We often meet patients who tell us, simply, “Botox me!” While the answer is usually an enthusiastic “You got it!,” Botox® is best for certain dynamic wrinkles, and there are actually a number of highly effective wrinkle treatments that we can use to give you a personalized, optimal result. As a nurse injector in Atlanta, I always customize a plan based on each type of wrinkle you want to treat! Here’s everything in our arsenal, plus your treatment options by the area.

Medical-grade wrinkle treatments

Wrinkle reduction can involve a range of treatments, and not every wrinkle requires an injectable. From facial treatments that improve skin quality to skincare you use at home, we believe in a complementary anti-aging approach using tools like:

• Laser treatments, peels, and facials like chemical peels, microneedling, Hydrafacial®, and laser peels are effective anti-aging options for combating fine lines and improving overall skin quality. Each year, I receive a HALO Laser Treatment to boost collagen deep in the dermis, which is literally what prevents wrinkles.
• Botox-type injectable neurotoxins like Botox® and Dysport® treat dynamic wrinkles, especially in the upper face. I use Botox to preserve youthfulness or to slow the signs of aging, or even if you want to smooth or soften existing lines! I take a unique approach to treatment plans for each individual, because no two faces are the same. With consistent treatments, neurotoxin patients will be so happy with the investment they make in their skin—after treatment AND long term!
• Dermal fillers like Juvéderm® and Restylane® treat dynamic and static wrinkles, especially naso-labial folds and marionette lines below the corners of the mouth. Filler is an AMAZING tool to soften lines and restore volume. By using a hyaluronic acid based dermal filler, the boost and glow your skin will achieve is absolutely stunning!
• Medical-grade skincare is a critical part of our arsenal for supporting your in-office treatments with an effective, wrinkle-fighting skincare regimen at home. Skin care is the security for your investment: In-office treatments are amazing, but if you don’t have a daily regimen at home, then you are not fighting wrinkles at max capacity! 70% of your anti-aging routine is at home with a curated medical grade routine, and then 30% stems from in-office procedures.

Dynamic vs. static wrinkles

The first thing to know about wrinkles before I select a treatment is that they can be either dynamic or static. Dynamic lines appear when you’re smiling, frowning, squinting, or making other facial expressions. Static wrinkles are etched into the skin, even when your face is at rest, and tend to form in your thirties or later as your body’s production of collagen and elastin (the building blocks of plump, elastic skin) begins to diminish.

Each type of wrinkle, depending on its location in the face or neck, calls for a different anti-aging approach. Most dynamic wrinkles respond best to Botox-type injectables, although some (namely the nasolabial folds) can be treated with filler. However, once wrinkles become static, they usually require filler, laser treatments, and/or a surgical lifting procedure to reverse. Both dynamic and static wrinkles, in any area of the face or neck, can also benefit from skin resurfacing facials and a medical grade skin care routine.

I always customize a plan based on each type of wrinkle you want to treat!

Wrinkle formation and treatment, by the area

Here’s how wrinkles form in the key areas of the face, and my go-tos for smoothing them out:

Forehead

Horizontal forehead wrinkles are caused by movement of the frontalis muscle, especially when raising the brows; these lines can deepen with sun damage. Treat forehead lines with neuromodulators like Botox or Dysport. For best results, relax these muscles early to slow wrinkles’ formation!

Frown lines (between the eyebrows)

The “11”-shaped lines that form between the eyebrows are the original territory of our faithful friend Botox. Injected into the muscles below the inner eyebrows that pull your brow down into a frown, neurotoxin stops those lines from frowning, allowing the skin to smooth itself out.

Crow’s feet (eyes)

These lines emanate from the edges of your eyes when smiling or squinting, and may be made worse by sun exposure—so always wear a good pair of sunglasses, in addition to sunscreen and a hat! Botox is highly effective for crow’s feet, and it’s a good idea to pair it with a topical medical-grade eye cream to reduce the appearance of these fine lines.

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Nasolabial folds

These folds that extend from the nose to the outside corners of the mouth, framing your smile, are often caused by movement when smiling. Some people are genetically predisposed to have deep nasolabial folds because of their inherited anatomy. The best way to treat nasolabial folds is with dermal fillers like Restylane Lyft, which can be injected deeply in the dermis and also in the more shallow epidermis layer to “fill” the wrinkles and soften their appearance.

Lips

Wrinkles in and around the lips form due to drinking through straws, smoking, general volume loss over time, and even movement as you talk. To treat wrinkles here, we typically use lip fillers to replace lost volume and smooth perioral lines (a.k.a. smoker’s lines). We can also use a small amount of Botox above the upper lip to soften the muscle and allow the upper lip to curl outward with a technique commonly called the “lip flip.”

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Neck

In the neck, you may see horizontal lines that form from looking down at your phone or computer (tech neck), as well as vertical platysmal band lines that become distinct due to thinning skin. To improve the texture of thin, delicate neck skin, RF microneedling and laser skin resurfacing are effective options. To address the vertical bands, Botox can be injected to soften the muscles that cause them. And when sagging tissues in the lower face and neck have progressed beyond the power of non-surgical treatments, a facelift and/or neck lift with one of our Atlanta plastic surgeons is the ultimate neck rejuvenation procedure.

• Related: Why Microneedling with RF is Superior to Traditional Microneedling »

Prevent wrinkles with good choices, skincare, and Botox-type injectables

There are a handful of proven ways to stop wrinkles from worsening: Botox or Dysport can be injected preventatively to stop dynamic wrinkles from forming in the first place. Protect skin from sun exposure with sunscreen, hats, seeking shade, and wearing sunglasses! You can counter the very real effects of air pollution on skin aging by applying antioxidants, such as Vitamin C, in your skincare routine. And products like retinol (tretinoin) are highly effective when used as directed. Most importantly, make good choices: eat a nutrient-dense diet, and get regular exercise and quality sleep!

Schedule your appointment with one of our expert nurse injectors at The Swan Center for Plastic Surgery. Our team of Expert Injectors, our aestheticians, and our Atlanta plastic surgeons are here to make treating your wrinkles as effective and efficient as possible, with a full range of injectables, skin treatments, and plastic surgery offerings—including minimally invasive alternatives! Call us at 770-667-0904 or contact us online to begin.

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Can you treat wrinkles at home?

While at-home treatments simply can’t deliver the kind of transformation that is possible with plastic surgery or injectables, certain products can help slow the signs of aging and soften fine lines. The team at MindBodyGreen recently discussed various tactics for reducing wrinkles at home; here are our favorite ideas from their list:

• SPF. You’ve surely had the importance of wearing sunscreen impressed upon you from a young age, but we’ll reiterate it here: sunscreen is one of your first and best lines of defense against wrinkles because it blocks the sun’s harmful UV rays from damaging elastin fibers in your skin.
• Smart topical products. Medical-grade skincare products can further protect your skin while providing essential nutrients such as retinoids, alpha-hydroxy acids, niacinamide, anti-aging peptides, and/or growth factors. But with so many options, it’s important to consult with a medical skincare professional to help determine which products are appropriate for treating your unique skin concerns. (Working with a medical practice will also save you from wasting time and money on OTC skincare: while some products include similar nutrients, the concentrations are much lower, making it unlikely you will see any real results.) From Revision Skincare to ZO Skin Health, shop our favorite skincare products here. Our skin care specialists tailor at home regimens to fit your specific needs. We recommend a personal consultation to get you on track to proper skin health.
• Supplements. When it comes to supplements, many are not medically proven; however, one supplement long-known for its ability to support skin health is vitamin C. Vitamin C helps promote collagen production and is needed for its synthesis and maintenance. Making sure you get enough vitamin C in your diet will likely improve your skin’s overall health—just make sure to choose a high-quality, trusted supplement brand.

Incorporating these at-home techniques should provide some noticeable wrinkle protection and modest reduction over time, but if you really want to see smoother, more youthful skin fast, it’s time to head to a true medspa.

At-home treatments simply can’t deliver the kind of transformation that is possible with plastic surgery or injectables, but certain products can help slow aging and soften fine lines.

How can a medspa treat wrinkles without injectables?

A true medical spa offers a variety of physician-supervised treatments designed to remove layers of dead skin cells, hydrate skin, and encourage collagen production. Here are a few of our favorite non-injectable medspa treatments for wrinkles and lines:

• A HydraFacial can help you achieve softer, smoother skin in a relaxing treatment that involves zero needles or downtime. The treatment utilizes a gentle, deep-cleansing jet of water infused with nourishing antioxidant serums to exfoliate, cleanse, and finally replenish your skin’s essential nutrients. For an added rejuvenating boost, your HydraFacial can be customized to include a connective tissue growth factor designed to promote natural collagen and elastin production and help reduce the appearance of wrinkles. Unlike some skin treatments, HydraFacial is also completely safe for patients who have darker complexions, as well as for those with skin issues such as melasma.

• Radiofrequency microneedling delivers high-intensity radiofrequency energy deep into your skin via an array of insulated needles. This warms the deep dermis to stimulate new collagen fiber growth and tighten skin, leading to visible skin improvements that improve over the following months. This hard-working treatment has been touted by celebrities for its ability to quickly diminish fine lines and other blemishes, like sunspots and acne scars.

• Laser skin resurfacing may sound intimidating, but it’s one of the most effective methods of treating wrinkles and lines on the face and body. Laser skin resurfacing utilizes focused beams of heat and light energy to encourage newer, healthier skin growth. At The Swan Center, we use the HALO Hybrid Fractional Laser because it provides the fully rejuvenating benefits of an ablative laser but with less downtime.

What’s the best way to permanently get rid of wrinkles?

Unfortunately, short of having surgical procedures at intervals, there’s really no way to permanently remove and prevent wrinkles. However, since deep lines—like nasolabial “smile” lines—are caused in part by volume loss, dermal fillers can go a long way in reducing their appearance.

We know you are probably reading this in an effort to avoid fillers, but before you write injectables off, let’s consider the main reasons people give for wanting to avoid them:

• Fear of poor results: Many people assume injectable fillers create a fake, puffy look because they have only noticed patients with poor results. Consider, however, that you’ve likely seen lots of good injectable work without realizing it—after all, most celebrities make use of them. And the truth is, retaining a completely natural look is possible: skilled injectors who understand advanced techniques consistently achieve this goal. For example, when treating the nasolabial folds, a physician who is fully versed in facial anatomy will often take an indirect approach with fillers, treating surrounding areas to naturally lift the tissues below (rather than only treating the immediate area which can lead to the “duck face” look).
• Fear of needles/pain: A skilled injector will take a number of steps to reduce pain and anxiety during treatment. If this is an issue for you, talk to your provider and consider trying a minor injectable treatment first.
• A perception that fillers can be harmful: While it is true that some unscrupulous providers have injected patients with harmful substances, legitimate filler products have a long history of safe use on millions of patients.
• A desire to avoid “unnatural” substances: It would be easy to assume injectable fillers must be made of foreign substances, but hyaluronic acid—the key ingredient in our go-to dermal filler, Restylane—is already produced naturally in your body. Fillers simply boost the amount you have, placing it right where you most want it.

We advocate for dermal fillers because they can achieve structural appearance changes that no other non-surgical option offers. For example, plumping the cheeks with fillers will not only help reduce smile lines but also give a lifted look to your entire face, reflect more light into your eyes, and enhance your face’s symmetry.

But do I need dermal fillers to get rid of wrinkles?

There are essentially three options to choose from when it comes to fighting wrinkles:

• Utilize medical-grade skincare and medspa wrinkle treatments as a way to slow aging and soften the appearance of fine lines.
• Use dermal filler injections; they are the safest, most effective way to immediately reduce the appearance of wrinkles (and you can choose a completely natural hyaluronic-acid based formula).
• Have a surgical lifting procedure; while surgery requires an investment of time and money, a skillfully performed facelift can treat deeper folds and wrinkles, turning back the clock about a decade.

While the most ideal long-term results ultimately come from using a combination of all of the above techniques, if you want to completely avoid fillers, we suggest being extra attentive to your skincare routine, seeking regular medspa treatments, and having a surgical procedure when skin laxity becomes more apparent.

Wrinkle reduction in Atlanta

At The Swan Center in Atlanta, our board certified plastic surgeons and skilled aestheticians have the skill, experience, and technology to help you reverse and prevent the signs of aging with or without injectables. To make a skincare plan that meets your goals and comfort level, contact us today or call (770) 667-0904.