Recently, it seems that “patients’” and doctors’ preferences, that are fast and do not demand great amounts of time for rehabilitation, gain ground. These methods cannot substitute the surgical methods, such as the face lift, yet they act either in a complementary way or as a precaution in younger ages. The two most commonly used methods are: the botulinum toxin (Botox, Vistabel, Dysport) and the use of materials that “fill” the wrinkles.
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The face muscles and those of nape, have the unique attribute to end on the skin of the according area. Their contraction makes the skin move and therefore makes grins and expressions. They are responsible for the face expressions and function semi-automatically. The action of every muscle provokes wrinkles, which are vertical to the muscle’s axis. These are the expression wrinkles. The forehead’s horizontal wrinkles (forehead muscle), the vertical wrinkles of the glabella and the wrinkles of the goose leg are some examples. The paralysis of those muscles would make the wrinkles disappear. The botulinum toxin acts this way, which causes temporal abolition of a muscle function, should it is injected with the toxin. The toxin physiologically acts as a temporary block of the neural ends on the muscle.
The use of this medicine, though recent for the wrinkle treatment (certified from the Greek and the American Medication Organizations), it is used since decades to other medical fields, so its safety is proven. Yet, there are rarely reported topical implications during the application to the glabella, where the release of the medicine in the elevator causes a short term paresis.
The experience in applying the medicine is of great importance for achieving a harmonic balance to the face.
The most common and safest use is on the forehead, the glabella and the goose leg. There are also some other muscle groups, which if a trained doctor applies the toxin selectively, he could have stunning results in the expression and appearance of the face. A safe application is made also in the area of the nape, which is responsible for the wrinkles on the neck.
The duration of the results vary from person to person. We could say that the duration is roughly 8 months after which the treatment should be repeated to retain the result.
Gravity and time sag the face and make deep wrinkles. The lip-cheek channels are a result of gravity and time. We cannot improve those wrinkles through paresis, we can, however, soften them if we “fill” them. Wrinkles round the mouth are restricted to be dealt with botulinum toxin (mouth paresis causes functional deficiency). They can, however, be dealt with “filling” the boundaries of the lips achieving a discrete and appealing view on the mouth.
These substances are separated into temporary and permanent, depending on their duration.
The permanent substances, although commonly used in the past, they are not used today, due to high probability of granuloma appearance. Typical representative of this group is the liquid silicone, where its use is now forbidden due to its many complications. Substances of a middle range (mixtures of hyaluronic acid and glass microspheres, etc) gave a more extended result, but started not being used since cases of granulomas were reported after years from the treatment.
Substances that are absorbed from the organism and need re-application every 6-8 months are preferred:
It is usually of oxen derivation. Concerns have been raised after the “mad cow” disease, which made doctors and patients cautious to its use, although its production is fully controlled in closed farms and from totally healthy animals.
It is the substance that is used mainly today to correct wrinkles. You can find it in the market under various names and in different densities according to the treatment you would like to follow. A lighter hyaluronic acid is used to treat the external wrinkles and a denser to the deeper wrinkles.
The term mid-treatment was given for the small shots of hyaluronic acid in multiple and vicinal points on the face and neck. Definitely, a small shot of hyaluronic acid under the skin in multiple points causes an expansion and a sense of robustness on the face. There are views that this way the skin collagen is reinforced etc, and are being checked for verification. The “mid-treatment” should be revised every 6-8 months.