How Do We Get Expression Wrinkles? A Guide to Skin’s Life Cycle

Millions of people each year choose a specific treatment to counteract facial wrinkles: BOTOX®. Patients in the Philadelphia area who come to Dr. Timothy Greco’s office have often heard about the popular injectable, but are still curious about how it works. To understand neuromodulators like BOTOX®, it’s important to first understand the overall structure of the skin and how it changes throughout a person’s life, and the effects of the muscles of facial expression on the overlying skin.

Cells on the outer surface of skin, the body’s largest organ, form a protective barrier against the external environment. The dead cells create a tough layer called the stratum corneum, which continuously flakes away. Shed cells are replaced approximately every four weeks by new cells produced in the deeper epidermal layers. The length of this skin cycle is influenced by age, as the process takes longer for someone in their 50s or 60s than it does for younger adults.

Older skin is more susceptible to wrinkles because of this slowing cell turnover, as well as the fact that the skin has been folded repeatedly into the same facial expressions for decades. Existing collagen is continually strained, even as it is being produced in smaller and smaller quantities in the skin.

Also, the dermis, which is the middle layer of skin that sits beneath the epidermis, thins over time as it loses the chemicals that nourish it. In a person’s youth, this layer has a strong structure made up of proteins called collagen and elastin, which hold it together and maintain its structure and elasticity. As these proteins diminish with age, the structure weakens and the skin grows increasingly inelastic.

Facial expressions are important for communicating subtle emotions or intention to other people. Think of smiles and raised eyebrows for happiness, a frown for sadness, wide eyes and an open mouth for surprise, furrowed brows and a scowl for anger, and any in-between variation you can think of. Studies have shown that humans are capable of up to 21 unique expressions. Unfortunately, as we go through life, our go-to expressions cause the associated muscles to pull on the skin in the same way over and over. This repetitive action coupled with dwindling collagen and elastin means the skin no longer springs back to its original position as easily. Thus, “dynamic wrinkles” are born.

BOTOX® works not by filling in these lines as fillers do, but by blocking the chemical messages that tell facial muscles to contract. When these muscles stay at rest, the surface remains smoother and appears refreshed.

Want to soften wrinkles with BOTOX®? Our team at Dr. Timothy Greco’s practice will discuss the treatment with you to determine whether it is a suitable choice. Dr. Greco has been injecting BOTOX® for more than 30 years and has instructed other physicians nationally and internationally on the aesthetic application of BOTOX®. We invite you to request a complimentary non-surgical or surgical consultation in the Philadelphia area to learn more about what we offer.

5 Ways to Protect Your Eyes After Blepharoplasty

During a blepharoplasty (eyelid surgery), Dr. Timothy Greco will get rid of unwanted tissue—including excess fat and loose skin—from around the eyes to correct the damaging effects of aging. This opens them up by removing any puffiness, making the eyes look younger, refreshed, and brighter. If you’ve decided that this surgery is the right choice for you, the staff at the office of Dr. Timothy M. Greco in the Philadelphia area advises that eyelid surgery will require you to take special care of your eyes as you recover from surgery.

Here are five important recovery tips from Dr. Timothy Greco and staff that anyone having eyelid surgery will benefit from knowing. Note that you will also get specific post-operative instructions to help prevent any complications.

During the first few days after blepharoplasty, it’s common to experience discomfort, which will gradually improve with time. Patients also frequently experience eyelid swelling, tightness, bruising, and itching. Blurred vision, excessive tearing, numb eyelids, and sensitivity to light are normal during the first few weeks. To help treat these side effects of eyelid surgery:

1. Use the prescribed eye drops or ointments—such as antibiotics, steroids, and artificial tears—to ward off infections and stop inflammation. You may also need to take pain medication to reduce any discomfort.

2. Prevent damage to your eyes from exposure to sunlight or wind during your ride home from surgery or anytime you go outside afterward by wearing dark-tinted sunglasses. Sunscreen is beneficial after the eyelid skin has healed from surgery.

3.  Take time to rest and limit your activity. Don’t do any heavy lifting, bending, or physical exercise during the first two weeks. This can cause excess bruising and swelling and adversely affect the result of your surgery.

4. To help with post-procedure swelling and bruising, frequently ice the eye area throughout the day with cold compresses. This will provide soothing relief to the eyes and help with decreasing bruising and swelling.

5. Be careful about your sleep position. It is recommended to sleep with your head elevated on pillows and in a semi-upright position after surgery so that you keep your head higher than your heart to decrease swelling.

Planning your eyelid surgery and want more information about what to expect? Let us help make sure your procedure goes as smoothly as possible. Learn more about what’s involved in blepharoplasty recovery by calling the office of Timothy M. Greco, MD, FACS in the Philadelphia area at (610) 664-8830 or fill out a contact form to get started today.