How To Banish Wrinkles


By: Dr. Francesca Lewis MD, FAAD Special to the Boca and Delray newspapers

Facial lines and creases are multi-factorial, related to genetics, sun exposure, and smoking history among other factors. Thankfully, we have many different treatment options in our tool best to treat wrinkles, and often we employ a combination approach for the best results.

Botox treatments are wrinkle relaxing injections that temporarily soften the lines of the forehead, the furrows between the eyebrows (“11” lines) and the crow’s feet around the eyes. They are safe and effective and give a more youthful appearance by relaxing the muscle’s ability to contract. The injections only take minutes to perform, and the results are visible after 1 week and can last from 3-6 months. These injections are still some of the most popular non-surgical cosmetic treatments available today.

I often get asked what age to start Botox injections. The optimal time to start is when we start to see fine lines at rest (meaning without contraction of the muscles). If we start Botox injections at this point and continue them regularly, we can prevent the development of deeper lines and wrinkles over time. So in a sense, Botox injections these days have become “preventative” as part of an anti-aging regimen.

Dermal fillers are injectables that restore natural volume to the face and soften lines and creases. These can be used in areas that we lose volume such as the cheeks, “parentheses lines,” marionette creases, lips, vertical lip lines, chin, and jowls. The most common dermal fillers used are hyaluronic acid based. Hyaluronic acid is a substance normally found in our skin around our collagen fibers. In these injectable forms, hyaluronic acid is safe and gives a very natural looking result. Juvederm products are hyaluronic acid based and include a family of products suitable to correct different areas. There is minimal downtime with filler injections and side effects such as bruising, swelling and redness are temporary. Depending on the filler used, results can last from 6-24 months. It is very important to choose a Board-Certified Dermatologist or Plastic Surgeon who is well-versed in facial anatomy for Botox and filler injections.

As discussed in our last installment, non-ablative fractional laser resurfacing can erase years of sun damage by increasing collagen production and smoothing fine lines and wrinkles. This technology delivers heat into the skin through thousands of microscopic columns that stimulate collagen remodeling. The surrounding skin is unaffected thus allowing the skin to recover more quickly and with less downtime than traditional resurfacing lasers. Best results are achieved in a series of 3-4 treatments.

Microneedling is a novel collagen stimulating procedure that offers great results in a series of treatments by creating microscopic injuries to the skin to create collagen production. These treatments can be used to treat acne scars, fine lines, pigmentation and surface imperfections of the skin. Microneedling can also be combined with PRP topical application, a.k.a what is known as the “vampire facial” or “plasma facial.” During these treatments the patient’s own blood is collected and spun down to yield the most highly concentrated serum with growth factors that induce new collagen formation. This can then be applied to the skin after a microneedling procedure to gain maximal benefit.

Make an appointment to see Dr. Francesca Lewis at Delray Dermatology + Cosmetic Center by calling 561-440-8020,