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.

Exploring the Causes and Types of Skin Aging

Are unwanted wrinkles and lines bringing you down? There are a wide variety of cosmetic solutions at your disposal, but it can be difficult knowing which one is most suitable for your specific needs. The range of possibilities is a common source of confusion, especially for those who may be new to the aesthetics industry.

One of the main things to know is that BOTOX® and fillers are not the same and are not used interchangeably. BOTOX® targets one form of skin aging, while dermal fillers address another. If you’re interested in getting started with wrinkle treatments or other forms of plastic surgery in the Philadelphia area, Dr. Timothy Greco, a double board-certified facial plastic surgeon, can explain the basics.

The cause of the wrinkles being treated will determine which treatments to pursue. There are two basic wrinkle groups: dynamic and static.

Dynamic wrinkles are related to muscle activity and are most visible when people make facial expressions. Picture forehead lines appearing when someone raises their eyebrows. Static wrinkles develop in the skin due to the effects of aging, sun exposure, gravity, other environmental factors, and lifestyle habits.

Within these two groups, wrinkles can be further classified into four subtypes: expression wrinkles, elastic wrinkles, compression wrinkles, and gravitational folds.

Expression wrinkles appear from repeated facial expressions, while elastic wrinkles are caused by excess sun exposure. Compression wrinkles come from pressure on the face as we sleep. Gravitational folds, such as severe creases like nasolabial folds and saggy skin, are formed due to the combined influence of time, gravity, and other damage.

To put it simply, if your wrinkles are caused by muscle action, your go-to would be a neuromodulator, while wrinkles associated with other types of damage are best addressed with other treatments, such as fillers.

BOTOX® is a neuromodulator, meaning it influences the activity of nerves. Once injected, it has a relaxing effect on wrinkle-causing facial muscles. Hyaluronic acid-based soft tissue fillers like JUVEDERM®, on the other hand, replenish essential volume in the skin to temporarily smooth our indentations. More severe aging may require a facelift or other surgery for complete rejuvenation.

Curious about the benefits of available skin treatments? Get more details on neuromodulators, fillers, skin rejuvenation, and more from Timothy M. Greco, MD, PC’s Philadelphia-based plastic surgery practice. Call today at (610) 664-8830 or submit a contact form to tell more about yourself.