Understanding wrinkles and their treatment options

Bela Vida Med Spa and Wellness

Aesthetic Medical Spa & Wellness Specialist Located in Ocoee, FL

Middle Age Struggles…You Can Win the War Against Wrinkles! Most of us are confused by the various options available for addressing facial wrinkles and volume loss. Our endless pursuit of beauty, especially flawless skin, has come at an exciting time wherein new treatment **options** are available for everyone and anyone.

Skin starts to age just about the same time as we become teenagers. The natural aging process, called intrinsic aging, is largely controlled by our genes and shows up as visible lines on our face, a loss of youthful fullness, and thinner, drier skin. Extrinsic aging – the environment and lifestyle choices – unfortunately can add to skin aging prematurely.

Dynamic wrinkles form as a result of muscle motion — including the way we express ourselves — as well as from habitual movement, as is the case of vertical lip lines in smokers and crow’s feet in tennis players who often squint in the sun. When our facial muscles contract, the skin over those muscles stretches to accommodate. When we’re young, our skin bounces back after squinting, smiling or laughing.

Eventually, however, our skin can no longer bounce back, and the dynamic wrinkles start to become more permanent, which is called static wrinkles. The most common dynamic wrinkles are across the forehead, at the outer corners of your eyes (crow’s feet) and between the eyebrows.

Static wrinkles are caused by gravity, the loss of fat and collagen, and the loss of the skin’s elasticity. These types of wrinkles are visible regardless of the muscle action. They are always there, hence the term “static.” Dynamic wrinkles eventually become static wrinkles. Some wrinkles are really more folds than lines and may be dynamic or static. The deep lines that run from the nose to the sides of the mouth are called nasolabial folds. Lines that start at the corners of the mouth and go downward toward the jawline are called marionette lines.

They form for three reasons: years of dynamic facial movements, static forces such as gravity and chronological aging.

There are many treatments for these types of wrinkles available including creams and lotions, chemical peels, Botox injections, fillers, dermabrasion and lasers. The right choice for each person is based on the severity of his or her wrinkles, individual factors and the patient’s goals of treatment.

Effective topical creams and lotions contain some form of retinoic acid (Retin A or vitamin A derivatives) that helps reduce wrinkles. These products cause skin cells to turn over faster, which reduce pore size and smooth skin. They also build collagen under the skin to help replace what is being lost in the aging process. Topical Retin A is a prescription product and comes in several strengths and formulations. The vitamin A derivatives have weaker activity and are present in several over-the-counter beauty products.

Available treatment options

What you put in your body matters. Choose healthy foods – plenty of fruits and vegetables. Antioxidants such as beta-carotene and vitamins C, E, and A can curb the damage caused by free radicals that harm skin cells and cause signs of aging.

Drink at least 64 oz of pure water every day for the sake of your skin, the largest organ in your body. It’s one of the easiest anti-aging treatments to practice; better hydration can reduce puffiness, help clear adult acne, create smaller pores, improve dry, itchy skin, improve pH balance and improve moisture and elasticity in the skin.

Exercise regularly for your physical, emotional and mental health, to increase oxygen and blood flow to nourish skin cells and carry away waste and free radicals, and to reduce stress levels which impact your skin (acne and eczema worsen with stress, for example.)

Get enough sleep (seven to nine hours is recommended) so your body can rest and renew itself. Not enough sleep accelerates the aging process, worsens existing skin conditions, such as acne breakouts, and contributes to weight gain, results in poor water balance, leading to puffy bags and circles under your eyes, dry skin and wrinkles.

If you smoke, STOP. Why stop smoking? Smoking narrows blood vessels, decreasing blood flow and limiting oxygen and nutrients reaching the skin’s surface. Chemicals in tobacco smoke also destroy collagen and elastin, the connective fibers that keep skin wrinkle-free. Lines on your face are one result, but research also shows that smokers have accelerated signs of aging from the neck down.

When you quit smoking, blood and nutrient flow to the outer layers of your skin improves almost immediately. Though your skin will never fully return to its original pre-smoking state, most of what’s damaged can be vastly improved, including collagen and elastin renewal. In fact, even just a few days after you’ve kicked the habit, you’ll likely see your complexion become brighter and rosier, and you may find that your skin appears less saggy.

Is Medical Grade Skincare Worth it?

The major difference in over the counter skincare versus medical or pharmaceutical grade skincare (cosmeceuticals) is the potency and strength of active ingredients. Any type of medical grade product must pass through the scrutiny of the FDA with controlled trials to be proven safe and effective. Medical grade products provide many benefits as they contain higher levels of such active ingredients as antioxidants, retinols, and peptides. Because of their clinical nature and strength, these skincare lines provide more noticeable results than over the counter brands sold in stores. Medical-grade skincare brands have invested in clinical research to guarantee that their products work, using highly stabilized ingredients that last longer and take longer to degrade. When you are purchasing products at the drug store or department store, there is typically no one holding their feet to the fire, thus product makers can market them however they see fit (e.g. “take 10 years off with one application”)

Another key advantage is an effective delivery method for the active ingredients to penetrate the skin. Medical-grade skincare products are designed with advanced technologies specifically to penetrate deeper down to dermal levels healing and improvement can happen.

It typically takes less product to achieve the results you desire with medical grade skincare, so it turns out to be a superior product for better outcomes at a better value. Investing in a medical grade product for your skin pays off in the long run as part of your overall goal toward an effective anti-aging treatment strategy.

Schedule an appointment for a free consultation for a skin assessment and guidance to the best skincare products for your skin type. Spend less time searching on your own for over the counter products that might not work for you. Instead, work with a licensed professional you trust and invest in a customized and effective anti-aging skincare routine that can improve your skin’s current condition, prevent premature aging and protect against future damage. In addition, your consultant can work with you to adjust the treatment plan if necessary or if you decide to change your skincare goals.

Essential Skincare Routine

No way around it. People who have good looking, youthful, healthy skin are people who also are willing to put the work in. Every day. That’s why it is called routine. An essential medical grade skincare routine is as important as your essential workout routine for health, well-being and beauty. Here are the basic the steps of an essential anti-aging routine you can do at home. The items and sequence of product order may vary based upon the skincare brand you choose, your skin condition and your commitment level. Be sure and give each product a moment to dry between application.

Cleanser – to remove any residual night cream and clean out impurities in the morning; to remove make-up and environmental grime from the day

Toner or astringent – to replenish skin through hydration and remove dead cells, makeup and dirt left behind after cleansing; to rebalance skin’s PH level; to tone and tighten pores.

Exfoliator – to slough off any dead skin cells (couple of times a week)

Antioxidant Serum – Vitamin C is a workhorse helping to boost sun protection, fight off free radicals and environmental toxins, and give the skin an overall glow

Eye Cream – to moisturize and minimize fine lines and wrinkles. Choose an eye cream with caffeine or growth factors to depuff and rejuvenate the delicate eye area

Moisturizer or Hydrator – to deliver moisture and retain moisture; to create a barrier that keeps oil from escaping and harmful outside elements from irritating skin

Sunscreen – to protect your skin from the damage of sun exposure with a broad-spectrum screen to guard against both UVA and UVB rays. Many dermatologists say sunscreen over/after everything else – otherwise it prevents penetration of beneficial ingredients.

As part of your overall strategy, these steps are a smart foundation and can support any anti-aging treatments and procedures you choose to pursue to restore, regain and maintain youthful looking skin whatever your age! If you would like a complimentary consultation to discuss your personal anti-aging goals and concerns (from exploring the best options for your skin type and goals, to customizing a treatment plan for optimal results, to financing options), please contact us at Bela Vida Med Spa and Wellness and schedule an appointment today.

Consulting with medical professionals who are specifically and rigorously trained and certified in aesthetic treatments is the best way to determine a treatment plan with the best non-surgical anti-aging procedures for you to achieve your best outcome. But it’s helpful to be at least familiar with the options.

What are some of the most popular non-invasive and minimally invasive anti-aging treatments available that can help you achieve younger looking skin?

Injectables (Neurotoxins, Fillers, and Collagen Stimulators)

More than one-third of American adults are considering a cosmetic procedure in 2019, according to a 2018 Harris Poll cited by RealSelf, the leading online source for people considering an elective cosmetic treatment. In a 2018 Aesthetics Trend Report, injectables continued to be a top trend. In fact, three out of the top 10 most researched minimally invasive procedures were: Botox® (No. 1), Juvederm® (No. 3), and Restylane® (No. 9). Botox takes the top spot on this list for the second year in a row and interest increased 11% compared to 2017. In the online comprehensive 2019 Worth It Rankings on aesthetic procedures, injectable fillers dominated the non-surgical categories.

The category of anti-aging injectables are FDA-approved to relax facial wrinkles and folds (such as smile lines and crow’s feet), contour the body (reducing a “double chin” for example) and improve the signs of facial fat loss by creating structure, framework and restoring volume to the face and lips. Injectables can be lunch-hour perfect with little to no discomfort for those who want to see immediate results with no downtime.


In 2019, neurotoxins remain the single most popular injectable cosmetic procedure in the United States – commonly used to smooth wrinkles around the eyes, frown lines between the eyebrows and forehead creases and other areas of facial expression. FDA-approved neurotoxins are injected to relax specific wrinkle-producing muscles.

Botox products are effective for dynamic wrinkles. A tiny injection of Botox in just the right places weakens the muscle, allowing it to relax, and removes the wrinkle. Botox is effective for wrinkles between the eyes, crow’s feet and forehead.

Typical results last three to four months.

The current neurotoxins on the market are Botox® Cosmetic, Dysport®, Xeomin® and Jeuveau™ (just introduced in early 2019). Botox – a purified protein derived from the botulinum toxin – is the first and best known and has been the #1 selling anti-aging treatment of its kind. But since the introduction of Dysport®, Xeomin® and Jeuveau™ many trained injectors, including those at our practice, prefer having these three excellent neurotoxin options as well to create a custom treatment for clients. They each have their own distinctive benefits in smoothing forehead creases, brow furrows – known as the “11’s”– crow’s feet around the eyes, and lines around the lip area.

Dermal Fillers

As people age, the natural loss of skin’s collagen, hyaluronic acid and elasticity results in wrinkles and loss of fullness in the face especially around the eyes, mouth, cheeks, and jaw line. Injectable dermal fillers are temporary anti-aging treatments that can plump thin lips, enhance shallow contours, soften facial creases, remove or diminish wrinkles and improve the appearance of recessed scars. The minimally invasive procedure of injecting soft-tissue dermal fillers, such as Juvederm®, Radiesse®, Restylane®, Revanesse®, and Belotero®, give natural looking and long-lasting results with regular, ongoing treatments, which makes them very popular non-surgical options.

Dermal fillers can be effective for static wrinkles to replace lost volume and re-plump the tissue. Two types of fillers are used: a deeper injection of thicker filler which serves to replace lost volume such as in the cheekbone area, and a thinner filler which is used to fill in finer lines around the mouth area.

Hands-down, dermal fillers are a great option as an anti-aging treatment for younger looking hands, which take a lot of abuse. Sadly, the resulting dry skin, wrinkles, and sun damage tend to be a real giveaway on your real age. Radiesse®, calcium hydroxyapatite (ions of calcium and phosphate), was the first dermal filler approved for use in the hands. Restylane Lyft was the first hyaluronic filler approved for the back of your hands.

Collagen Stimulators

Starting around the age of 18, the body’s natural “scaffolding,” known as collagen, decreases in production typically from sun damage, stress and environmental factors.

Sculptra® is a collagen stimulator, stimulating the body’s own natural collagen production to help restore the skin’s inner structure. This procedure increases lost facial volume and the result can last up to two years.

Fat Reduction

Injectables can be used to reduce fat in the submental area, the dreaded double chin that people of all ages can experience because of genetics, weight gain, hormonal status, or just getting older. Many people find an injectable and Sculpture a welcome non-surgical alternative to surgical procedures such as liposuction to improve the profile of their chin and neckline.

One fat reduction injectable under the brand name Kybella® uses a synthetic form of the bile acid, deoxycholic acid (which is produced by your body), to destroy fat cells beneath the chin area so it can’t store fat anymore. The acid gradually kills fat cells, which are metabolized by the body over the following weeks. This non-surgical procedure may have some side effects (swelling, bruising, redness, numbness, pain), but they typically subside in one or two weeks. It can change your profile and improve the shape and contour of your jawline, which makes it very popular with both men and women.


Microneedling is an anti-aging treatment that is a collagen-inducing therapy used to improve skin texture, reduce the appearance of acne scarring, sun damage, fine lines and enlarged pores. Microneedling creates micro-channels by using tiny needles that are set to penetrate different depths of the top layer of skin, which allows serums and skincare products to treat the skin.

Radiofrequency (RF) energy is transmitted through the needles to heat the deeper tissues. This minimally invasive procedure is most used on the face, neck and chest to stimulate healing, collagen production and new skin cell development to reveal healthier, glowing skin. However, it can also be used on the buttocks and stomach for reducing stretch marks and tightening the skin. Benefits are seen over time because the collagen builds as the skin heals and results can be seen for months.

When you visit your anti-aging treatment clinic, you might ask your physician about this non-surgical procedure by one of its brand names, Vivace®, to achieve tighter, smoother, skin with a reduction in wrinkles, pores, or scarring.


Platelet Rich Plasma (PRP) uses the body’s own plasma in many non-surgical anti-aging procedures. PRP is incredible for improving fine lines and wrinkles. How? Platelets. When you suffer small injuries to your skin, platelets clot to stop any bleeding and release growth factors to signal tissue regeneration, including increased collagen and hyaluronic acid production. Collagen adds support to new skin and hyaluronic acid nourishes and hydrates, while at the same time, the growth factors stimulate skin cells to divide, creating new, younger, healed skin. These growth factors also improve circulation and remove damaged skin cells. The PRP treatment process begins with a withdrawal of blood, which is then spun in a centrifuge to separate out the platelet-rich plasma from red and white blood cells. At this stage, plasma contains a higher concentration of tissue rejuvenating platelets. The PRP is then injected near fine lines and wrinkles. This isn’t a cover-up procedure designed to temporarily hide skin imperfections. The skin is genuinely rejuvenated by the platelets’ healing process, and new skin is formed to replace wrinkled, dried skin damaged by time, the sun, and other factors. PRP is applied topically with treatments such as microneedling, often called a vampire facial or injected into the tissue, often called a vampire facelift. It rejuvenates the skin by promoting collagen and elastin growth, to make skin tighter and smoother.

Fractional Laser Skin Resurfacing

Fractional laser skin resurfacing can be effective in softening wrinkles and reducing pigmentation issues on the face, neck, chest, arms and hands. With this anti-aging treatment, a fractional laser delivers precise microbeams of laser light into the lower layers of skin, creating deep and narrow columns of tissue coagulation which stimulates natural healing and the growth of healthy new tissue. The gold standard in laser skin resurfacing for superficial and deeper conditions is Fraxel Dual®; however, the Palomar Fractional Lux 1540 has steadily replaced Fraxel in many practices because Lux 1540 sessions are said to be less painful by many patients than Fraxel treatments.

The Palomar Fractional Lux 1540 is perfect for real results without post-surgical downtime. Lux 1540 is exceptional in that it treats both the epidermal and dermal layers of the skin without down time. The laser improves skin tone and quality, color, and texture treating stretch Marks (striae). Skin color becomes more uniform and imperfections such as freckles, brown spots, broken capillaries, acne scars, and/or enlarged pores are reduced. A non-invasive laser therapy treats fine lines and wrinkles, surface scarring (like acne) and surgical scarring, sun damage and pigmentation such as age spots and melasma (dark-patterned facial pigmentation). At our practice, it’s one of our most popular treatments.

The 1540 fractional laser is a great option for men and women who want the results of aggressive ablative lasers without the side effects or downtime. The laser converts energy into microscopic treatment zones to treat a fraction of the skin at a time. This is how new collagen production is stimulated and how existing collagen fibers are tightened and rearranged. Collagen remodeling is triggered when the body believes it has been injured and stress is placed on the collagen fibers. The 1540 fractional laser creates “controlled injuries” to the epidermal and dermal layers without harming the top layer. This allows for no downtime or recovery of peeling skin. This laser combines fractional resurfacing with gentle, non-ablative laser energy for a comprehensive skin treatment that requires little to no downtime and involves only minor side effects. Due to its gentle nature, multiple sessions, usually 3-4 sessions, are required for full results. More than 85% of patients claimed their skin looked younger, smoother, and saw a noticeable glow following a series of 4 treatments spaced 3-4 weeks apart.

Chemical Peels

Chemical peels typically are used on the face, neck and hands to improve the appearance of aging skin by using a chemical solution to exfoliate the outer layer of old skin. A peel treats fine lines around the mouth and under the eyes, facial wrinkles, mild scarring, age spots, sun damage and the overall tone and texture of the skin. The new, regenerated skin is substantially smoother and less wrinkled than the old skin. According to the American Society for Dermatologic Surgery, peels fall in three basic categories.

Superficial or lunchtime peel
Alpha-hydroxy acid or another mild acid penetrates the outer layer of skin and exfoliates to improve rough skin or discoloration on the face, neck, chest or hands. Superficial chemical peels are a great choice for those who have never had a professional chemical peel service, or people looking for mild correction and skincare maintenance
Medium peel
glycolic or trichloroacetic acid penetrates the outer and middle layers of skin to remove damaged skin cells to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration, rough skin, or treat actinic keratosis (AK), a common pre-cancerous skin condition.
Deep peels
trichloroacetic acid or phenol acid deeply penetrates the middle layer of skin to remove damaged skin cells to diminish moderate lines, age spots, freckles and shallow scars. This facial procedure can be performed only once but provides a dramatic improvement in skin appearance. The deeper the peel, the longer the recovery down time due to increased skin sensitivity, redness, inflammation, skin peeling and healing, along with a higher risk of complications.

The three most popular peels are the Perfect Derma Peel (medium depth), the Obagi® Blue Radiance Peel (superficial), and the SkinMedica® Vitalize Peel (medium depth).

Stem Cell Facelift

This revolutionary treatment provides the regenerative benefits of stem cell therapy for the purpose of anti-aging, but requires no surgery, no downtime, and does not require knives/scalpels. On the most basic level, stem cells migrate to sites of inflammation, dramatically calm down the inflammatory cascade and then lay down a new cellular framework. This results in dramatic skin rejuvenation and a natural lift that can last 3 years – without surgery or considerable downtime. We utilize umbilical cord stem cells for this procedure which are derived from a cord bank.

Skin Tightening – Non-Surgical Face Lift

For a sagging lower face and neck, brow furrows, as well as creepy lines across your chest, an energy treatment using radio frequency may be just what the doctor ordered.

Radio frequency (RF) skin tightening is a nonsurgical and noninvasive skin tightening and anti-aging treatment.
During RF treatment, current flows from the electrodes of an RF device into your skin, heating the tissues beneath to stimulate collagen and elastin production.
RF skin tightening is very safe; the only common side effect is mild to moderate pain during treatment.
RF skin tightening requires no downtime or post-treatment skin care.

During a radio frequency (RF) skin tightening procedure, heat is used to encourage the production of new collagen and elastin. The renewed production of these components helps to eliminate wrinkles and fine lines and tightens skin.

RF skin tightening works by targeting the tissue beneath the outer layer of your skin, or epidermis, with radio frequency energy. This energy generates heat, resulting in new collagen production. This procedure also triggers fibroplasia, the process in which the body forms new fibrous tissue and stimulates the production of collagen, causing collagen fibers to become shorter and more tense. At the same time, the molecules that make up collagen are left undamaged.

Skin elasticity increases and loose, sagging skin is tightened.
Patients may notice skin tightening immediately after treatment. Other patients may notice results within six months of initial treatment or require multiple procedures before noticing an effect. In general, and with proper skin care, results last for two to three years.

RF facials are effective in elevating the brow line, cheek area. The surface area of a person’s jowls, or saggy skin below the cheeks, can be decreased after undergoing RF treatment. Facial rejuvenation of the cheeks via radiofrequency skin tightening is safe for all skin types. Studies have shown that skin laxity in the cheeks and neck is improved in 96% of patients following treatment. RF treatments can be used on areas of the body other than the face – including the neck, abdomen, arms, thighs, knees and buttocks. In some cases, patients undergo treatments for the purpose of body contouring, which reduces fat in addition to tightening sagging skin and wrinkles.

RF treatments are associated with minimal pain, erythema, or reddening of the skin that typically fades within 24 hours after treatment, and edema, or swelling. Swelling can be expected to last for up to 24 hours after treatment, although some patients may experience edema for up to one week.


Elegant eyebrows rule in the age of selfies. Thinning eyebrows can make one look older than your years. People with naturally sparse eyebrows or those who have over-plucked eyebrows and would like fuller and/or more defined brows can benefit from microblading. The precise process uses a small hand-held sloped blade tool which works like a pen, and just barely scratches the surface and implant feather strokes with a medical grade pigment on the epidermis layer. The effect creates fine, natural hair strokes. Unlike tattooing, microblading is not in the deep layer of the skin but on the surface and is not permanent. The color lasts around 12 to 18 months for most. Microblading is not only a great anti-aging treatment for stimulating and supplementing hair, it’s also a popular choice amongst cancer survivors experiencing hair loss as a side effect of chemotherapy and radiation.

Trends on the Manscape. No Doubt. No Downtime is Attractive to Men.

A new report from the American Society of Plastic Surgeons reveals that more than 1.3 million cosmetic procedures were performed on men in 2018, representing an almost 30% increase since 2000. Non-invasive anti-aging treatments continue to grow in popularity among men of even younger ages, who have their own specific set of concerns and issues. Men typically are interested in procedures that yield a more youthful appearance (while maintaining a masculine appearance) with as little downtime as possible.

Non-surgical procedures can answer many of their needs, with a more natural way to address stubborn fat pockets, double chins, fine lines, wrinkles, loss of volume in their face and love handles.

Many men find the first signs of aging that can negatively impact their self confidence in both their career and in their personal life are the very same troublesome signs women face: crow’s feet around the eyes, deep furrows in the forehead and the ‘11’s’ – the frown lines between the eyebrows.

Along with looking youthful and fit, it can be important in the marketplace to look relaxed, well-rested and energetic, like you have all the vigor and energy you need to go the distance. In 2018, 450,000 injectables with neurotoxins, such as Xeomin® and Botox® (often referred to as “Botox” when used on men) were performed on men to achieve a more youthful appearance.

Loss of volume in the face can lead to deep folds and wrinkles and men often seek the benefits of non-surgical dermal fillers over invasive treatments like facelifts, turning to either hyaluronic acid or calcium hydroxylapatite dermal fillers to improve pitted scarring, restore volume loss, soften lines around the mouth and add fulness back to the lips, and revitalize their looks. The brevity of treatment time away from work (easily a lunchtime procedure) and minimal downtime again are strong advantages, as are the longevity of results – from six months to two years.

In our culture, a sharp defined jawline and chin in a man is a sign of health, youthfulness and fitness. Loose or sagging skin and jowls can obscure the definition of the jawline with age. Non-surgical options include Ultherapy®, neurotoxins, dermal fillers and fat melting injectables.

Injecting dermal fillers directly to the jawline enhances the edge of the bony angle and mandible, and results can last 12-18 months. Neurotoxins can be placed directly into the masseter muscles of the face which can enhance the more V-like facial shape with results lasting 3-4 months. Mild excess fat under the chin can be melted with a deoxcholic acid, such as Kybella with permanent results since the fat is physically melted and absorbed into the body to eliminated in waste.

Energy treatments using ultrasound technology (Ultherapy®) targets the deeper SMAS superficial musculoaponeurotic system which is the same muscle a surgeon would manipulate in a facelift. The anti-aging procedure delivers energy (heat) into the skin to stimulate the production of collagen and elastin – which when rejuvenated, tightens the skin with no damage to outer layers of skin. Optimal results take between three and six months with results continuing for a year.

The men’s personal care market is expected to hit $166 billion globally by 2022; men’s prestige skincare sales in the U.S. rose 9% to almost $123 million in 2018. Women traditionally have been the buyers of products for men, but men increasingly are buying for themselves. Rising awareness of the importance of self-care, overall body care, wellness and fitness, and the growing influence of social media presence professionally and personally are major factors driving the purchase growth among men.