As we age, wrinkles are formed by four different mechanisms:
1) The constant movement of muscles causes creases and wrinkles in the face. The medical term for these creases is dynamic rhytids, and they are commonly found on the forehead, between the eyes (frown lines), and around the eyes (crow’s feet).
Treatment: Botox, Dysport, and Xeomin.
2) Sun exposure and UV light stimulates enzymes in the skin that break down collagen and the supporting structures of the skin. This process causes fine wrinkles on the face.
Treatment: Good skin care, medical-grade skin peels, and laser resurfacing
3) Over time, the skin loses elasticity and it descends or sags. Underneath the skin, there are ligaments and other tissues that tether the skin to the underlying bone, fat, and muscle. The pleating of the skin over these attachments may cause deep wrinkles and depressions such as tear troughs, pre-jowl sulci, and deeping of the nasolabial folds.
4) Finally, unlike the rest of the body, the face loses volume over time. A volumized young face appears bright and energetic and it has smooth transitions from one facial area to the next. Topography is the study of the relief features or surface configuration of an area. Dr. Kulbersh believes that the loss of volume due to aging changes the facial topography creating more “hills and valleys” on the face. These valleys increase facial shadowing, giving a dark, tired, and aged appearance. This is similar to a grape and a raisin. A grape is volumized, has smooth transitions, and reflects light at all angles. A raisin is a grape that has lost volume, which has many “hills and valleys” and shadowing. A raisin is not as visually appealing as its “younger” grape form.
There are multiple causes of wrinkles on the face. Dr. Jonathan Kulbersh trained and practiced in Beverly Hills with facial plastic surgeons, general plastic surgeons, oculoplastic surgeons, and dermatologists. He would be happy to evaluate the skin of patients in his offices in Charlotte and Columbia. Dr. Kulbersh is a facial aesthetic plastic surgery specialist that welcomes new patients to his practice.