What are “crow’s feet” and how are they formed?
Horizontal wrinkles across the temples and around the outer eyes are commonly referred to as “crow’s feet”. They are a common phenomenon even among very young people. “Crow’s feet” are formed mainly due to the activity of the eye muscles, which are responsible for the face mimics. Every time we smile or blink into the bright sun, the muscles contracts and, as a result, numerous horizontal wrinkles appear around the eyes. “Crow’s feet” can be single wrinkles or a group of wrinkles in the upper, middle and lower part of the temple. We do not usually notice them at a young age, as our skin is still firm and hydrated, however “crow’s feet” become permanent when skin loses its firmness and hydration. With time, the lines around our eyes get deeper even when the muscle is relaxed.
What is hyaluronic acid?
Hyaluronic acid is a natural ingredient of human skin. It is produced by fibroblasts which form the structural framework for human tissues. Hyaluronic acid fills intercellular areas and makes perfect environment for skin cells. It is also responsible for stimulating the production of collagen and protecting all skin elements from exposure to free radicals. Hyaluronic acid also contributes to tissue hydrodynamics; it is responsible for the amount of water tied in the skin which makes it an ideal moisturizing factor. However, over time human skin begins to lose its natural resources of hyaluronic acid which affects the work of fibroblasts. Consequently, the amount of collagen decreases which contributes to the loss in its volume. This process can be stopped with a single injection of hyaluronic acid to help your skin regain its youthful look.
Products rich in hyaluronic acid
There are many products rich in hyaluronic acid. Brands available on the Polish market include: Restylane, Juvederm, Succeev, Stylage, Teosyal. Each of the brands offers a wide variety of different texture, such as Restylane Vital (light texture), or Juvederm Voluma (rich texture).
Products rich in natural hyaluronic acid (Juvederm Hydrate) are mainly used for mezotherapy which instantly improves hydration and rejuvenation of skin. Other similar products are additionally supplemented with glycerine, glicerol and mannitol which make the product perfect moisturizers.
There is a variety of different dermal fillers depending on the area to be treated, ranging from hydrating fillers which are perfect for the décolletage, smooth fillers ideal for the lips or denser fillers for volumising which are most suitable for the cheeks. Sometimes a combination of fillers are used on a particular area to achieve the perfect result. Products which are used at Ekoderm as dermal fillers all have a proven track record for safety and so you can be assured that they are perfectly safe. We use world’s best known brands such as Restylane, Juvederm and Succeev. Every client is unique so at Ekoderm our practitioners make sure that the best possible treatment is chosen for each individual client. To reduce wrinkles around the eyes we choose from a wide variety of treatments: Restylane, Restylane Vital, Juvederm Ultra 2, Juvederm Ultra 3, Succeev Two.
How does the treatment work?
The product rich in hyaluronic acid is injected evenly into the skin. The treatment is performed with a needle which injects proper amount of the product along each crease with numerous punctures. It can also be distributed along the wrinkle from one puncture on each side of the crease with special elastic cannula. After the injection, the product is evenly distributed and massaged properly by the practitioner.
Do I need local anaesthetic?
Our usual practice is to apply an anaesthetic cream (Emla) 30-40 minutes before the injection. We can also inject the puncture sites with local anaesthetic which is normally used in dental surgery so that the area feels numb and discomfort is kept to minimum. In any case, however, the practitioner needs to be informed about possible allergic reactions.
Who is the treatment for?
The treatment is designed for any woman or man who feels uncomfortable with horizontal creases around the eyes called “crow’s feet”. This usually happens at the age of 40, especially with people who have dynamic facial expressions.
What are the results?
After the treatment the wrinkles look filled and visibly more shallow. The skin around the eyes is firmer and smoother due to improved hydration, especially when the muscles are relaxed. However, the skin will still wrinkle when the muscles are working when we smile or express other emotions with our facial mimics.
The natural property of hyaluronic acid is to gradually absorb water and increase its volume so the volumising result of the injection is even more distinct many weeks after the treatment. Hyaluronic acid is also responsible for the production of collagen so the final result is replenished volume and younger looking skin.When do I see the final results of the treatment?
The final results should be expected after 2 - 3 weeks after the treatment. It is usually then that the practitioner together with the patient make the decision concerning additional treatments which are sometimes necessary, especially with deeper wrinkles. It is easier to correct “crow’s feet” gradually which means that sometimes more product has to be injected after 2 or 3 weeks. It usually takes another 3-4 weeks before the final result can be enjoyed.
How many treatments do I need to see satisfactory results?
Younger patients, under 40 years of age, are usually satisfied with a single injection of 0,3 - 0,5 ml of hyaluronic acid. To see satisfactory results, older patients (55-60 years old ) usually require another treatment done every 3 to 4 weeks after the first injection.
How long do I see the results of the treatment?
Satisfactory results, which have been achieved after 1 - 3 treatments, can usually be enjoyed for up to 6 months. This period of time depends on the patient’s age, the power of the muscles and their work, the kind of the filler as well as the patient’s general physical condition and lifestyle. It must be emphasized that smoking can significantly diminish the results of the treatment.
How often do I need to repeat the treatment?
The treatment should be repeated every 6 to 8 months, depending on how long the patient can enjoy the results. Further treatments usually require less product as the increased amount of collagen in the skin strengthens its structure and helps it look younger. Such treatments are usually called “maintenance therapy”.
How do I look just after the treatment?
After the treatment you should expect the area to be a little swollen, red and tender which is caused by the filler and swelling. Puncture sites are still visible but these will disappear soon. The treated area can be swollen and tender which is caused by the filler. Shortly after the treatment hematoma and bruising may occur but they usually disappear within a few days. Bruising sometimes takes a couple of days to develop and 10-14 days to change colour and resolve with no further damage to the final result.
Before the treatment
There is no need for any preliminary medical preparation, but patients have to be in good physical condition. One week before the treatment patients should not take aspirin or any other medication that decrease blood coagulability. Patients are advised to take medicine containing aescin (Aescin 3x2 tablets, Reparil 3x2 capsules) to minimize the risk of hematoma. Patients who tend to suffer from herpes should prophylactically take acyclovir (Heviran tablets 400 mg twice a day) two days before the treatment.
After the treatment
After the treatment patients should apply a thin film of soothing gel and massage the area twice a day (use: Cicalfat, Cetaphil MD, Cicaplast Baume B5, Sensicure). If bruising occurs, it can be treated with Auriderm, Ortholan Vein, Lioton 1000 or Reparil gels. Patients are also advised to continue taking Aescin or Reparil for a few days. Finally, when redness, tenderness, hardening and bruises clear up, patients can discontinue medication and resume their usual skin care practices. It is recommended that patients use high quality skin care products with sun filter SPF50+.
How can I keep the result for longer?
At Ekoderm we believe that aftercare is just as important as the treatment itself which is why we advise patients to look after their skin properly on a daily basis. You can do it by using a high factor sun protection that will protect against both UVA and UVB radiation (SPF 30-50+), as well as products which contain antioxidants such as vitamin C, vitamin E or flavonoid. We also advise our patients to take diet supplements which contain vitamin C, vitamin E, coenzyme Q10 and flavonoid. It is important to refrain from smoking which is responsible for accelerating ageing processes and greatly diminishes all results of aesthetic treatments which have been achieved so far. The whole range of skin rejuvenating treatments such as medical skin peels and mezotherapy are also highly recommended.
Recommended supplementary treatments
Patients who are planning “crow’s feet“ reduction should consider treatments with Botulinum Toxin (Botox, Azzalure, Bocouture) in order to weaken the muscles temporarily. Two weeks after this treatment the wrinkles can be filled with hyaluronic acid which finally can be followed by skin rejuvenating therapy. This will help to stimulate skin for better production of collagen. The therapy includes a series of medical skin peels (pyruvic acid, glycolic salicylic acid,) along with mezotherapy with hyaluronic acid (Juvederm Hydrate) or products rich in multiple ingredients (NCTF HA, NEWEST, UP GRADE). Peels and mezotherapy should be repeated a few times every 2 to 4 weeks. Another therapy we recommend is an intensive regenerating treatment REGENERIS.
Patients who wish to reduce wrinkles around the eyes should also consider resurfacing performed with the use of a fractional laser Palomar StarLux500 Lux 1540 or photorejuvenating treatment with laser handpiece MagG. Any laser therapy can be followed by injections with Botulinum Toxin.
Who can perform treatments?
At Ekoderm all treatments are performed by experienced doctors trained in aesthetic medicine who have been given appropriate certificates.