I hear you because it’s our genes plus environmental factors.  We can look at our parents and sibs which generally gives us a pretty good sense for where we might be headed.  Please keep in mind that it can take some time and money to repair damage already done, but it CAN be done.  The maintenance phase after that is much easier.

If you are serious about wanting to correct deep lines and wrinkles, you’ll want to find a really wonderful cosmetically oriented board certified dermatologist to help guide you through the process.

What causes wrinkles and deep lines?

  • Muscles of facial expression.  Like you described above, repetitive movements and expressions make a difference.  On the good side crow’s feet may mean you are smiling a lot.  Smokers tend to have deeper upper lip lines, as do people who use straws frequently.  Kissing is the good side of this. 🙂
  • Sun damage.  Look at both sides of your face.  Is the driver’s side worse?  If so, it’s because UVA goes through window glass, including cars. UVA causes wrinkles over time, therefore it’s good to block it with a high zinc sunscreen.  (Carolyn could you link to sunscreens here please)
  • Volume loss due to weight loss, aging or illness.  Think of this like a deflating balloon.  As we age, many of us lose fat in our faces or it redistributes in ways we don’t like.  Illness and poor nutrition for any reason contribute.

Some examples of fixes:

  1. For deep crow’s feet, Botox/dysport are the first step.  The CF won’t be gone completely, but they will start to soften, and it helps to prevent the lines from getting deeper. Other things to consider are hyaluronic acid (HA) fillers for more volume support and also directly in the lines themselves.  Also lasers like the CO2 (carbon dioxide) fractionated laser or the Fraxel Dual may be helpful to rebuild the collagen.
  2.  For deeper upper lip lines, again a little Botox/dysport (needs to be done lightly) help to reduce the creasing with talking, etc.  Upper lip line fillers both superficial and deep support.  Peels, if done correctly are helpful here, as are certain lasers.  Often 3-4 strategies over time will create the best results. Multiple treatments are the norm, if the lines are deep.
  3.  Deep cheek lines are a different problem.  For them, often the best approach is to replace the volume lost in the mid face (area between the eyes and the mouth), tighten everything (we use deep radiofrequency like Profound on our patients over 45ish), then to resurface with a laser.  These are just some examples.  We have other strategies now also, but these are the most common ones.

I hope this helps,

Dr. Brandith Irwin

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