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Facial lines and wrinkles — codes and concepts

As we age, our skin droops and develops wrinkles, lines and furrows (also called rhytids). The number of wrinkles and how deep they are depends on a variety of factors ranging from our genetic makeup, the type of skin color, its characteristics and how sensitive it is to the effect of the ultraviolet rays coming from sun exposure and exposure to environmental factors like smoke and air pollutants.
The severity of these changes in an individual depends on genetic tendency, skin phototype and exposure to environmental factors.
An often used method to grade skin aging is called the Glogau’s classification which rates the skin as follows:

Mild
Few wrinkles, requires little or no make-up for coverage

Moderate
Early wrinkling, sallow complexion, requires little makeup

Advanced
Persistent wrinkling, skin discolouration with broken blood vessels and actinic keratoses, often wears make-up

Severe
Severe wrinkling and furrows, actinic keratoses, often wears make-up but it may not hide the ageing changes

Another classification commonly used to describe the degree of skin wrinkling, the Fitzpatrick classification refers to the lines around the mouth and eyes

Class I: Fine wrinkles
Class II: Fine-to-moderately deep wrinkles and moderate number of lines
Class III: Fine-to-deep wrinkles, numerous lines, and possibly redundant folds

How do facial lines and wrinkles form?

Facial lines and wrinkles (rhytides) form because of the following factors:

  • Degenerative changes in the skin makeup that naturally occurs as we age
  • Ultraviolet damage from sun exposure
  • Overuse of the muscles of facial expression or hands
  • Gravity
  • Scars, wounds and injury
  • Results of surgery
  • Acne and acne scars
  • Skin diseases that have a tendency to scar like Lupus.
  • Smoking and even second hand smoke exposure.

There is often a degree of asymmetry to the lines, as people tend to smile or frown more on one side than the other, or consistently sleep on the right or the left cheek.

Fine lines
Fine lines and wrinkles arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by sun damage and exposure to environmental toxins particularly tobacco smoke.

Furrows
Deeper lines or furrows are classified as dynamic or static. Dynamic lines appear with movement i.e. the activity of facial muscles. Static lines are unchanged with muscle movement. Eventually dynamic lines become static.

  • Crow’s feet around the eyes are due to smiling and activity of the eyelid muscles (orbicularis oculi).
  • Worry lines on the forehead are due to contraction of the frontalis muscle when raising the eyebrows
  • Frown lines between the eyebrows are due to contraction of corrugator supercilii muscles and procerus muscle when concentrating or angry

LOOKING FOR NON-SURGICAL TREATMENTS IN NYC?

Here at Dagan MD, we're committed to helping you look and feel your best after undergoing one of our non-surgical treatments.
We take great care to discuss your individual needs and come up with the best solution for your needs.
If you choose Dagan MD for your treatment in NYC, you can rest assured that your recovery time will be a fraction of the recovery time for more traditional techniques.
Let us help you get started looking and feeling years younger in no time.

Call us today at (212) 585-3242 to schedule a consultation or use our online form to contact us for more information.

What treatment is available?

Remarkable changes in facial appearance can be obtained, giving a younger appearance and improving complexion. Often combinations of different cosmetic procedures are required for the best results.

It is most important to protect the skin from the sun life-long using sunscreens on exposed areas daily, and to avoid smoking and exposure to second-hand smoke or other pollutants.

Moisturizers
Ageing skin feels and looks better when moisturisers are applied regularly. These improve the water-holding capacity of the skin. Choose one that feels nice to apply, doesn’t sting or burn or provoke acne.

  • Use tepid or warm tap water and a non-soap cleanser to wash your face twice daily.
  • If you will be outdoors even briefly, include UV-protection as part of your morning regime.

Anti-aging formulas
Many face creams may include so-called anti-aging ingredients. These may include anti-oxidants and/or exfoliants including:

  • Topical retinoids
  • Vitamin c
  • Alpha hydroxy acids
  • Polypeptides
  • Various plant extracts

With the exception of the topical retinoids, the effectiveness of many of these anti-ageing ingedients is unproven.

Resurfacing
Resurfacing refers to various techniques in which the top layers of the epidermis are peeled off using chemical or mechanical means. Chemical peels may even out pigmentation and improve skin texture. They can improve fine lines and static furrows but have no effect on dynamic lines.

  • Superficial and medium-depth chemical peels
  • Dermabrasion and microdermabrasion
  • Neodynium:YAG or carbon dioxide laser resurfacing
  • Non-ablative laser, intense pulsed light or thermal resurfacing including thermage

Implantation
Individual lines and furrows can be lifted up with implants, i.e. temporary or permanent fillers or grafts. They can also be used to improve the appearance of a thinning lip.

Botulinum toxin
Botulinum toxin is most useful for dynamic lines. It can be used to paralyse the muscles that are responsible for frown lines, crow’s feet and forehead lines. It can also be used to change the shape of the eyebrows and to soften so-called smoker’s lines around the lips, among other uses.

Cosmetic surgery
Cosmetic facial surgery involves repositioning facial tissues (rhytidectomy) and altering the structure of the sagging tissues.

  • A facelift or mid-face lift remove excessive skin and tighten underlying muscles of the lower two thirds of the face (cheek and neck).
  • A forehead or brow lift, and mid-temporal lift reduce static lines and lift up drooping eyebrows.
  • Rhinoplasty may lift up the tip of the nose, reshape it or thin out excessive tissue due to rhinophyma
  • Upper and/or lower blepharoplasty removes redundant skin and fat pads from the eyelids.
  • Correction of platysmal bands in the neck by an open plication technique improve the appearance of a sagging neck.

CLIENT REVIEWS

Meet Our Customers

“Love Dagan so much! Went to him for my nose surgery and am now coming to him again for keloid treatment. He's the best!“

Verified Patient - Via ZocDoc

“The staff at Dr. Dagan’s office is always so friendly and welcoming! They know their patient files inside out and are so knowledgeable on insurance coverage issues which is a huge boost to seamless care! Dr. Dagan is thorough, thoughtful and kind!“

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“Dr. Dagan gave in-depth and well-informed explanations and answers for all questions I had and was very friendly. Thank you!“

Mike L. - Via ZocDoc

“The process with Kiran and Dr.Dagan was great and easy. I had to reschedule the procedure and they worked with my schedule. Kiran went above and beyond dealing with my insurance issue’s. Dr.Dagan was quick with the followup as well would definitely recommend as an ent was the first to really listen to my concerns.“

Isham Taveras - Via Google

“As soon as you walk in you’re greeted with an amazing staff. The doctor is extremely knowledgeable and has exceptional bedside manner. Would highly recommend.“

Janet Avezova - Via Google

“Dr Dagan and his staff are absolutely amazing. They have worked tirelessly with my insurance company to get my procedure covered. His staff is professional and kind. The doctor is caring and has a wonderful bedside manner. Highly highly recommend.“

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“Dr. Dagan was very friendly and took the time to clearly explain everything in terms that I could understand.“

Kristi Nootens - Via Google

“I traveled from Brooklyn up to Midtown for Dr. Dagan on purpose. No one else I can trust. Twice now he's been on point.“

Rodney S. - Via ZocDoc

“Dr. Dagan is very knowledgable and personable. He performed a procedure for scar revision with very good results.“

Robert F. - Via ZocDoc

“The location was easy to find and easy to get to. The staff was very friendly, and my concerns were addressed.“

Diana O. - Via ZocDoc

“Dr. Dagan was most generous with his time, gave me a thorough examination, and made great recommendations!“

Elenor R. - Via ZocDoc

“Most professional and effective doctors visit ever! I’d never have expected this experience today.“

Kyoungok K. - Via ZocDoc

“Really straight forward. dr. Dagan went through my issue and made me feel at ease. Would recommend.“

Stephen M. - Via ZocDoc

“Dr. Dagan was through and professional, diagnosing my problem accurately with good follow up.“

Verified Patient - Via ZocDoc

“Dr. Dagan is amazing and is very detailed, takes his time. I did not feel rushed at all and felt very comfortable during my cosmetic visit. I never had botox before so I was very satisfied with how it looked and went. The staff is very welcoming and I was well taken care of by everyone. Highly recommend him.“

Kiran Saini - Via Google

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