Dr. Ric Izquierdo member for 36 weeks 6 days Send a message

The “lines of animation” is their official name. Forehead lines, crow’s feet, lines from the nose to the corners of the mouth and beyond. What causes these grooves? Animation and aging. Unfortunately, you can’t stop either one. In the last ten years there’s been an explosion of great new products and options that have less side effects than previous materials and give superior results.

In the 1980’s, ophthalmologists started using the toxin from bacteria because of its known effect on paralyzing muscles. They began using it on patients who had uncontrollable ticks of the facial area, commonly around the eyes. The spasmodic twitching was suppressed and something else was noted: in older patients, their lines of animation were gone. Botox subsequently underwent FDA evaluation and was approved for the frown lines between the brows. All other lines and wrinkles (forehead, crow’s feet, upper lip lines) were treated “off label”, meaning at the discretion of the physician. These areas also benefit greatly from Botox. In general, Botox is used for lines in the upper face above the bottom of the nose, while the wrinkle fillers are used in the lower face.

For the lower face, new products were developed to replace collagen (the only available filler). Restylane and Juvéderm are both made from a naturally occurring substance in the skin: hyaluronic acid. They can be used for the nasolabial folds and the lips. Less commonly, they can fill the frown lines between the brows and the crease between the lower lid and cheek. Because of their similarity with your body, they maintain volume correction for a longer time, usually 4 to 6 months. A newer filler is Radiesse. This filler can last from 9 to 12 months. However, it is a totally different substance (hydroxyapetite), which resembles bone more than skin. It can be used for the nasolabial folds, but not the lips or other fine wrinkles. It also needs to be placed at a deeper level to minimize the chance of lumpiness and hardness. For all these injections, we usually give nerve blocks to make the injection process tolerable.

Last, but not forgotten, is fat. Usually plentiful and not a foreign substance. Done correctly, fat can give an almost permanent result in some hands. It does require more of a procedure: taking the fat out, preparing it, and injecting it in a way that will survive as a live graft (much like a skin graft). It’s a great option in some people.

Remember, the longevity of the filler will vary with the site injected and each particular person. Also, search for a physician’s practice with a long history of good results and experience.

Ricardo Izquierdo, M.D., FACS
Board Certified Aesthetic Plastic Surgeon
ric.izquierdo@faceandbodychicago.com
www.FaceAndBodyChicago.com