Why are deep wrinkles on the face only skin deep?

Why are deep wrinkles on the face only skin deep?

With Today’s Busy Lifestyle, There Is Increasing Pressure For People Not Only To Be Physically Healthy But Also To Look Good.

No matter if you’re at work, at home, or going out with friends and family – there is an underlying feeling or some would say constant pressure to look good. Many key opinion leaders blame the media for their portrayal of unttainable body images. Whether we like it or not social media, posting pictures on Facebook and Instagram are now firmly part of our daily lives. For younger generations social media is defintley the norm!

It is in our nature to judge someone else on their appearance and of course in turn we can be on the receiving end of that judgement. Whether we like it or not, it is something that happens and as we age and mature so does our appearnce. Facebook is now 14 years old and Instagram is approaching the ripe old age of 10! For those of us who were early adopters of Facebook we now have an extensive record of how our appearance has changed over the past decade and with that you will also be able to see how much you have aged.

But ageing is natural, right? You might look at some of your old pictures and smile or in some cases cringe. You might think back to how your lifestyle was a little bit ‘laissez faire’ and think how did I even manage to surive on so little sleep……perhaps some of the changes you have noticed might even be attributed to some hedonistic choices in your youth!

We can't change the lifestyle we once had, but we can make changes starting today! More importantly we can stop or even reverse some of the negative changes attributed to ageing.

So let's talk about SKIN.

In particular, we are going to talk about deep wrinkles. You know those irritating and conspicuous wrinkles that seem to surface like craggy mountains on your skin during those important nights out or early mornings when you are wondering if everyone is looking at the furrows on your forehead.

So, before we discuss them, let's explain what skin is made of so we can understand a little bit of the science behind treating those pesky wrinkles.


What is skin made of –

Human skin is composed of three layers:

1. Epidermis (the outer layer)

2. Dermis (the middle layer) and

3. Hypodermis (the lowermost layer)

Did you know that in the middle layer there is a compound called the Extracellular Matrix, or ECM for short? The ECM gives the skin its elasticity and tensile strength. The ECM is composed of proteins and fibres, which are mainly produced by fibroblasts. Fibroblasts are the most common cells of connective tissue.

The most abundant component in the ECM is collagen. Collagen is protein that ensures the structural unity of the skin. Fibroblasts expose through a collagen network, and the resulting mechanical tension regulates collagen synthesis.

Now, I know this all sounds complex, so bear with us, but the better educated we are about how skin works, the better we are at understanding what wrinkles are and how we can solve them.

So, during the ageing process, our collagen fibres deteriorate, and fragmented collagen concentrates.

As a result, the tension of the skin decreases and fibroblast activity is impaired, leading to decreased collagen production and an increase in collagen-degrading enzymes.

You guessed it…


Wrinkles and loose skin occur with ageing. The process is different in all of us. In some people the process is so slow that it results in very little ageing.

As we age, you lose muscle mass and collagen, and it is hard for the skin to bind water.

Ageing also brings hormonal changes.

Estrogen levels start dropping in your late 30s, and this is yet another cause of wrinkles.

Social issues like smoking, yes, and drinking excessive alcohol over an extended period are also proven to enhance these processes. Likewise, sun exposure can cause sun damage-ageing which again is a leading cause of developing skin issues.

I know this may sound a little depressing but….. don’t worry.

“All problems become smaller when you confront them instead of dodging them.”


Deep Wrinkle Treatments

Luckily the Aesthetics world can now offer a multitude of wrinkle treatments that can help.

In previous blogs (LINK: https://rutlandaesthetics.com/treating-cleavage-wrinkles-decolletage-rejuvenating/), we have explained several treatments for cleavage wrinkles and rejuvenating the décolletage.

Skin peels and Mesotherapy are one of the initial choices when it comes to treating wrinkles.

But, after some time you may need another set of treatments and more intense results.

You may feel that even though you have had some therapy, you still have visible wrinkles on your face that you would like to improve.

If so, have you considered Dermal Fillers?

What are dermal fillers?

Traditonally in Aesthetic medicine, the primary two treatments which are used to rejuvenate the ageing face are Botox and dermal fillers.

Botox or botulinim toxin type A is primarily used for wrinkles caused by muscle expression.

Dermal fillers are used to replace volume loss.

With ageing, the most noticeable volume loss is in the cheeks, temples and lower face. Hyaluronic acid, that is found in dermal fillers, is the product of choice when performing volume replacement or facial contouring.

Hyaluronic acid is something we have naturally in the face, along with elastin and collagen.

In dermal fillers Hyaluronic acid comes in the form of a gel which is injected into facial areas of which show volume loss.

Also, besides the dermal fillers that contain hyaluronic acids, there are also other filler compounds that we can use that have different structural properties that are suited for various issues.

Let’s explain more.

What is the hyaluronic acid?

Hyaluronic acid is a non sulfated glycosaminoglycan found in our skin tissues, mainly in the outer layer, the connectivity and neural tissue and is produced naturally by the body.

Hyaluronic acid (HA) has been evaluated as the best candidate for dermal fillers because of its biodegradability, and can be used effectively to produce excellent results that can last for up to 16 months.

What are the most popular dermal fillers?

As we said, there are many different types of fillers available. The most commonly used brands are Juvederm (Allergan), Boletero (Merz) and Teoxane. These are the most commonly used because they have a long safety history.

At Vysana we only use dermal fillers that have an excellent safety profile and produce amazing results. We use Teoxane and Boletero that we source direct from either the manufacturer or from a pharmacy that is authorised to sell dermal fillers.

Teoxane and Belotero are examples of brands of dermal fillers that have different properties.

The fillers properties, also known as G Prime are determined by the concentration of hyaluronic acid. All these HA contain sugar molecules which are cross-linked. So, if you have a cross-linked molecule – it lasts longer.

- Teoxane Ultradeep & Belotero Volume

Give volume, and can last for almost two years.

It is going to be thicker, so we place it in areas such as cheeks, temples and the molar areas. This helps solve issues like volume loss in the cheeks and consequently the lower face. They can be used in the jaw line to correct heavy jowls and to give the jaw more definition.

Before and after the treatment with Teoxane; Photo source: Teoxane.

- Teoxane RHA3 and RHA 2 and Belotero Balance or Intense

Good for malleable and more “liquid places” like the lower face and lips.

We use this to help solve issues like volume replacement in the lips and around the lower mouth and other areas where there has been volume loss.

The latest advancements in dermal fillers are the skin boosters such as Redensity 1, Profhilo and Nucleophil which are a bit like Mesotherapy.

A lot of little boluses of the filler are put over the face like in Mesotherapy, and an excellent and beautiful result is obtained. It is made to improve the skin quality for up to 9 months.

Skin boosters are designed for all ages and skin types and can be used for the neck, decolletage, and hands.

Teoxane fillers are perfect for providing structure but still allow movement as they are a malleable type of dermal filler. They are very soft and get to integrate well into the skin tissue.

Radiesse fillers, also made by Merz Pharmaceutical are a popular alternative to Hyaluronic acid based dermal fillers because they provide scaffolding to areas of the face that need support as well as voume replacement. This filler contains calcium hydroxyapatite that is used to stimulate collagen. This filler is used primarily in older clients where more collagen stimulation is necessary.

What results can be expected from using dermal fillers?

As we said, for this procedure only a needle is used (not a scalpel). That is the most fantastic thing about the dermal fillers. The desired results can be achieved without going under the knife.

For example, with the procedure of filling the eye bags, we can get rid of the dark circles and eye bags under the eyes. We can also straighten the nose i.e. a non-surgical rhinoplasty.

With dermal fillers, a neck lifting of the jowl area that starts dropping with time is also possible.

Moreover, dermal fillers can do a non-surgical facelift where we can place careful boluses of a chosen filler in areas of the face to tighten the face, lift it and rejuvenate it in a very natural way.

Surprising results can be achieved with these treatments.

Many celebrities appear to have had treatment with dermal fillers.

Amanda Holden, Hellen Mirren, Kate Middleton, Nicole Kidman, Reese Witherspoon, etc. are a few examples we are aware of that have used dermal fillers.

Deep wrinkles

The recovery time after a procedure is relatively short.

In fact, for most patients, it lasts from one to seven days.

The most common side effects that may occur are the facial swelling and some bruising.

However, all this goes away very quickly with proper treatment like Arnica cream and ice.

On very, very rare occasions, a person can get an allergic reaction or infection after the procedure. However, if this happens, you will be in the hand of an experienced doctor, of course, so there is no need to worry. This is why we stress the importance of knowing who your medical practitioner is and their medical experience.

Antibiotics or antihistamines will solve these problems if they occur.

The results from one treatment with dermal fillers last about 9-18 months. With repetitive treatments with fillers, natural collagen is made. In this way, the effect may last up to 4 years.

The price range for one treatment depends on the result that is required. A good practitioner will always quote you a price after a consultation.

Deep Wrinkle Treatments

Volume replacement and facial contouring, with dermal fillers, can be considered a marriage between art and science. They are often the cornerstone of any facial rejuvenation treatment as they are versatile, effective and capable of producing amazing natural results. It is also important to remember that Dermal fillers are classed as an injectable medical device and you should consider the positives and negatives when considering treatment. In the right hands they are a safe and effective medical device that can help to restore your youthful appearance.

Every single client or patient that comes to our clinic is given a bespoke and individualised treatment plan. This means that they can be confident that Dr Dhesi has selected a product that is right for their skin type and facial structure. Selection of the right dermal filler is incredibly important when treating facial rejuvenation. For example, dermal fillers for the cheeks would not necessarily have been right for lower face rejuvenation.

Who would you trust to perform an injectable treatment? This is something you need to ask yourself when booking a treatment in a clinic. Is your injector a healthcare professional? Do they understand the product they are using, do they understand your facial anatomy and most importantly do they know what to do if you experience any side effects or problems? Rutland Aesthetics is Dr led and patient safety is at the heart of every treatment that we offer and although we offer an enjoyable and often relaxing experience the clinic always prepared to treat and manage any concerns that patients have.

Treating deep wrinkles with dermal fillers is the industry standard across the world. But there are new and innovative treatments being developed and tested in clinics across the UK. In order to produce natural rejuvenation practitioners are combing skin needling with products such as Profhilo, Rederm, Synthetic stem cells and Patient’s own plasm to treat volume loss and deep wrinkles. Radio frequency skin tightening and high intensity ultrasound are just a few of the non dermal filler treatments that are available. In order to make an informed decision about what is the best treatment for you it is best to discuss your questions with a medical professional and this should preferably be done in a consultation before you decide to have any treatment.

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