Aging Skin

We often blame gravity, but really it’s the loss of volume underneath the skin which is responsible for aging and sagging skin. Dermal fillers are increasing rapidly in popularity because they work well, are relatively inexpensive, give immediate results, and require essentially no recovery. In most cases, injections can be performed with minimal swelling, enabling patients to return to work or their regular activities immediately.

Close up of a woman's face before and after applying Juvederm®

Uses of Dermal Fillers

Dermal fillers are very flexible and can give great results in many different applications. They are commonly used for:

  • Facial folds and wrinkles: Dermal fillers like JUVÉDERM® XC, Restylane®, and Perlane® are an excellent complement to BOTOX® Cosmetic and Dysport® injections because they correct a different type of wrinkle. Combine the two treatments with laser skin resurfacing, and virtually all your wrinkles can be erased.

  • Restoring facial volume: As we age, our face naturally loses volume and what fat we have is often displaced by gravity. This gives the face a wan, tired appearance. Dermal fillers like JUVÉDERM® XC, Restylane®, and Perlane® and RADIESSE® Volumizing Filler can be used to fill in areas that have lost volume, restoring a youthful fullness to your face.

  • Lip augmentation: The lips also tend to lose volume as we age, which is especially important to women. Thin lips can create an older, sterner appearance. Cosmoderm, Juvéderm and Restylane are great treatment for restoring volume to lips.

  • Facial reshaping: Some people do not have the facial shape they desire, and in many cases this can be at least partly corrected with dermal fillers like Radiesse, Sculptra or Restylane. These fillers can be used to give the appearance of higher cheekbones or a stronger chin.

  • Very Fine Lines: With BELOTERO®, the physician can inject the filler superficially to address very fine lines and wrinkles around the mouth, eyes and cheeks.
    In all these applications, dermal fillers provide good clinical results that last from four months to a year.
    Close up of a woman's face before and after applying Restylane®

    Types of Dermal Fillers

    Dermal fillers are not all alike, nor are they equally effective for all applications. At the Washington Institute of Dermatologic Laser Surgery, we offer many different types of dermal fillers:

    • Hyaluronic Acid-Based Fillers: These fillers derived from a natural moisturizer found in the skin and elsewhere have grown rapidly in popularity since they were first approved for cosmetic treatments in 2003. We offer Restylane, Perlane, Juvéderm, and Juvéderm Ultra.

    • Composite Fillers: These fillers have been developed to increase the options for dermal fillers. Composite fillers try to extend the lifespan of results by combining a smooth carrier gel and durable microspheres into a single injection. The gel ensures easy injection, but is absorbed quickly. The spheres remain where injected for an extended period (possibly permanently), and the body fills in around them with collagen. We offer both FDA-approved composite fillers:
      Radiesse and Artefill.
    • SculptraAesthetic is an injectable treatment that works by stimulating your body to produce more facial volume. SculptraAesthetic is FDA-approved for the treatment of facial volume loss with results lasting beyond 24 months.
        • Close up of a woman's face before and after deep FX treatment

            Close up of a woman's cheeks before and after applying Fraxel
              Close up of a woman's face before and after treatment
                Close up of a woman's face before and after applying Fraxel

            Skin Resurfacing

            Many patients who undergo a doctor-performed skin-enhancement procedure select a procedure that falls into the broad category of “skin resurfacing.” In skin resurfacing procedures, layers of the skin are removed by one means or another to expose smoother, more youthful-looking skin underneath.

            Some skin resurfacing procedures produce lasting results that improve the appearance of the skin for years to come. These often work by stimulating the body’s production of collagen, a fibrous protein in the supporting layer of skin, that plays a crucial role in keeping the skin smooth and elastic. Skin resurfacing procedures of this type include laser skin resurfacing and chemical peels.

            More Intense Skin Resurfacing

            Fractional Ablative Lasers (Fraxel re:pair or Lumenis Ultrapulse) are used to vaporize skin in a layer-by-layer fashion to reduce wrinkling and increase skin tightening. These are the most effective treatments for skin rejuvenation, but are associated with some post-treatment recovery. Typically, only one or two treatments are necessary for the desired result depending on the severity of the skin condition being treated.

            Less Invasive Skin Resurfacing

            Today’s array of cosmetic procedures includes procedures that are less expensive, cause less discomfort, and have short recovery times. These techniques include chemical peels and microdermabrasion.The tradeoff is that these more superficial means can’t be expected to produce the long-term results of deeper skin resurfacing. But they often succeed in perking up tired, dull-looking skin and giving it a refreshing, healthy glow.

            A Middle Road

            Fraxel Re:store laser skin treatment is an attempt to reap the benefits of deep skin resurfacing without the recovery and discomfort that traditionally accompanies these more invasive procedures. By application of controlled amounts of focused heat to the skin (the rejuvenating potential of the skin’s deeper layer can be restored. The Fraxel Re:store Laser treatments are generally delivered as a series of three to five monthly treatments. GentleWave LED Treatment is often applied to enhance post-treatment recovery after Fraxel treatment.


            Microneedling has proven helpful in smoothing the vertical wrinkles that are often seen around the mouth (perioral rhytides) as well as the wrinkles around the eyes (crow’s feet or periocular rhytides). These wrinkles are often caused by repetitive muscle movements in the areas as well as by destruction of collagen due to cumulative sun damage through the years. The thin skin around the eyes makes them more prone to wrinkling as well.

            As our skin ages, the production of the skin’s primary building block (collagen) slows down which causes the skin to look and feel thin. By stimulating the production of new skin cells, microneedling creates a more youthful and uniform skin appearance. Clinical results from microneedling are natural, subtle, and achieved over time as the body repairs itself. As a result, microneedling can be used to minimize wrinkles in all skin types.

            Microneedling involves the delivery of discrete wounds to the skin using a specialized (disposable and motorized) tip with thin needles. The tiny (virtually painless) pricks to the skin’s dermal and epidermal layers serve to stimulate the growth of new collagen and elastin. Recovery is fast- a matter of a few days during which time the treated skin appears pink in color while it is being repaired from within.

            Microneedling treatments can be performed alone, but a series of 3 to 5 treatments at monthly time intervals are often recommended to maximize the clinical response. Each minimally invasive procedure is performed within a 30 minute office visit. Our physicians will determine the best treatment strategy for each individual based on the degree of skin damage and patient concerns.

            During the procedure, there may be light bleeding, but the skin appears only minimally pink (without bleeding) at the completion of the treatment. As such, microneedling is considered a “no downtime” treatment. The healing process is quick and painless. Mild skin redness and swelling (like a sunburn) is expected, but resolves quickly within a few days. Skin care products to enhance the results from the microneedling procedure are supplied in order to maximize the benefits from treatment. In most cases, makeup can be applied the following day. Favorable clinical responses are often observed within 3-4 weeks after microneedling treatment as the collagen begins to form.

            With all our dermal filler and skin resurfacing options, we can find an ideal treatment for everyone. We will assess the major signs of aging you wish to combat, discuss a treatment strategy, how long you want results to last, and what cost profile best fits your budget to help you get the best possible results. To learn more about these and other options we offer and which might be right for you, please schedule a facial rejuvenation consultation at the Washington Institute of Dermatologic Laser Surgery today.

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