06/20/2024
We always should be mindful of our patients’ financial constraints, and offer them the best bang for the buck so-to-speak. I had treated this patient in her mid-70s on various occasions with temple and cheek filler, botulinum neurotoxin, but she is now most bothered by the fine lines in her lower cheek and around her mouth area. I addressed her superficial creases more directly with a combination treatment using two different injectable cross-linked hyaluronic acid products designed specifically for this purpose.
Other skin resurfacing options include cosmeceuticals, prescription products, micro-doses of botulinum toxin, hyper-dilute biostimulators, chemical peels, laser and light modalities, microneedling, fractional microneedling coupled with Radio Frequency, PDO threads, PRP, PRF, and other energy modalities. Many of these approaches aim to create micro-trauma to encourage the skin to heal itself to a state better than its current baseline. Most of the device-related procedures are more pricey.
Back in 2003, when Restylane was introduced into the United States as an FDA-approved biphasic, stabilized hyaluronic acid filler, it became a new benchmark that would eventually replace collagen filler products. However, by design, it was not ideal to treat superficial creases due to its thickness, particle size, concentration, and elastic modulus.
Although it was initially used for treating laugh lines of the face, it was less than ideal for treating superficial skin creases.
We now have a variety of hyaluronic acid filler products with different concentrations, lift capacities, compressibility, elasticities, and other physical properties that allow us to choose the right tool for the job.
