Long-term severe overexposure to the sun, especially when combined with cigarette smoking, are largely responsible for the appearance of a "prune face," i.e. the vertical, crinkly and often cross-hatched lines that typically may be seen on the cheeks and chin region. Up until recently these problems have been particularly difficult to treat nonsurgically. Home anti-aging creams, intended for treating age spots, discolorations, and very fine wrinkles and injections of fillers and volumizing agents, best suited to improving well-defined wrinkles and folds, have proven of limited value.
More recently, I have found that a series of treatments, spaced at monthly intervals, consisting of microdroplets of certain filler materials injected in a grid pattern throughout the area alternating with mesotherapy injections (consisting of tiny amounts of hyaluronic acid, vitamins, amino acids, minerals, coenzymes, and antioxidants), to be quite effective in improving these difficult-to-treat areas. Microdroplets of filler material instilled in this manner have been shown to increase the production of collagen in the dermis presumably by stretching the collagen-producing cells, which in turn stimulates them to manufacture more collagen. The mesotherapy solution is believed to provide additional building block materials to further support new, rejuvenating collagen synthesis.