How can I remove the deep wrinkles on the bridge of my nose? They are visible even when resting my face. (photos)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Neuromodulators (such as Botox, Dysport, Xeomin, and Jeuveau), lasers, microneedling/PRP, and fillers work very well in combination to improve nose creases / bunny lines and can give long-term results. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer​

Hello and thank you for your question. Horizontal lines across the top of the nose are frequently caused by repeated facial movements. If that is the case for you, the best treatment might be a neuromodulator like Botox, which works by relaxing the facial muscle that causes the wrinkle to form. If the problem is collagen loss, a collagen stimulating treatment like RF microneedling might be a better option. This procedure creates micro-channels in the skin that trigger the body to produce more collagen, smoothing away wrinkles from the inside out. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess your specific needs in person and create a customized treatment plan to produce the best result for you.

I just treated myself with very superficial injections of Belotero Balance for wrinkle lines in the same area (only slightly deeper than the ones shown in the photos). These are very quick and easy to treat (as I said, I did my own standing in front of a mirror) and, in experienced hands, can literally be done in a minute or two. Alternatively, Dermastamp professional microneedling can also be used for this kind of very superficial wrinkling, although filler would be my first choice. Additionally, a couple of microdroplets of Botox in the area may lessen the muscle movements in the region that give rise to these wrinkles. Just make sure to consult with a board certified cosmetic dermatologist and not some venue hawking the latest fraxel laser or other "bells and whistles" device it just purchased. Hope this helps Best of luck.

Micro-Needling is a form of Collagen Induction Therapy (CIT) which is performed by a physician in the office setting. CIT creates controlled injuries underneath the skin’s surface. These controlled injuries induce the body to respond through the formation of new tissue including collagen and elastin. In addition to inducing neocollagenesis, the channels made from the micro-needles allow topical serums to be absorbed more effectively through the top layer of skin to optimize outcomes. I frequently capitalize on this opportunity to perform the procedure using platelet-rich plasma (PRP) which can dramatically enhance outcomes through the addition of the patient's own super concentrated growth factors. Micro-Needling is fantastic for helping improve fine lines (to moderate wrinkles), uneven texture of the skin, moderate skin laxity (looseness), diminished texture, tone, color, or 'no glow,' atrophic (depressed) acne scars, sun damage, and even stretch marks and traumatic scars. For the area around the nose, as in this question, I would likely customize the treatment with strategically placed micro-concentrated Botox and possibly small amounts very superficially placed dermal filler to achieve an optimal cosmetic outcome.