Anti-Wrinkle Treatments

The high UV index in Brisbane contributes to the premature ageing of skin. Laser resurfacing and collagen treatments aim to stimulate collagen production and replace age-related collagen loss.  Anti-wrinkle relaxants reduce those muscle movements that contribute towards the formation of deeper facial lines.

  • Wrinkles are classified into two relatively broad groups.  Dynamic winkles are exaggerated through muscle movement, static wrinkles occur when these muscles are at rest.
  • Dynamic wrinkles are best treated with anti-wrinkle injections.
  • Static wrinkles benefit the most from dermal fillers, chemical peels and laser treatments.
  • Static wrinkles around the forehead and smile lines can be prevented by anti-wrinkle injections.
  • Fine lines can be prevented with the use of sunscreen and Vitamin A prescriptions.

Wrinkles can be a combination of both intrinsic and extrinsic factors.

Intrinsic ageing refers to the universal age-related changes experienced by all. With increasing age, gravity takes effect and deepens lines and increases skin laxity. There is a steady decrease in dermal collagen and elastin production; these two fibre types are the building blocks of the skin. Fine lines are an early sign of intrinsic aging.

Extrinsic ageing is due external factors. In Queensland, UV damage is the major cause of early skin ageing and wrinkles. Years of accumulated solar exposure predispose us to uneven skin texture, hyperpigmentation and fine wrinkling. As time progresses, these finer wrinkles deepen and become more pronounced.  UV radiation also decreases the thickness of the upper layers of the skin and fragments the ordered networks of collagen and elastin. Both of these proteins form a scaffold within the skin and so help prevent the formation of wrinkles. The gradual loss of skin tone over time correlates to the reduction in quantity and quality of collagen and elastin fibers.

Smoking also contributes to premature skin wrinkling, especially those around the upper lip that are often referred to as smoker’s lines.

The initial step in wrinkle management is careful clinical examination by a dermatologist to ascertain its most probable cause through the assessment of dynamic and static wrinkles.

The aims of wrinkle treatments are threefold:

  1. Treat dynamic wrinkling
  2. Address static wrinkles and replace dermal volume loss
  3. Prevent further UV damage, reduce future extrinsic aging and slow down intrinsic aging processes

Dynamic wrinkles are due to repetitive muscle movements. In many cases, existing wrinkles are exaggerated by these dynamic muscle movements. Examples include frown lines, forehead lines that appear when looking upwards and crow’s feet where a smile reveals lines that radiating from the area around the eye. The aim of dynamic wrinkle treatment is to reduce muscle tone in the associated muscle groups. Anti-wrinkle treatments such as anti-wrinkle injections can dramatically reduce dynamic wrinkling.

Anti-wrinkle injections can dramatically reduce dynamic wrinkles and reduce frown lines (wrinkles between the eyebrows), crow’s feet (wrinkles around the eyes) and smokers lines (wrinkles around the upper lip). This treatment is effective with a safety record spanning 20 years.

What are anti-wrinkle injections?

Anti-wrinkle injections introduce a natural, purified protein into the facial muscles that relax them to create an improved cosmetic appearance. The active ingredient is a muscle relaxant obtained from laboratory-grade non-pathogenic bacteria. Due to the effects of this product, anti-wrinkle injections are a prescription-only medication.

How do anti-wrinkle injections work?

The active ingredient in anti-wrinkle injections binds to the nerve endings and prevents the release of chemical transmitters that activate muscle contraction. In short, this natural, purified protein relaxes the muscles that cause wrinkles.

This process may take up to 2 weeks for the maximal effect to be seen. After a few months, the nerve endings grow new connections to the muscles and the effect wears off. Injections are typically repeated two to three times a year or as directed by your dermatologist.

What does treatment with anti-wrinkle injections involve?

The first step is to have a consultation with a consultant dermatologist. He or she will evaluate the condition of your skin to see whether anti-wrinkle injection therapy is appropriate for you. They will also discuss the expected outcome and answer any questions you may have.

Anti-wrinkle injections are a non-surgical treatment for deeper facial lines. A small quantity of muscle relaxant is injected into the selected facial muscles with a very fine needle. Discomfort from injections is minimal and brief, comparable to an insect bite.  Ice application or anaesthetic cream can be applied 30 minutes prior to the procedure to minimize any discomfort.

Slight redness at the injection site is frequently seen but this usually fades within a few hours. Make-up, if desired, can be worn after the anti-wrinkle injection procedure. Results are usually seen after a week; however, it may take up to 2 weeks for the full effect to become apparent.

How long do anti-wrinkle injections last?

Anti-wrinkle injections last for approximately 3 to 4 months in the majority of clients. With repeat anti-wrinkle injection treatments the effect tends to last longer, as the associated muscles weaken over time.

Are anti-wrinkle injections safe?

With a track record of over 20 years, anti-wrinkle injections are considered to be a safe skin rejuvenating therapy. In fact, the same proteins used in anti-wrinkle injections are commonly used in much higher doses to treat paediatric muscle spasms and lazy eye syndrome.

Do I need to take any precautions after anti-wrinkle injections?

Normal activities can be resumed soon after treatment; however, there are some basic precautions that should be taken to reduce the risk of side effects and obtain the best results.

  • Ice may be applied to the treated area to help reduce discomfort, swelling and bruising
  • Try to exercise the treated muscles for the first hour after treatment. If you forget, this will not impact your treatment in a negative way
  • Do not lie down or take part in strenuous exercise for 4 hours after treatment
  • Do not have a facial, nor rub or massage the treated areas for 24 hours after treatment

As this is a cosmetic procedure, no Medicare rebate is available.

Dermal fillers can significantly soften wrinkles and creases in the lower half of the face, particularly the crease running down from each side of the nose to the corners of the mouth – the nasolabial fold. Dermal fillers are a safe, non-surgical and effective method of lifting, rejuvenating and toning the face.

What are dermal fillers?

Dermal fillers, as their name suggests, fill or replace skin volume loss which occurs through a reduction in skin collagen and elastin quality and production. Fillers provide an immediate dose of collagen and ground substance, instantly filling hollows, furrows, wrinkles and lines. Cutis Clinic experienced cosmetic injectors use natural, anti-allergenic fillers called hyaluronans.

Which areas can be treated?

  • Lips
  • Nasolabial fold
  • Cheeks
  • Frown lines, forehead creases and wrinkles
  • Acne and chicken-pox scars

What does the procedure involve?

During a consultation with one of our cosmetic injectors, we will discuss and advise on whether dermal fillers are suitable for you. You will be informed as regards the best dermal filler type, which area can be successfully treated and what the expected outcome will be. In addition, we will give information concerning the duration of the results and the cost of dermal filler treatment.

The procedure involves multiple injections to the treatment area. The needles used are extremely fine; even so, we use a combination of ice and a numbing cream prior to injections, reducing your discomfort to a completely manageable level. The procedure takes 20 to 40 minutes depending on the treated area.

What will I look like after the treatment and how long will the results last?

Immediately after a dermal filler procedure, you can expect slight redness and swelling. This is absolutely normal and a temporary inconvenience that settles within a day or two. If desired, light make-up may be applied the following day. The majority of our clients feel comfortable enough to resume work and daily activities immediately after treatment. Bruising may develop a day or two after dermal filler treatment but any discolouration will settle within 3-5 days.

Dermal filler longevity depends upon the treated area and the type of fillers used. On average, dermal fillers last 6-8 months; however, much like the metabolic rate, individual variations apply.

What is the best dermal filler for me?

Cutis Clinic offers a range of temporary fillers, each suited to different applications. Our highly-trained and experienced cosmetic injectors will be able to advise you as to which dermal filler is best, depending on the location of deeper lines, filler longevity and your desired results.

**Cutis Clinic does not perform permanent filler treatments due to the risk of potentially serious side effects and complications.

Can dermal fillers be combined with other treatments?

Absolutely! Fillers are only one arm of the rejuvenation process. Fillers are frequently combined with anti-wrinkle injections, which relax the underlying muscles. Balance is the key to natural facial rejuvenation. Apart from treating loss volume, the use of fractionated laser and TCA peels can improve skin texture, tone and clarity.

More on dermal fillers

The technical advances in laser skin tightening devices and continuous refinements in the technique have made laser treatment an excellent treatment for fine lines and all the way through to deep wrinkling. With laser treatment, other visible signs of aging such as uneven texture, hyperpigmentation and loss of skin tone are also significantly improved.

What types of lasers can be used for wrinkles?

Laser maybe performed as full resurfacing – a combination of Erbium and CO2, or as fractionated laser resurfacing (Fraxel). Fractionated laser resurfacing has the added advantage of reducing recovery times, however several treatments may be required.

Treatment parameters and technique will depend on the degree of photodamage, the extent of wrinkling and the recovery time allowed. A detailed examination and discussion of treatment options is essential for optimal results.

Fractionated laser has provided a revolution in the treatment of facial rejuvenation. Fractional laser induces thousands of micro-punctures to the deeper layers of the skin whilst leaving surrounding tissues intact. This allows the skin to heal much more rapidly when compared to complete skin treatments such as laser resurfacing. Fractionation stimulates collagen production, at the same time vaporizing superficial and deep areas of excess pigmentation. This technique promotes the skin’s healing process and creates new, tighter tissue with improved skin texture.

What are the main advantages of  Fraxel or Fractionated Laser Therapy?

ProFractional has the unique ability to penetrate very deep into the skin without damaging the surrounding tissue.  This combination provides efficacious collagen remodeling (treatment depth) and a high safety margin (low thermal damage) for all skin types,  making ProFractional one of the safest and most effective resurfacing lasers available.

What areas of the body can be treated?

Most areas of the skin can be treated with the fractional laser.  Popular treatment areas are the face and neck, followed by the décolletage and hands.  Your laser practitioner will adjust the laser settings for each specific area.

How long will it take to recover?

Complete healing typically occurs within a few days and most clients feel comfortable enough to return to normal activities and apply make-up a day or two after treatment.  There may be some swelling; this will subside within a few days.

When should I expect results?

As your skin heals in the days following your treatment, you may notice a tightening effect; however, the true benefit of most fractionated therapy takes place 4 to 6 months afterwards when the effects of deep collagen remodeling become visible.  It may take several months to see the optimal results of your fractionated laser treatment.

More on Fractionated laser treatments

TCA peeling is an effective treatment for sun damage, hyperpigmentation, freckles and wrinkles. Chemical peels such as TCA remove the upper layers of the skin but also induce collagen remodeling which works to improve both skin texture and skin tone.

What is a TCA peel?

TCA (trichloroacetic acid) peels are a time-tested treatment for sun damage, uneven skin texture and reduced skin tone. Peeling with TCA gives a very predictable result.  The procedure takes approximately 10-15 minutes and is conducted in one of our operating theatres.  Generally, one to three peels are conducted over a period of six to ten weeks.

How long do I need to recover from a TCA peel?

Recovery from TCA peels depends on two important factors; the concentration of TCA used and also the selected treatment site.  The most common concentration used for facial peels is  TCA 20-25% which has a typical recovery time of 6-8 days.  TCA peels of the chest area generally take longer to heal – 10-12 days in total.

What conditions can be treated with TCA peels?

TCA peels are an excellent method for treating skin hyperpigmentation, freckles, sun damage, melasma and uneven skin texture. In addition, higher strength TCA peels can soften wrinkles and increase skin tone. Higher concentrations of TCA stimulate the production of dermal collagen which accounts for this skin tone improvement and reduction in wrinkles and facial lines.

TCA peels are recommended for very sun-damaged skin and stubborn hyperpigmentation.

More on TCA peels

More on Chemical peels

Glycolic and lactic acid peels can reduce fine lines.  Peels conducted on site at Cutis Clinic are typically initiated at concentration that range from 20% through to 70%. Preparations can be purchased to provide a home-based maintenance plan.  These are usually teamed with Tretinoin for superior results.   Alpha Hydroxy Acids increase dermal collagen production through the stimulation of collagen-producing cells called fibroblasts.

What are Alpha Hydroxy Acid (AHA) peels?

AHA peeling agents are the most commonly used type of chemical peel, frequently referred to as the ‘lunch time peel’. Side effects are uncommon, recovery is quick (within an hour or two), and the procedure is affordable.  Our peel concentrations begin at 20% and typically end at 70%.  We recommend a series of peels at intervals of 2-3 weeks.

How do AHA peels differ from TCA peels?

Alpha hydroxy acid peels are gentle peels with little or no downtime. This makes them ideal for superfical hyperpigmentation and the correction of very fine lines. TCA (trichloroacetic acid) peels are more appropriate for deeper skin treatments and, depending on the concentration used, require a downtime of 6-8 days. TCA peels are recommended for severe hyperpigmentation and deeper lines or wrinkles.

How are chemical peels performed?

All forms of chemical peeling are conducted at Cutis Clinic. Our specialist practitioners assess all clients prior to any peel to determine both the skin type and the best agent/concentration. Glycolic acid peels are conducted by experienced registered nurses; TCA peels are carried out by a consultant dermatologist.

How do I know which chemical peel is right for my condition?

Several important factors should be considered when finding out which treatment is best for you.  Our trained registered nurses will look at a range of factors such as the condition of your skin, the degree and depth of hyperpigmentation, presence of acne, sun damage, skin type and the recovery or downtime preferences.  We may inform you of alternative options to help achieve the best results.

Why are Cutis Clinic peels different?

Chemical peels at Cutis Clinic are performed by experienced registered nurses or specialist dermatologists. All clients are carefully assessed prior to treatment. We offer 5 different types of chemical peel with varying concentrations. This enables us to prescribe an accurate regime for your specific requirements.

Chemical peels conducted at Cutis Clinic are, on the whole, much stronger than those conducted at the beauty therapist or day spa. Our experience and accessibility to additional treatments such as fractional lasers, BBL and PDT ensure our clients are continuously offered the best treatment options for their skin.

More on chemical peels

The prevention of wrinkles requires a reduction in extrinsic factors such as UV and cigarette smoke exposure.  Sunscreen forms the basis of UV protection, as do anti-oxidants such as Vitamin C.

Dermatologists often prescribe topical retinoids such as Tretinoin. Retinoids stimulate collagen production as well as increase the thickness of the epidermal layers,  diminishing fine but visible lines.  Unless contraindicative, we suggest the nightly use of retinoids in your skin care regime. Prescription retinoids are approximately 100-1000 times higher in concentration then over-the-counter products.  A single prescription typically cost less than $30 and lasts for up to 4 months.

The treatment of wrinkles is only one aspect of the ageing process. We should all be concentrating on preventing photodamage in order to slow this process down. A licenced dermatologist is able to inform you as to correct use of products and provide an unbiased assessment of your daily skincare regime.  Wrinkles rarely occur in isolation – a professional assessment of your skin tone and texture together with experienced advice regarding appropriate treatments provides a natural, balanced and harmonious outcome for every Cutis Clinic client.

Treatments Dynamic wrinkle reduction Static wrinkle reduction Effects on skin texture
Anti-wrinkle injections +++++ ++ Nil
Laser treatment + +++ +++++
Fillers ++ ++++ Nil
TCA peels +++ ++++
Glycolic peels + ++

Dr Davin Lim
Consultant Dermatologist

At Cutis Clinic, our dermatologists have an array of treatment options on hand to treat wrinkles and premature skin ageing.  The progress of fractionated lasers over recent years has given patients a new way to reduce wrinkles and rejuvenate the skin, providing consistently excellent results with minimal down time.

Addressing the appearance of facial lines is only one part of skin ageing treatment. A range of therapies designed to reduce the effects of photodamage and improve skin texture and pigmentation offer our clients a better outcome.