How can I get rid of these creases/lines/wrinkles on my forehead?

Dr. Dean Kane Q & A worried, frown lines Q. I’m only in my mid 20’s and I already have these! They’re deep when you feel them. Not sure what causes them as they aren’t from frowning/smiling. Just wondering what sort of options I have to get rid of them? A. Botox is your first line of reversal; relaxing the muscle which creates the fold; which etches the “line” into the dermis; which allows for the repair mechanisms of the skin to resupport the dermal injury. ​ ​Botox by itself will not get rid of the line. Sun protection, retinoids and possibly fillers will also help. Facial Aging are created from the 5 different layers of the skin, fat, muscle and bone. ​ During the first 20 years or so of life, the body genetically determines how to develop and repair a constantly changing “face” including all these layers (as it does elsewhere in the body). Thereafter it remains robust in repairing itself from injury but the accumulation of environmental, health and nutritional exposure will add to the passive inability for the body to care for itself after 30. This is when physical changes such as skin laxity, irregular pigmentation, lines and wrinkles and skin diseases occur. We now have many options to rejuvenate the layer or layers of the face which need care or stimulation to reverse the aging trend. 1. The top layer or stratum corneum of the epidermis is the rough, pigmented layer of the skin; creating most of the depth of the wrinkle.
  • Exfoliation is best for this using:
  • microdermabrasion,
  • Retin-A (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper epidermis,
  • Some lasers and chemical peels.
  1. The second layer is the dermis which thins with aging. The natural collagen, elastin and hyaluronic acid (which hydrate and toughen the skin) are thickened by the use of:
  • fillers (Restylane and Juvederm), or
  • Retinoids (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper dermal skin cells.
  • Sculptra properly managed is the latest sensation in stimulating firming and thickening of the dermis
3. The next layer or fat also thins or droops with age and maybe:
  • filled (Restylane and Juvederm), fat grafting or
  • redraped (threadlift, short-scar, traditional, endoscopic face / neck / brow lifts / cheek)
  1. The muscle which creases the skin into wrinkles and folds is weakened and rebalanced with
  • Botox or similar injectable muscle relaxers like Dysport or Xeomin.
Everyone needs one or more layered improvement and in personalized combinations to achieve their optimal result. ​You can understand why it takes a talented individual, preferably a Board Certified Plastic Surgeon or ENT Facial Surgeon with great experience to evaluate your needs and find a plan that works best for you. ​ All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a well versed, Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he limited in his skills. ​ ​All the best!
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