The face is the area of the body most exposed to external aggressions, such as the sun, cold or pollution, that is why it is where the dreaded wrinkles appear before. Among the wrinkles, we find the ‘dynamic wrinkles’, those that appear as a consequence of the repetitive movement of the muscles of the face , or what is commonly known as expression wrinkles. Due to movement, they are located where muscle contractures are greatest, such as between the eyebrows, the forehead, around the eyes (shaped like crow’s feet), on the back of the nose, around the mouth and nose (furrow nasogenian, perioral or barcode and commissures) and even on the chin and neck.
To combat expression wrinkles there are several treatments. The best known and most effective is the injection of botulinum toxin ( Botox ), but there are some more, as explained by Dr. Ernesto J. Pérez Hernández, aesthetic doctor at the FEMM clinic , who reminds us that the best way to treat wrinkles it is prevention through treatments that “designed to help the dermis maintain optimal levels of hydration and continue to receive the active ingredients it needs to stay firm.”
Better known by its trade name, Botox, it is one of the most demanded treatments in the world thanks to its effectiveness and the speed of results. In order to reduce expression lines, “it acts in the transmission of the nervous impulse of the mimic muscles and its results are noticeable from the first day. The areas where it is commonly used are the frown, forehead and crow’s feet. Botox also allows us to slightly modify the position of the eyebrows, raising the lateral tail a little, in such a way that it brings luminosity to the look ”, says Dr. Ernesto J. Pérez Hernández. It is administered through almost painless microinjections for about 20 minutes and its effect lasts between 6 and 8 months. Although it is very safe, It is contraindicated in the case of “diseases of muscle contraction , such as Myasthenia Gravis, although they are rare and generally diagnosed diseases.” After treatment some mild side effects may appear, such as local pain, edema or headache. The price can range between € 170 and € 500, depending on the number of areas to be treated.
Mesotherapy consists of the injection of certain substances that improve the quality of the skin and attenuate or prevent the effects of aging.and, therefore, expression lines. To achieve this, “one of the most used combinations is hyaluronic acid with vitamins, a cocktail that acts by increasing the thickness of the facial skin, providing elasticity and firmness and reducing the effects of cellular oxidation”. With this treatment these substances that are diminished by the passage of time or external agents such as the sun, cold or pollution are restored. The effects of hyaluronic acid treatments last between 6 and 8 months and radiesse cost in india is usually around € 200 per session. This treatment is only contraindicated in case of “active skin diseases to be treated, for example, if the patient if he has herpes on the lip is not injected until he is cured”.
Platelet Rich Plasma (PRP)
It is one of the most effective and innovative treatments and consists of extracting a small amount of blood from the patient that, through a centrifuge, is separated into several parts, one of which is Platelet Rich Plasma (PRP) . A calcium compound is added to these platelets to activate the platelets and release growth factors, which are the key elements of treatment. Then it is injected. These growth factors are responsible for “stimulating cell regeneration, increasing the formation of new blood vessels and producing new tissue”,that is why it is also effective against alopecia. The procedure lasts one hour and is safe, because “when extracted from the patient themselves, they do not produce allergies, rejection or contagion of diseases, but it is not recommended in patients with any serological alteration detected in the previous analysis, we recommend carrying out. For example, in patients with hepatitis or HIV markers, it is not recommended to do it ”. Being so personal, it is not known exactly how long the results last, since “it depends, to a large extent, on the growth factors present in the treated blood; in general, in patients with active diseases, who take many medications, with a lot of stress or smokers, the results are not as long-lasting ”, warns Dr. Ernesto J. Pérez Hernández. Its price is about € 450 per session.
Cross-linked hyaluronic acid
Although injections with cross-linked hyaluronic acid are recommended above all for flaccidity, as it has a filling and volumizing effect, especially at the level of dark circles, lips and cheekbones, it is very effective in reducing the nasolabial fold. It is a “resorbable filler, more compatible and safer than other fillers, which allows you to recover lost volumes or increase volume in certain areas of the face. In addition, it has a moisturizing effect ”. Its effects last between about a year, but “with some second-generation and highly cross-linked hyaluronics you can see results of up to 24 months.” As it is a substance naturally present in the human body, it is only contraindicated in the case of “pregnancy, lactation, autoimmune diseases in an active phase (what is usually called outbreaks) or the presence of previous permanent implants in the same area. The price ranges between € 350 and € 750, depending on the type of hyaluronic acid and the units used in each treatment.
Morpheus8 Radio Frequency
Morpheus8 is a fractional radio frequency device, that is, distributed in multiple points that are applied in the same area. This technology has a double function, on the one hand, it coagulates the fat and on the other it tightens the connective tissue (the one under the skin with say collagen, elastic fibers and elastin), and eliminates both wrinkles and scarsthus providing a more youthful appearance. “It has an applicator made up of 24 microneedles that introduce heat waves into the subdermal tissue, making it minimally invasive, safe and highly effective.” Results without immediate and last between one and two years. People who are pregnant, nursing, under 18 years of age, with a pacemaker, or with poorly controlled endocrine disorders, such as diabetes or thyroid dysfunction, are better off not having this treatment. In small areas, such as faces, the price is around € 400 per session.
EnerJet is a technology indicated, in addition to reducing expression lines, to tighten the skin and reduce scars and stretch marks . It consists of “introducing selected active ingredients into the dermis with a pressure jet injection, allowing the dermal filler to spread in always precise quantities. EnerJet generates microtraumas that trigger a natural healing process. In this way, the body itself produces collagen to remodel the dermis.”. It is an optimal treatment for all skin types, of any age and at any time of the year and its effects, when wrinkles are treated, last between 6 and 8 months. It is only contraindicated “in cases of active infections in the area to be treated or known allergy to the active ingredients used”. The price per session is about € 400.
Calcium hydroxyapatite (the best-known brand is Radiesse) is a substance that, injected, “ solves the progressive thinning of the skin that occurs over time and that generates sagging and wrinkles. This dermal filler redensifies the skin of the face and neck, as it is a very good inducer of collagen formation, strong enough to produce long-lasting satisfactory aesthetic results ”, assures Dr. Pérez Hernández. Its effects last an average of 18 months and it is contraindicated in cases of “known allergy to the active ingredient and in collagen diseases, since part of the effect depends on the stimulation of collagen”. A treatment can cost around € 450.
Chemical facial peel
This treatment evens out skin tone and texture, improves wrinkles, and makes blemishes and pores less visible. Basically, “it consists of applying a substance to the skin that gradually removes layers of it. The deeper the peeling, the greater the epidermal renewal and, therefore, the result is more noticeable ”. Because it is an aggressive treatment, it is recommended to do it in winter, and even so it will be necessary to use a photoprotective cream so that ultraviolet light does not produce hyperpigmentationof the skin on, especially in case of deep chemical peel. The duration also depends on the type of peel, “the mildest ones have fewer side effects, but also less results. On the contrary, the most aggressive ones can cause some discomfort after treatment, such as erythema, tightness of the skin, peeling … The price depends on the type of pelling, from € 300 to € 2,500 the deepest.