Patient Information — An Overview of Wrinkle Treatments

Since there are different types of wrinkles and lines, there are also various therapeutic treatments. Of them all, lifting operations, which involve the tightening of the facial skin under general anaesthetic are indeed the most invasive. However, for most wrinkles, less invasive procedures are usually sufficient. Dr. Boris Sommer specializes in gentle wrinkle therapy. His guide “Sanfte Schönheit - Faltentherapie mit Botox & Co“ (Gentle Aesthetic Wrinkle Therapy with Botox & Co) was published in 2005 by the Trias Verlag (ISBN 3-8304-3230-5).

Most of the procedures mentioned here can be performed without interfering with the patient’s regular schedule or activities. To determine which treatment is most suitable for you, we recommend a personal discussion with the doctor.

What are the different procedures that are available to treat wrinkles and lines?

Filling the wrinkles (injectable materials and soft tissue augmentation)
Individual skin folds, for example, those that extend from corner of nose around the mouth and down to the chin (doctors refer to them as nasalobial folds) can be smoothed out with one of several suitable materials, including hyaluronic acid, collagen and polylactic acid.

Subcision
Originating from Latin, the term refers to the act of separating the skin tissue in the affected area from the deeper tissue. A minor surgical procedure is required to release the skin tissue and cause the depression to lift.

Botulinum toxin
Dynamic wrinkles caused by frequent muscle movement, such as smile, frown and worry lines that appear between the eyes or on the forehead, are best treated with botulinum toxin.

Peeling or dermabrasion
Peeling and dermabrasion return the skin to its former youthful look, removing the superficial skin to allow healthier skin cells to surface for smoother texture and tighter skin. These procedures are especially suitable for older patients who frequently have many fine lines or liver spots throughout their entire faces.

Mesotherapy treatment
In cosmetic medicine, mesotherapy is considered a gentle treatment for the rejuvenation of the skin. It doesn’t completely remove wrinkles and lines, but it is more of an overall revitalizer that improves the skin’s general appearance. It is especially recommended to treat tiny creases in the face, throat and neckline areas. The active substances are injected with a tiny needle and stimulate the metabolic function.

Does it make sense to combine different treatments and procedures?

Yes. Since not all wrinkles have the same origin, different therapies are required. Thus, a combination of various procedures to rejuvenate the skin often makes sense, for example, botulinum toxin for the forehead, fillers for nasalobial folds and dermabrasion for fine lines around the mouth. The specific areas to be treated and a plan will be discussed in personal consultation with the doctor.

What is meant by soft tissue augmentation with fillers and how is it performed?

If the skin exhibits deep furrows and folds in several areas of the face, the injection of fillers can be performed to stabilize and reverse the formation of wrinkles. This procedure is also suitable for zones where aging processes have led to the loss of subcutaneous fat (for example, the cheeks). Several suitable filler materials are available. The actual injection procedure, regardless of the material, is the same. The tiniest needle possible is used to inject the material where it is required in the subcutaneous layer or between the subcutaneous layer and the skin, depending on the depth of the wrinkle. Careful placement of the material is essential, as deposit in the wrong skin layer can lead to complications. For this reason, the doctor performing the procedure must have very accurate anatomical knowledge. Local anaesthetics may be required when fillers are applied to highly sensitive areas, such as the upper lip, etc.

When can I proceed with my usual activities without feeling self-conscious about how I look?

Thanks to the use of the smallest possible needles, only minute traces of needle punctures may be slightly visible following injection of the filler under wrinkles. They are easily covered with makeup until they disappear (usually within two hours). Light swelling, which is usually so faint that it is not noticeable, may last a day. Depending on the individual or extent of blood vessels in the operated area, slight bruises are, unfortunately, not always avoidable. Should they occur, makeup will easily cover them.