How Skin Ages

How Skin Ages:

What is happening to my skin?
It's a common question from patients concerned about the unwanted - and often premature - signs of aging skin. As you know, there are multiple factors contributing to these signs. The following is a quick review.

It is about cell turnover
Skin's top layers act as a protective barrier for the body, keeping harmful disease and pollutants out and essential body fluids in. At the deepest layer, new cells are formed that begin to migrate up toward the skin's surface. There, they are eventually exfoliated.

• In young, healthy skin, this cellular turnover process takes about 40 days: 28 days to reach the surface and 12 days to slough off.
• In young, healthy skin, new skin cells are well organized, uniform in size, shape, pigmentation and structure.
  

The Changing Function of our Aging Skin
Over time, skin accumulates damage from many sources - such as sun exposure, hormonal changes, trauma, pollution and more. The functions of young, healthy skin start to break down.

On the surface, aging skin becomes discolored, lax, wrinkled, dry and rough. Cell turnover slows, reducing the availability of essential nutrients. Moreover, instead of producing healthy new cells, skin functions now produce cells that are abnormal.

Below the surface, collagen and elastin production slows. Collagen becomes disorganized, less dense and coarser and loses its uniform construction. This, combined with degeneration of elastin in the dermis, causes skin to wrinkle and sag. Less blood flow and moisture result in the dull, lifeless skin patients complain about.

Understanding Skin's Structure

This diagram, provided by http://www.yestheyrefake.net (thank you), will help you to understand your skin's structure, and how and why wrinkles develop.

The Skin & Its Definitions

A. melanocyte: an epidermal cell that produces melanin
B. muscle: a body tissue consisting of long cells that contract when stimulated and produce motion
C. sebaceous gland: any of the small sacculated glands lodged in the substance of the derma, usu. opening into the hair follicles, and secreting an oily or greasy material composed in great part of fat which softens and lubricates the hair and skin
D. hair shaft: the part of a hair projecting beyond the skin
E. epidermis: the outer epithelial layer of the external integument of the animal body that is derived from the embryonic epiblast; specif : the outer nonsensitive and nonvascular layer of the skin that overlies the dermis
F. dermis: the sensitive vascular inner mesodermic layer of the skin -- called also corium, cutis
G. subcutaneous tissue: of or pertaining to tissue being, living, or made under the top layers of skin
H. fat: animal tissue consisting chiefly of cells distended with greasy or oily matter
I. arterial blood vessel: any of the vessels through which bright red, oxygenated blood coming back from the lungs circulates in the body .
J. sweat gland: a simple tubular gland of the skin that secretes perspiration and in humans is widely distributed in nearly all parts of the skin -- called also sudoriferous gland
K. hair follicle: the tubular epithelial sheath that surrounds the lower part of the hair shaft and encloses at the bottom a vascular papilla supplying the growing basal part of the hair with nourishment
L. Pacinian corpuscle: an oval capsule that terminates some sensory nerve fibers esp. in the skin of the hands and feet

Dynamic, Static, and Skin Folds OH MY!!!

Not all wrinkles are created equally (or fairly, if you ask me). There are 3 types of wrinkles.

Dynamic wrinkles are the first type, and they are, in short, your smile lines and frown lines. No matter what you call them, they are the most troublesome of all wrinkles and often are the most difficult to treat. They are our crow's feet, scowl lines, forehead creases, and lip wrinkles. They develop because each time we smile, laugh, or frown, our skin creases or folds in the same way. After making the same expressions time after time, our skin "remembers" these creases even when they are not there. These wrinkles can be improved through laser resurfacing, dermabrasion, deep peels, BOTOX® Cosmetic, and fillers. However, even if these treatments could vanish your dynamic wrinkles, your dynamic wrinkles will return, because you will continue to make the same facial expressions that caused them in the first place. Interestingly, if you have ever seen anyone who has had one half of their face paralyzed, you may have noticed that the paralyzed side appears younger. This is because they do not move that side of the face, so there are no dynamic wrinkles.

Static Wrinkles are the second type, and they are wrinkles due to lack of elasticity of the skin caused from sun damage, smoking, genetics, poor nutrition, or from prolonged dynamic wrinkling. Static facial wrinkles are visible regardless of muscle contraction; they stay (hence the name “static”) even when the muscles are not contracting. This leads to the classic “crepiness” and multiple cross-hatching as is often seen in wrinkles on the cheeks and around the eyes. Techniques that increase the thickness of the skin or that remove the damaged skin are effective wrinkle treatments. Laser Skin Resurfacing and deeper chemical peels remove the damaged skin and stimulate new collagen formation to improve the skin’s appearance, elasticity and thickness. Topical creams and ointments such as Tretinoin (Retin-A), Vitamin C serum, and new collagen growth factor formulas are good maintenance systems to restore and maintain the skin’s youthfulness. Of course, daily sun protection is essential in preventing further sun damage and skin cancer. Multiple treatments of intense pulse light or light chemical peels and other non-ablative lasers can increase the thickness of the skin and collagen level without significant downtime.

Last, but, CERTAINLY, not least, are skin folds. The third type of wrinkles, called wrinkle folds, is often due to sagging of the underlying facial structures, most notably causing the deep grooves between the nose and mouth known as the naso-labial groove. Surgical procedures such as midface lifts, cheek lifts, and neck lifts offer the best corrective measures for these problems. Alternatively, the folds can be camouflaged temporarily by plumping up the groove from beneath with substances like collagen or soon to be FDA-approved hyaluronic acid derivatives like Restylane and Perlane. These materials typically last for anywhere from 3 to 9 months, depending on the material used and the location of the injection. Fat Transfer, depending on the material used and the location of the injection., whereby your own fat is removed from one area and then injected into the area where fullness is desired, is an excellent alternative to fillers from outside sources, and is one of the more permanent wrinkle treatments.

Frownies... Better than Botox...

Frownies, are they better than Botox? HECK NO. But they come pretty close.

Frownies are Facial Pads of natural, skin friendly material which are made to reduce or let disappear
wrinkles on the face, around the eyes and the mouth.
Frownies trains the underlying muscles in the face again. Its never too late to splint deep lines with Frownies.
You will see visible improvement overnight but continual usage is the key to lasting results.
Don´t think you have to live with deep wrinkles.
Frownies will diminish the visible signs of aging effectively and naturally.
Frownies are an effective, safe and payable alternative for Botox, and you can use them simply at home.

For Best Results
Frownies should be worn everyday for 30 days to effictively retrain facial muscles.
Afterwards, continue to use Frownies four or more times a week to mantain your more youthful appearance.
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Botox^® Alternative • All Natural • Dermatologist Approved

Q: Do I have to use Frownies every night?
A: We recommend using Frownies every night for 30 days to receive lasting results. After you have trained your facial muscles, you should wear Frownies a minimum of three to four days a week in order to maintain proper facial posture.

Q: Can I leave Frownies on overnight?
A: Yes, it is best to leave them on overnight or during a time when your muscles can be relaxed for an extended period (about four hours).

Q: Do Frownies really work?
A: We have been in the facial pad business since 1889 — over 115 years. Frownies work by training the facial muscles to stay in position. The facial muscles are attached to the skin, so as you retrain the muscles, the skin becomes tighter. By holding the muscles in place, the skin is allowed to smooth out.

You need to use parentheses there...

You need to use parentheses there, NOOOOO you do not need parentheses (only in English class do you need parentheses) on your face. Juvederm is an injectable filler, which can help you achieve dramatic results to eradicate you from a life of parentheses.

Frequently Asked Questions about Juvederm:

What is JUVÉDERM™?

Juvéderm™ is the only HA filller with FDA approval to last up to one year.* Ask your physician how you can get long-lasting results with Juvéderm™. Juvéderm™ injectable gel is a “next-generation” smooth consistency gel dermal filler that helps to instantly restore your skin's volume and smooth away facial wrinkles and folds like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth). Juvéderm™ comes in two formulations—Juvéderm™ Ultra and Juvéderm™ Ultra Plus.

*Juvéderm™ is indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).

What does JUVÉDERM™ do?

Juvéderm™ injectable gel temporarily adds volume to facial tissue and restores a smoother appearance to the face.

What is JUVÉDERM™ indicated for?

Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gels are indicated for injection into the mid to deep dermis (below the outer layer of skin) for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds (the creases running from the bottom of your nose to the corners of your mouth, aka smile lines or parentheses).

Why does JUVÉDERM™ come in two formulations?

Juvéderm™ injectable gel is available in two formulations to allow your healthcare professional to tailor treatment to your unique needs. Juvéderm™ Ultra provides versatility in contouring and volumizing facial wrinkles and folds. Juvéderm™ Ultra Plus is a more robust formulation for volumizing and correcting deeper folds and wrinkles.

What makes JUVÉDERM™ different from other dermal fillers?

JUVÉDERM™ is the ONLY hyaluronic acid (HA) filler FDA approved to last up to 1 year.* Our unique manufacturing process provides a high concentration of cross-linked hyaluronic acid for long-lasting results. It also works to create a smooth consistency gel that flows easily into the skin and provides a smooth, natural look and feel. All other hyaluronic acid dermal fillers currently on the market are made of granular consistency gels. And, Juvéderm™ is the first hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in persons of color.

*Juvéderm™ is indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).

How is JUVÉDERM™ injectable gel different from BOTOX® Cosmetic?

Juvéderm™ injectable gel is a “next-generation” hyaluronic acid dermal filler that provides volume and is used to treat wrinkles and folds resulting from a loss of volume beneath the surface of the skin such as perioral lines and nasolabial folds (lines around your mouth and nose). Juvéderm™ restores your skin's volume for a smooth, natural look and feel. BOTOX® Cosmetic is not a filler. BOTOX® Cosmetic relaxes muscle activity and is used to treat moderate to severe lines caused by the dominant frown muscles between the eyebrows (the glabellar area). This allows the two vertical lines between the brows, often referred to as the “11,” to temporarily diminish for a smoother appearance. For important safety information about BOTOX® Cosmetic, see below.

What is hyaluronic acid?

Hyaluronic acid is a naturally occurring substance found in all mammals that helps to hydrate and add volume to your skin. In addition to its use as an aesthetic treatment, hyaluronic acid has also been used for more than 20 years for injection into arthritic joints to aid movement as well as for eye surgeries and wound repair.

What is cross-linked hyaluronic acid?

“Uncross-linked” hyaluronic acid in its natural form is in a liquid state. “Cross-linking” is the process through which hyaluronic acid is made into a gel product that can be injected into the skin for long-lasting results.

How is JUVÉDERM™ injectable gel used in treatment?

Your healthcare provider eases Juvéderm™ injectable gel into the skin using a fine needle to temporarily fill in and augment the treatment area and smooth moderate to severe facial wrinkles and folds such as “smile lines” or “parentheses” (nasolabial folds) and “marionette lines” (oral commissures). Juvéderm™ temporarily adds volume to the skin and may give the appearance of a smoother surface.

What will treatment with JUVÉDERM™ injectable gel accomplish?

Juvéderm™ injectable gel will help to smooth moderate to severe facial wrinkles and folds. Most patients need one treatment to achieve optimal wrinkle smoothing. And one treatment could smooth your lines and wrinkles for up to 1 year. Ask your doctor what you should expect from your initial treatment and when they would recommend rescheduling another appointment.

Is treatment with JUVÉDERM™ injectable gel painful?

Injections may cause some discomfort during and after the injection. The smooth consistency gel of Juvéderm™ allows your doctor to administer it easily and smoothly. And, Juvéderm™ is injected directly into the skin using a fine needle to reduce injection discomfort. Your doctor may choose to numb (anesthetize) the treatment area to further minimize discomfort.

How long does treatment usually take?

The injection process takes only about 15 minutes. You'll also need to allow time to consult with your doctor prior to treatment.

What kind of doctor can provide treatment with JUVÉDERM™ injectable gel?

Any authorized healthcare professional can administer Juvéderm™ injectable gel, but dermatologists, plastic surgeons, ophthalmologists, otolaryngologists (ear, nose, and throat doctors), or physicians specializing in cosmetic procedures are generally more experienced. Click here to find an experienced doctor near you.

Does the correction last forever?

No. Correction is temporary; therefore, touch-up injections as well as repeat injections are usually needed to maintain optimal corrections.

How long do results last?

JUVÉDERM™ is the ONLY hyaluronic acid (HA) filler FDA approved to last up to 1 year.* Talk to your healthcare professional about Juvéderm™ today—so you can start seeing results!

*Juvéderm™ is indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).

What are the possible side effects of JUVÉDERM™ injectable gel?

Most side effects are mild or moderate in nature, and their duration is short lasting (7 days or less). The most common side effects include, but are not limited to, temporary injections site reactions such as redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching, and discoloration. As with all skin injection procedures there is a risk of infection.

Can people with different skin tones/colors be treated with JUVÉDERM™?

Yes. In fact, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that has proven its safety and effectiveness in persons of color. Studies with Juvéderm™ showed no increased risk of hyperpigmentation or hypertrophic scarring in patients of color.

Is Botox for me, or not...

Botox is the P.I.M.P., the Mack Daddy, the best of the best in wrinkle reduction... well, in my opinion it is. I recently got Botox injections, even though I swore I would never get them. Oh how my feelings changed, when I started noticing frown lines, and crow's feet at 27 years old... I absolutely LOVED the results I got from the Botox injections, but I digress, Botox is not for everyone. So here are some answers to a lot of frequently asked questions about Botox.

What exactly is BOTOX^® Cosmetic?
BOTOX^® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium. It is a nonsurgical, physician-administered treatment that can temporarily reduce moderate to severe frown lines between the brows in people 18 to 65 years of age. During treatment, very low doses of BOTOX^® Cosmetic are administered via a few tiny injections directly into the muscles that cause those stubborn lines. The treatment is usually done in about 10 minutes, and no recovery time is needed. Within days, you may see an improvement that can last up to 4 months. Results may vary.

How does BOTOX^® Cosmetic work?
Those moderate to severe frown lines between your brows form over time as the result of muscle activity. BOTOX^® Cosmetic is injected directly into the muscles between your brows. It works by blocking the transmission of nerve impulses to the injected muscles; this reduces the activity of the muscles that cause those persistent lines to form.

When will I see results from a BOTOX^® Cosmetic treatment?
Within days, you may see a marked improvement in the moderate to severe frown lines between your brows. Lines continue to improve for up to a month, and results can last for up to 4 months. In clinical trials, nearly 90% of men and women rated the improvement in their appearance as moderate to better 1 month after treatment. Results may vary.

How long does BOTOX^® Cosmetic last?
Results from treatment with BOTOX^® Cosmetic can last for up to 4 months. If you discontinue treatment, the frown lines between your brows gradually will look like they did before treatment.

Who should administer BOTOX^® Cosmetic?
Any authorized healthcare professional can administer BOTOX^® Cosmetic, but dermatologists, plastic surgeons, ophthalmologists, otolaryngologists (ear, nose, and throat doctors), or other physicians specializing in cosmetic procedures are generally more experienced. One of these physicians can help you decide if BOTOX^® Cosmetic is right for you.

To make the selection process easier, you may want to consider choosing a doctor from the BOTOX^® Cosmetic Physicians' Network. Members of the Network have medical practices that focus on facial aesthetics, as well as detailed knowledge of facial anatomy and experience injecting BOTOX^® Cosmetic. Their practices also offer other facial aesthetic treatments.

We make searching the Network easy with Find a Doctor. Just enter your ZIP code to locate a BOTOX^® Cosmetic Physicians' Network doctor in your area. Or, to find out if a doctor is part of the Network, you can type in his or her name.

Is treatment with BOTOX^® Cosmetic painful?
Discomfort is usually minimal and brief. Prior to injecting, your physician may choose to numb the area with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes. Many people are in and out of the physician’s office without downtime following BOTOX^® Cosmetic treatment.

Who should not use BOTOX^® Cosmetic?
BOTOX^® Cosmetic should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation. Patients with neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.

Will I experience any side effects?
The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects. For more details, see the full Prescribing Information.

Will my facial expressions continue to look natural?
Although the results are visible, a treatment with BOTOX^® Cosmetic will not radically change your facial appearance or make you look as if you "had work done." The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.

What will happen to the frown lines between my brows if I choose not to continue treatments?
If you do not continue treatments, the moderate to severe frown lines between your brows will gradually look like they did before treatment.

Is BOTOX^® Cosmetic affordable?
When considering your facial aesthetic options, BOTOX^® Cosmetic is quite affordable. According to an American Society for Aesthetic Plastic Surgery survey, BOTOX^® Cosmetic is one of the low-entry-cost facial aesthetic procedures in the United States. Like other appearance-related investments, such as hair coloring and cuts, teeth whitening, and chemical peels, the cost must be weighed relative to your expectations. Consult your doctor for further information.

Do treatment results differ?
To get the best results, it's important to go to a doctor who is experienced in administering BOTOX^® Cosmetic. You may want to consider choosing a doctor from the BOTOX^® Cosmetic Physicians' Network. Members of the Network have medical practices that focus on facial aesthetics, as well as detailed knowledge of facial anatomy and experience injecting BOTOX^® Cosmetic. Searching the Network is easy with Find a Doctor.