Beyond BOTOX®
Good anti-aging skin care in Toronto and Mississauga should start with education about what's available, including lasers, fillers, creams and BOTOX®. Mississauga and Toronto patients considering BOTOX or other treatment should seek consultation with a specialist familiar with the virtues, limitations and side effects of all options.
Wrinkles that make us look aged, tired, or grouchy are caused in part by loss of volume, elastin, and collagen. Toronto and Mississauga patients, like those everywhere, eventually notice "dynamic lines" that result from repeated folding of skin by underlying muscle contractions, like so-called glabellar lines or "crow's feet." Available wrinkle treatments include:
- Topical Skin Creams
- BOTOX Cosmetic
- Injectable Fillers
- Laser and Radio Frequency Treatments
- Surgery
Topical Skin Care
There is scientific support for the use of creams in wrinkle treatment and prevention. Topical skin creams are routinely combined with other treatments in Mississauga. BOTOX, fillers, lasers and surgery being among them. Topical Vitamin A, copper peptides and other amino acids and proteins, as well as antioxidants like Vitamin C, and a variety of other plant extracts and hydrating agents like hyaluronic acid and collagen, and exfoliating agents like glycolic acid and lactic acid are all used to improve skin appearance. Side effects of these topicals can include photosensitivity, break outs and irritation, so consultation with an appropriate physician or medical aesthetician is recommended. At-home skin care regimens can be augmented by in office treatments like peels and microdermabrasions for further reduction in the appearance of fine lines.
There is also a growing body of evidence in favor of oral antioxidants, like Coenzyme Q and grape seed extract, to improve skin appearance, and oral herbal supplements like the GliSODin line of products, are increasingly recognized as adjuncts to healthy skin regimens. The regular use of sunscreen is also important for wrinkle prevention. Further discussion of topical skin care and oral herbal supplements can be found on our skin care page.
BOTOX Cosmetic
BOTOX is made from naturally derived proteins and sugars, obtained from botulinum toxin, and modified in a laboratory. BOTOX has been used for a variety of medical conditions for over twenty years in Canada, including in Ontario. BOTOX works to improve skin appearance by preventing muscle contractions that lead to lines and wrinkles. The treatment is most often used for frown lines (so called glabellar lines), crow's feet, and wrinkles in the forehead. In addition to achieving a more youthful appearance, BOTOX in these areas often gives people a more pleasant expression, can also achieve an aesthetic "brow lift", and can give a shinier, smoother quality to the skin.
A BOTOX Cosmetic procedure typically involves 2 to 12 brief injections. It takes several days to two weeks to see the results of BOTOX. Toronto and Mississauga patients can anticipate the effects will last 3 to 4 months. For some Mississauga and Toronto BOTOX patients there may be minor redness that fades quickly, and can be concealed with makeup. Patients can return to their usual activities immediately, but should avoid lying down for 4 hours.
While BOTOX is considered safe and effective, there are potential side effects, and BOTOX Cosmetic should only be administered by physicians with the appropriate training and experience. There are contraindications to the use of BOTOX, for example pregnancy or breast feeding, or concomitant neurologic disease. Bruising, swelling, or in occasional instances, a droopy eyelid or eyebrow have occurred after BOTOX. Mississauga and Toronto patients should be aware that muscle weakness remote to the site of BOTOX injection, and other serious adverse side effects such as difficulty swallowing after injection in the neck area, are listed in the official drug monograph, as they have been very rarely reported. These cases have largely occurred when large amounts of BOTOX have been used for medical reasons, as opposed to cosmetic use.
Meet Dr. Michael J. Weinberg Plastic Surgeon, BSc, MD, MSc, FRCS(C)
Dr. Michael J. Weinberg is a Royal College certified plastic surgeon, and is committed to helping you achieve a youthful and vibrant appearance.
Injectable Fillers
The best known of the many wrinkle fillers is probably collagen. Toronto and Mississauga patients looking for wrinkle treatment today would be very unlikely to be treated with collagen injections however, as it proved to be an extremely temporary agent. The most popular modern wrinkle fillers are the hyaluronic acid filling agents such as JUVÉDERM® and Restylane®. Hyaluronic acid fillers are discussed in detail elsewhere on this site, however, it is worth understanding the basics here. These products do not have any effects on muscle contractions like BOTOX, but rather, they restore volume, and are most frequently used for "nasolabial" lines and "marionette" lines. Added benefits are seen when fillers are combined with topical skin creams and other skin care treatments. They can be used together with BOTOX. Toronto and Mississauga patients may have heard the term "non-surgical facelift" or "soft lift" applied to this combination use. There are a number of other popular filling agents including Sculptra®, made from biocompatible material that has long been used in suture material, and fat injections, which are a permanent type of filling procedure.
Radiofrequency Devices and Lasers
This is actually a huge topic as there are a myriad of devices available in this category. BOTOX and fillers can be used together with these devices for optimal results in some cases. Lasers produce light of one wavelength, which is transformed into heat energy essentially resulting in a controlled skin burn. As the skin heals, it contracts, resulting in tightening and smoothing. Fractionated laser devices produce microscopic injury in an intermittent or non-continuous way, such that only a "fraction" of the skin surface is treated.
Radiofrequency devices act similarly, but with effects more beneath, rather than at the skin surface. Thermage® and Thermogen are examples of radiofrequency devices. Some redness, swelling and bruising can be experienced afterward, but are usually mild compared with lasers.
Laser and radiofrequency treatments can treat large surface areas and tighten loose skin in the lower face, an issue less amenable to improvement with fillers and BOTOX. Toronto and Mississauga patients will find, however, that results are more variable and less predictable than with BOTOX and fillers. The more aggressive the laser treatment, the longer the downtime associated with treatment due to skin redness and hypo- or hyperpigmentation (i.e. areas of lighter or darker skin), and scarring can occur. It is very important than skin not be exposed to UV radiation after treatment.
Facelift Surgery
Patients may consider surgery when treatment of wrinkles cannot be sufficiently dealt with by creams, fillers, lasers and BOTOX. Mississauga and Toronto patients should be aware that options include both "long scar" conventional facelift procedure, and "short scar" facelift, sometimes referred to as an "S" lift, or weekend facelift. In both cases incisions are cleverly concealed in the hairline, or in natural skin folds, or behind the ear. Brow lifts and eyelid surgeries can also improve the appearance of wrinkles around the eyes and in the forehead. Detailed discussion of these surgeries can be found elsewhere on the relevant pages of this site.
In general, surgical procedures tend to be done when patients are suffering from skin laxity, such that there is loose, hanging, excess skin. Today patients can often temporize, treating wrinkles with skin care, BOTOX Cosmetic and fillers until such time as excessive skin laxity renders these treatments insufficient. The advantages of surgery are dramatic and long lasting results. However, surgery is clearly associated with greater potential risks and downtime, details of which can be found elsewhere on this site, and should be discussed more specifically during consultation with a good surgeon. Cosmetic facial surgery should only be carried out by a trained specialist, like a plastic surgeon, in an accredited surgical facility, and it is ideal to have the opinion of a specialist offering all forms of wrinkle treatment, both surgical and non-surgical, to insure you get the appropriate treatment for your needs.
For more information on wrinkle treatment in Toronto and Mississauga, contact Dr. Weinberg in Mississauga or in his downtown Toronto office in Yorkville. Call our office at 905-273-3045 (Mississauga) or 416-207-9090 (Toronto) or request an appointment online.
