The human face is not a steady structure. It undergoes a slow changing course from the birth to death.

This structural change is very slow, but continuous. Some of the visual changes in this process impair the feeling of youth and strength, therefore can lead to some psychological consequences.

Generally the major concern of people about the aging face is the wrinkles. Wrinkles may be static (which are always apparent), or dynamic (which occur with facial animation or mimics). They can be deep or superficial, fine or blunt. These characteristics of the wrinkles determine what to do for treating them.

Currently, dynamic fine wrinkles are generally treated with botox applications. Dynamic wrinkles are the results of contraction of the underlying mimic muscles. Botox is a bacterial toxin, which acts by temporarily preventing the contraction of mimic muscles and therefore avoiding the overlying skin from wrinkling. When applied carefully, it eliminates the wrinkles without any disruption in facial expression or loss of mimics. Botox is most commonly used for the fine wrinkles of the forehead, crow’s feet area or the frown lines. It’s the gold standard treatment for these areas. Botox application is reversible, and should be repeated every 6 months for optimal results. It does not have any severe side effects. Ease of application, reasonable price and brilliant side-effect profile makes it the shining star of anti-wrinkle therapies.

Deeper wrinkles are generally static in nature, therefore they do not respond to Botox applications. This kind of wrinkling (or grooving) needs additional volume to simply “level up” the area. This additional volume can be supplied by synthetic injectible fillers or fat transfer. Use of injectable fillers is a more practical solution, but their effect lasts for a shorter time, which is generally about a year. They can be applied in the office within minutes, and don’t have a downtime. Fat injection, on the other hand, is a long lasting-partly permanent procedure but is more demanding. Fat transfer is done in the O.R., and has a one week downtime because of the swelling and bruising. Biology of the fat grafts is a very popular scientific topic today, and new discoveries about the advantages of their stem cell content are increasing everyday. We know for sure that, the stem cells in the fat grafts act a critical role in survival of the transferred fatty tissue and the improvement of the overlying skin quality.

For the treatment of fine wrinkles, poor skin quality and acne scars, fractional laser therapy is also a major tool. Lasers evaporate the superficial layer of the skin totally, and heat up the deeper skin layers, resulting in a totally resurfaced, clear skin. Laser resurfacing improves the blood circulation of the skin and strikingly rejuvenates the face.

One of the latest contributions of modern biotechnology to facial aesthetics is the PRP (Platelet-Rich-Plasma) application.PRP is a growth factor concentrate which is obtained from a person’s own blood. When this concentrate is directly injected through the skin, it triggers a sequence of biologic events which results in increased tissue turnover. This chain of reactions is similar to what happens in the wound healing period. The factors promote renewal of the cells, collagen and improves the blood supply to the skin. As these factors are isolated from the person’s own blood, this application does not have any side effects.

As it can easily be understood, there are different ways to deal with the aging skin. The selection of the right tool to fight against a particular skin disorder, is the main role of the physician. There are pros and cons of each technique so they should be employed for the correct purpose. A deformity that will completely disappear with botox may not be a good reason for laser, or a filler may not give the desired result. The right thing to do is asking to be informed about the procedure, but also leaving the decision to the professional.