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About Face

Wrinkling

Chapter Two Aging Skin Factors That Age the Skin How Skin Ages Hollowing Sagging Wrinkling Vitamin A Acid Cream Nonsurgical Face-lifts Injection Treatments Peels

I have a certain fondness for wrinkling as the third most common skin problem associated with AGING. This is partly because a patient’s wrinkles tell me something of their personality, and partly because there are several, imaginative solutions available with which to deal with wrinkles.

As mentioned above, the degree of wrinkling varies with a patient’s heredity and race. I see many more fair-skinned patients for wrinkling than I do black, Oriental or olive-skinned Caucasian patients. The thicker and oilier the skin, the less likely it is to wrinkle. And, as noted, thin skin wrinkles faster than thick skin. That said, there are certain personality traits that also affect wrinkling.

In simple terms, the wrinkle pattern that appears in the upper half of the face is caused by squinters, frowners and eyebrow lifters. These are the only three movements that the forehead can produce. Any of these habitual facial expressions can begin as early as age six in some people, so you can imagine how entrenched some wrinkle patterns become.

Squinters end up with “crow’s feet”, wrinkles resembling the shape and texture of bird’s feet, around the outer corners of the eye. Sometimes, people squint due to long-term, uncorrected problems with eyesight, and I’ve also seen crow’s feet on scholars who are compulsive readers. Chronic frowners, on the other hand, develop glabellar frown lines, named for the glabella, or flat area of bone between the eyebrows. These are small, often deep, vertical lines between the eyes, But the most common upper facial expression is eyebrow lifting, which causes horizontal wrinkling of the forehead.

In a study I completed in 1988 with Dr. Haitham Masri, we found that statistics indicate that forty-eight percent of people are predominantly eyebrow raisers, while thirty-five percent are chronic frowners. Of course, no one uses a single type of fascial expressive movement, so there are blends of wrinkle patterns.

In the lower half of the face, wrinkling generally appears in two distinct areas. We’ve discussed before the vertical wrinkles that can appear around the mouth. This wrinkling is usually caused by bony atrophy, or hollowing.

The second area is in the lip-cheek groove, one of the boundaries that separates the eight “regional aesthetic units” of the face. (See Chapter One: The Facial Assessment.) The lip-cheek groove, which starts out as a shallow line at the juncture of the two units, deepens with age and becomes particularly pronounced in thin-skinned people during their thirties and forties.

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