of the Cayuga Medical Center Cleft Palate and Facial Deformities Team and Clinic. He can be reached at Cayuga Facial Surgery at (607) 277-7007.

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