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March 2017
Aesthetics
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MEDICINE AGAINST WRINKLES
Collagen or hyaluronic acid derivative based injections


The passing of time causes changes to occur on the face: the skin gets thinner and loses elasticity (elastosis). There are various aesthetic medicine techniques available today that work against aging and wrinkles which, thanks to simple injections of special substances into the skin, notably reduce these imperfections. An alternative could be plastic surgery or a lifting operation, for example, which allows for the repositioning of soft tissue which has moved downwards due to aging.

Wrinkles

There are two categories of wrinkles:

  • Wrinkles and facial expression lines. These are caused by depletion of the supporting structures of the derma: collagen, elastin and hyaluronic acid. Aging is not the only factor responsible for these imperfections though, since facial expressions, or better, strains caused by the underlying expression muscles, also cause these problems for young people. The most common wrinkles and lines can be seen in the image below.
  • Wrinkles and lines caused by aging and the breaking down of the profile. These are caused by a reduction in the elasticity and tone of the skin. They can be seen the most in on the forehead, the cheeks, around the mouth, along the jaw (turkey neck) and on the mouth.

Injection techniques
Treating wrinkles can be done in two ways:

  • lineal technique with tunnelling;
  • micro ponfi technique.

Lineal technique with tunnelling
After thoroughly disinfecting the skin, the needle is completely inserted into the superficial dermis and the product is injected whilst the needle is being extracted.

Micro ponfi technique
This involves a series of injections along the wrinkle that are 2mm apart from one another, creating a micro ponfi with a diameter of 1-2mm.

The products

Collagen
Bovine collagen is obtained from the skin of selected bovine which come from specific breeding farms. Collagen is available in various concentrations and there is also one type with cross-links. ‘Normal’ collagen interpenetrates human collagen, whilst cross-linked collagen forms ‘islands’ inside the dermis. Before treatment, two sensitivity tests must be carried out 3 weeks apart since intolerance reactions have occurred a few times one month after treatment and even when the tests were negative. Collagen has been used for over 15 years and is very effective and safe.

Derivatives of hyaluronic acid
A derivative of hyaluronic acid of animal origin has been used for some years now in gels (HylanB). Patients have not showed any side effects, such as reddening or swelling in the treated areas.

Hyaluronan (Restylane)
This is third generation hyaluronic acid. It has two main characteristics:

  • it is very stable thanks to the presence of a new type of cross-linking, which ensures that is lasts a long time in tissues;
  • it is not an animal extract, yet it still has very good biocompatibility.
Conclusion
There are various types of materials available today that are suitable to be injected into the dermis to treat wrinkles. However, these treatments have established methods and therefore they can only be performed by a doctor who will assess each case and, depending on the patient, will decide which of the recommended products or other products can be used, or if it is preferable to turn to cosmetic surgery.

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