Dr. Yves Herbert

Lines and wrinkles

Several factors contribute to the appearance of facial wrinkles:

  • Genetics and heredity
  • Unprotected sun exposure
  • Smoking
  • Face mimicry
  • Environmental factors, such as pollution and extreme temperature variations
  • An unhealthy lifestyle, such as poor hydration and poor skin care

These factors will determine the basic nature of the wrinkles:

  • Dynamic wrinkles
    • These wrinkles are caused by the repeated contraction of the muscles under the skin and are found mainly in the upper part of the face, in the glabella, forehead and around the eyes.
  • Static wrinkles
    • These wrinkles are rather caused by the gradual decrease of collagen in the skin and fat pads in the subcutaneous tissues. We find this type of wrinkles especially in the cheeks and the lower part of the face and they are usually accompanied by a lack of deep volume and overall sagging of the face.

Treatments

Each type of wrinkle requires a different approach and often the combination of several modalities to improve the appearance.

  • Dynamic wrinkles respond very well to drugs in the neuromodulators class (Botox®, Dysport®, Xeomin®). The active ingredient is the same in all trademarks and is the botulinum protein. This protein has the property of temporarily reducing, from three to five months, the contraction of the muscles where it is injected. These products are very safe and have rare and reversible side effects. Neuromodulator therapy is performed by very precise intramuscular injections and requires the person doing the treatment to have a good knowledge of the anatomy of the face and of the frequent anatomical variations from one patient to another.
  • Static wrinkles and volume deficits respond to fillers. The vast majority of products of this class commonly used are composed of hyaluronic acid. This acid is actually a complex sugar that naturally occurs in the skin to ensure its hydration. There are several trademarks in the Canadian market (Juvederm®, Restylane®, Teosyal®, Stylage®, Belotero®, Revanesse®, Princess®). All of these products have an enviable track record that proves their quality and safety, giving the physician the ability to choose the product that best suits the type of treatment required by their patient. These are all injectable products that are deposited under the skin or in the subcutaneous tissues using fine needles or cannulas. The treatment lasts only a few minutes and has little discomfort and side effects. The results obtained are of a variable duration, and go from six months to one year and sometimes more, depending on the product used and the depth of the injection.
    • There are also other injectable fillers that areto be used only by seasoned injectors with a lot of experience. The best known are Sculptra® and Radiesse®. Both stimulate the gradual formation of collagen during the weeks following treatment. They are therefore very useful in cases of pronounced thinning of the face, to restore lost volumes and redefine face contours.

In a comprehensive approach to facial rejuvenation, it is not uncommon to resort to the use of several treatment modalities. The face must be seen as a whole and the proposed solutions must aim for harmonious results. This is why the combination of neuromodulators and fillers is so popular because it aims at reducing dynamic wrinkles that sometimes make the face seem too severe, tired or sad, while restoring the missing volumes that cause the sagging and heaviness of the cheeks. These modalities are, moreover, compatible with other treatment approaches, such as photorejuvenation with the "Forever Young BBL" protocol for the correction of rosacea and pigment spots, or skin tightening by radio frequency with Venus Legacy®, for firmer contours. All these avenues of treatment are explored during the initial interview with the doctor who will be able to propose a treatment plan that takes into account the specific needs of each patient.