Article: Wrinkles
Cause suppression versus symptom suppression
Wrinkles are caused by contracture of the underlying muscles of the face, decrease in the elasticity of the skin or by loss of subcutaneous fat in combination with the force of gravity.
Treatment possibilities
In my opinion the most logical action to take is to tackle the cause in the treatment of wrinkles. Frown wrinkles for example, can be treated successfully by reducing the activity of the underlying muscles with botox-injections. On the other hand grooves in the face, which have developed by the force of gravity and the loss of subcutaneous fatty tissue, are best combated with a (mini)facelift which brings the skin back to its original place. Adding one’s own fatty tissue would also be useful, but this is technically cumbersome.
Only small quantities of injected fatty tissue survive and catch on, for example by filling out the upper lip. But small wrinkles in the upper lip can also be treated with a superficial laser treatment or shaving method.
Danger of injections
Lately the use of several products for raising wrinkles, which are injected, has soared tremendously. The request for wrinkle treatment is great and for this reason a fast, simple and relatively cheap treatment can count on success in advance. Moreover, the injection or filling out of wrinkles by none-plastic surgeons can be easily learned and this treatment can be carried out in a simple setting.
At the same time there are also hidden risks, because not all injections are innocent. Without medical surgical training those risks are difficult to assess. After a long training, in which I also did research in the field of wound healing, I became extremely careful with these products: I do use botox however, but products which remain permanently present in the body, I do not use.
The fact is that it is difficult to predict how these permanent products are going to react in the long term. Usually cartilage or scar tissue forms around the injected substance. When the skin starts to age and becomes thinner, or the subcutaneous fatty tissue shrinks, these products can come to the surface and lumps and bumps can become visible.
Furthermore, it is good we realize that the face forms a dynamic whole. Through the functioning of the facial muscles, the mimic, the face is in constant movement. If subcutaneous cartilage has formed due to the given injection and hard spots have developed, the expression can show strange and unnatural changes.
Dr. Erik Jan Timmenga
