Reviewed by Varnada Karriem-Norwood on May 29, 2012

Sources

American Society for Aesthetic Plastic Surgery. Harold Brody, MD, American Academy of Dermatologists. Sumayah Jamal, MD, NYU School of Medicine. Robert Kotler, MD, FACS, Robert Palmer, USC School of Medicine. Skin Cancer Foundation.

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Video Transcript

Narrator: From botox to face creams, from lasers to dermabrasion, Americans spend about 12 million dollars a year in the war against wrinkles. After all, who wants to look older than they feel?

Maria: This can't me.  

Dr. Kotler: No, must have been your twin.

Maria: Not even. It's my grandmother.

Narrator: By age 60, Maria Gould's fair skin showed significant signs of aging.

Dr. Francis Palmer: We age at a rate that's going to be determined by our genetic makeup, and then environment. What did we do? How much sun exposure did we have? Did we gain a lot of weight and then lose it? How much elasticity is in our skin?

Narrator: As we age, the layers of our skin change. The outer layer-- or epidermis—thins, allowing much needed moisture to escape. In the 2nd layer, or dermis, less collagen is produced and fibers that give the skin flexibility wear out. At the same time, fat cells in the subcutaneous layer get smaller, leading to sagging and creasing. Add in years of damage from smoking or from sun exposure…

Maria: Wow.

Dr. Kotler: There's the sun damage

Narrator: Maria fought back with a deep chemical peel that took years off her face.

Robert Kotler, MD, FACS: Surgery cannot be expected to pull out all of the fine little lines. It can't be expected to change the quality of the skin any more than pulling a shirt is the substitute for ironing it. This is a very common misconception, very common, that surgery is the answer to aged skin of the face. It isn't. Surgery is an answer to sags and bags, the jowls, sagging neck, heavy platysma, the neck muscle flapping in the breeze, the turkey neck, whatever you want to call it, surgery is the answer. But, it can't address skin quality.

Sylvie Lemay Levy, RN: Okay, let me have you smile really big for me

Narrator: A bit of botox tackles leftover dynamic wrinkles…those caused by muscle movements such as frowns and smiles.

Sumayah Jamal, MD: If you're a squinter, and if you can possibly use some sort of behavioral modification, it will help you not to form permanent wrinkles in the future.

Sylvie Lemay Levy, RN: The center lines have a lot of memory, so I can make them softer, but they are not going to go away 100%, but when I make your lips a little fuller it will stretch them out.

Narrator: Linda Burns is more concerned with her static wrinkles, those that occur in the folds of the face and around the lips as the skin ages…

Sylvie Lemay Levy, RN: Usually we use botox up in the forehead, around the eyes, to soften the weakened muscles, but in this area, we don't want to weaken muscles so that you can't smile. We plump instead.

Narrator: Plumping is done with an injectable derma filler. Depending on the type, the results can last from 6 to 18 months.

Dr. Francis Palmer: People come, I want it to be permanent, I want it to last forever, and I said, really, what if there's a lump or bump? It can happen. Now, you permanently have a lump or a bump, so that's not something that you necessarily want. I think that the idea that it slowly goes away over a long period of time is not such a bad idea.

Narrator: For mild wrinkles, laser resurfacing, microdermabrasion, and topical treatments like retinoids can be effective. But the best way to treat wrinkles is to reduce your risk. Don't smoke, eat foods full of antioxidants and above all--use sunscreen every day. After all, wrinkles could be the least of your worries.

Dr. Harold Brody, MD: Someone dies of skin cancer-malignant skin cancer every hour—about one every 67 minutes.

Narrator: For WebMD, I'm Sandee LaMotte.