I'm aware I can get Botox for the lines near my eyes and a filler for deep lines near my mouth, but my biggest area of concern is the thin wrinkly skin on my cheeks (see pictures). It makes me look older than my 40 years. I have very thin skin--not sure whether to call the lines wrinkles, fine lines or just plain skin damage. I read that chemical peels can thin the skin out even more. I don't want to do any more damage. Is there a procedure to fix or improve the appearance of these lines on my cheeks?
I Have Aging Thin Sun Damaged Skin. What Can I Do to Fix Crinkly Fine Lines and Wrinkles on my Cheeks? (photo)
Doctor Answers (10)
Fine wrinkles and pigmentation problems of facial skin is best treated with medical grade skin care followed by CO2 laser resurfacing. It also improves on the skin quality in general. Better color, better skin quality, long term results.
Recovery 2 weeks, then redness of the face for few weeks.
How to correct fine crinkly lines and wrinkles on cheeks
You need a combination of methods to produce new collagen to plump the skin and a face the wrinkles.
Personally I would start with fractional non-ablative Erbium laser treatments to build new collagen and plump the skin. You will need 3-4 treatments and don't expect immediate results as it takes several months to build the new collagen however it will happen.
If in the fourth month you're not seeing results then a final combined laser resurfacing treatment with the 1540 laser followed immediately by a 20/9/40 ablative fractional erbium laser treatment will be her best option.
There are many different non-ablative fractional erbium laser is out there the way links include 1540, 1450, and 1585.
The wrinkles you see are a natural result of decreasing collagen and elastin that occurs as we age. Fillers and chemical peels do not address this fundamental problem.
Dermal heating stimulates the natural production of collagen, elastin and hyaluronic acid. This reduces wrinkles by treating their underlying cause. The result is truly younger skin at a molecular level with increased elasticity and thickness. I am consistently impressed by ePrime, which delivers fractionated radiofrequency to precisely heat the deep dermis. This approach would be perfect for you.
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Treatment of fine lines
It's normal to start noticing the early signs of aging in your thirties and forties. The best treatment for texture, pores and fine lines is the microablative fractionated CO2 laser like SmartSkin. This laser is very effective for wrinkles, acne scars, and improving skin texture. You seem to have a fair skin complexion. This laser treatment is very precise and predictable. You will have two days of swelling, two days of peeling and two days of redness. To maintain your result I would consider using SkinMedica TNS essential serum with growth factors.
Treating Fine Lines and Wrinkles across the Cheeks
Sun overexposure, cigarettes, alcohol, ill health, and select medications are just some of the contributing factors that can cause a premature aging of the skin. Before recommending a treatment, you’d have to be examined to identify the source of your problem. Based on the results of your examination, I might recommend a combination of treatments. However, I’d starting with Platelet Rich Plasma (PRP) therapy to revive the skin and reduce the appearance of those fine lines and wrinkles crisscrossing your cheeks. The treatment involves the injection of your own extracted blood platelets. The nutrients and growth factors can then repair the damaged tissue by jumpstarting the body's natural collagen and hyaluronic production.
The Punctuated Phenol Peel Works Well For Crepeyness and Fine Wrinkles
Chemical peels have been a reliable mainstays of the cosmetic physician's toolbox for well over a century. The "Punctuated Phenol Peel"--a very recent advance in chemical peeling technique--is one that is sure to put chemical peeling squarely back on the map and in competition with the more expensive, more heavily hyped laser and light-based therapies currently intensively marketed to consumers. The technique works especially well for crepey and finely wrinkled skin.
The procedure is simple, requires no sedation, and has little or no downtime. Using 88% plain phenol, fine lines and crinkles are treated in punctuated (i.e. fractionated or pixelated) fashion. Using a very finely pointed applicator, the chemical is applied in a serial spot fashion with each spot separated from surrounding treatment spots by approximately one-quarter inch. The use of serial spot coverage, rather than coverage of whole areas, allows for rapid recovery as healing takes place from the intervening non-treated areas. It is precisely the same rational for the use of fractional lasers.
The "Punctuated Phenol Peel" technique is a novel approach to rejuvenation that limits the overall potential for toxicity and downtime of traditional deep peels while constituting focal spots of more intense peeling. Wrinkle lines and crepeyness can be traced in this punctuated fashion, and treatment sessions can be repeated at monthly intervals if necessary until the desired result is obtained. (When appropriate, acne scarred areas may likewise be treated in a punctuated fashion.)
Consultation with and treatment by an aesthetic physician experienced in chemical peeling is an absolute must for determining the appropriateness of this novel approach for any particular situation.
Fine lines and wrinkles - try this first
Thin skin can get dehydrated very easily. The lack of moisture in the skin will accentuate even the tiniest of lines.
I would recommend that you embark on a topical skin program first. Even if you decide to have laser procedures or peels, you'll need to pay attention to the moisture content in your skin.
There are over the counter lotions and creams which contain ceramides that would be helpful in moisture retention.
Most people forget that skin care can often mitigate many of the issues they have with their skin.
A further topical step might be retinoids - but with your skin fragility you may prefer to go with retinols instead of RX products as they are less irritating to sensitive skin.
Chemical peels or fractional laser might be the next step, but I would recommend a soft first step to see what kind of improvement you get with products.
3 Unique Ways to Reduce Facial Wrinkles without Downtime
My recommended treatment plan for Crepey, Fine Line Facial Wrinkles, would depend upon an examination but I will do my best to respond. First I would not recommend a laser resurfacing procedure at you age. The reasons are: 1. SLOW RECOVERY 2. A difficult post-laser treatment plan. 3.We tend to reserve laser resurfacing for the older patient with extremely deep wrinkles. I would therefore recommend a plan that is less aggressive and will give you about a 40% to 50% improvement with minimal downtime.
• Pelevee' Skin Treatments x 3 per year (see link below for details)
• Profractional Laser: once per year
• Topical Tripeptide Cell Activator (with Stem Cell)
This plan of action will give a good controlled semi-conservative approach that will help promote collagen production in the deep layers of your skin and will also help delay the overly envasive Full Laser Resurfacing which may be required in your late 50's.
Wrinkles on cheeks
For fine wrinkles on cheeks, I would suggest addressing them from both the inside and the outside. Address the inside with a filler such as Sculptra, Juvederm, Radiesse or Fat Grafting which will replace missing volume and give more support to the overlying dermis. From the outside, address the fine lines and wrinkles with a combination of laser resurfacing, daily Retin A (or equivalent use) and chemical peels. You are right that these wrinkles cannot be treated with Botox and it will significantly affect the animation of your mid face and lips.
Reversing signs of early aging, thin skin and chemical peels. Consider CO2 resurfacing
Chemical Peels actually strengthen and thicken the skin. A vital part of improving your skin though is your daily routine. Some of the clinical products I would recommend are Vitamin C&E to neutralize free radical damage, a NIA 24 product which is designed to thicken and strengthen the skin, and Retin A or a Retinaldehyde to stimulate cellular turnover, therefore reducing the signs of aging. That, coupled with Chemical Peels, Needling (along with PRP/Platelet Rich Plasma injections or topical infusion (no downtime)), would introduce you to a good program. CO2 laser resurfacing is always an excellent choice as well, but it depends on whether you want to ease into the process or jump in! Either way, you need an experienced and trusted clinician to advise and educate you as well as administer your treatment.