The skinny on Rhytids…wrinkles
Dr. Raghu Athré is one of the few cosmetic and reconstructive surgeons in Houston who is a double board certified Facial Plastic surgeon, certified in Otolaryngology and Head/Neck Surgery. After completing his training, Dr. Athré started his own practice, Athré Facial Aesthetics, in his hometown of Houston, TX. Dr. Athré... more
Rhytids are the scientific term for wrinkles, plus they sound a lot better than wrinkles. One of the most common questions I get asked is how to fix wrinkles. Here’s a few thoughts on rhytids…how to prevent them and how to fix them.
In order to continue, we need to first categorize rhytids. Fine rhytids are small wrinkles that appear around the crow’s feet region, or around the mouth (commonly called smoker’s lines). Intermediate rhytids are a further exacerbation of fine rhytids. They can also occur in the cheek; and the forehead lines and the lines between the eyebrows (glabellar lines) are common examples of intermediate rhytids. Finally, deep rhytids are structural lines such as smile lines, and the jowl lines.
Fine rhytids and intermediate rhytids can be prevented. The primary reason for fine and intermediate rhytids is loss of skin elasticity and collagen. Therefore, prevention of these lines includes things that reduce the degradation of collagen and increase the skin’s production of collagen. The first line of defense in this process is a healthy lifestyle, good hydration, good nutrition, and sun protection. The next line of defense is a medical-grade skin care regimen like what is available at our office. Medical grade skin care regimens frequently contain pharmaceutical doses of retinol or tretinoin. Both chemicals are in the vitamin A family, and when applied topically, build collagen and reduce the appearance of fine lines/rhytids.
Included in such a regimen will likely be a gentle skin cleanser (NOT SOAP), a moisturizer, and a prescription grade sunblock. For skin to be supple, it needs MOISTURE. Skin naturally makes oil to keep itself moisturized and supple. Soap is too harsh for facial skin and strips too much of the inherent moisture of the skin. Similarly, retinoids can strip moisture from the skin as they grow collagen. Therefore, a moisturizer will be necessary.
If fine rhytids and intermediate rhytids need to be fixed, there are lots of options. The first option is skin correction procedures. In this category, you have facials like our Hydroluxx facial, microneedling, microneedling with PRP, and light chemical peels. These procedures gently resurface the skin and trigger growth of new collagen and increase the elasticity and plumpness of the skin. The second option is Botox and Dysport. These injections work in a very different way. They actually paralyze the underlying muscle so that the muscle itself cannot move and thereby stops the rhytid. Botox and Dysport do not grow new collagen, but they can stop the progression of fine and intermediate rhytids by preventing muscle movement from “creasing” the skin above it.
The next treatment option for fine and intermediate rhytids is a more invasive laser resurfacing or skin peel. Either laser resurfacing or deep skin peels are performed by me in the procedure room. They are more invasive than any of the above-mentioned therapies and require more downtime. However, the results can be amazing and can seriously increase the plumpness, and elasticity of the skin. Finally, dermal fillers can be used for some intermediate rhytids. Depending on the type of dermal filler, some fillers can lead to some localized collagen growth, but most fillers simply fill in the rhytid much like bondo would fill in a small dent in a car door.
Deep rhytids are primarily caused by structural issues such as drooping or ptosis of the tissues. Deep rhytids normally need more invasive options to correct them. The starting point on this type of rhytids is injectable filler agents such as Restylane of Juvederm. Dermal filler agents do a great job of lifting the tissues and filling in the rhytid. They can last for up to 1 year. The gold standard for correcting deeper structural rhytids is a surgical procedure. Examples of procedures that can be used to address deeper rhytids include the RT Mini lift, face lift, deep plane face lift, 3D Lift, brow lift, etc.
I hope this helps everyone with respect to treatment options for rhytids. And always remember…there is no cure like prevention. So, please use skin care!
