Fine lines and wrinkles around the eyes and mouth are a normal part of the aging process. Wrinkles occur naturally as subcutaneous fat and skin elasticity is lost. The face having a much shallower layer of subcutaneous tissue is one of the first places that wrinkles will appear.

Add in the damage that frequent sun exposure does to the skin and it is now wonder that many women have skin that makes them look older than they really are.

Luckily women (and men) now have several options available for wrinkle removal. While not as long lasting as plastic surgery (facelifts) they do offer a solution for the short term, with fewer risks. If wrinkles are a concern, discuss these options with your dermatologist.

• Botox
  Botox injections have been in use about 10 years for the short-term treatment of fines lines and wrinkles in the face. Botox works by relaxing the muscles and making the line disappear. Some of the common areas treated include crow's feet, frown lines, laugh lines, and forehead wrinkles. The effects of Botox usually last about 3 - 6 months and can then be repeated. Although Botox is a protein toxin produced by the clostridium botulinum bacteria it is injected in such small amounts that its effects remain localized. It has very few side effects
• Collagen
  Collagen is a natural protein that acts as the support structure of the skin. In young skin, the collagen framework is intact and the skin remains moisturized and elastic. Over time, however, the support structure weakens and the skin loses elasticity. Dermatologists have used injectable bovine collagen for over 25 years. Used primarily as a tissue filler to soften lines around the mouth, it has also been used successfully to augment lips, correct the early degrees of muscle loss around the mouth associated with aging, and erase acne scars. Like Botox its effects are temporary and normally last about 3-4 months. About 10% of the population is allergic to bovine collagen, so skin tests must be done before it can be used for wrinkle removal.
• Fat
  Autologous fat transfer is a wrinkle filler procedure in which fat is removed from one part of the body, such as the thighs, buttocks or stomach, via tumescent liposuction and used to fill in deeper wrinkles and contour the "hills and valleys" associated with aging. Since a patient's own fat is used in the procedure, there are no allergic reactions associated with this type of filler. This is a more involved procedure because fat is removed from one part of the body and added to another. The results are not permanent, as loss of facial subcutaneous fat is a natural part of the aging process, no matter where that fat originated.
• Hyaluronic Acid
  Hyaluronic Acid is a soft tissue filler that has been used with much success in Canada and Europe. It is being studied in the United States but has not yet received FDA approval. Hyaluronic acid is a gel that is actually a natural occurring and basic component of human skin. The gel serves to "float" the skin cells rather than fill in vacant wrinkles, which makes hyaluronic acid suitable for larger folds of skin around the mouth and cheeks. Studies show a low incidence of allergic reaction and with longer action. Results tend to last up to six to nine months.

Overall these procedures carry much lower risk than surgery. These procedures are considered cosmetic, with no health benefits (other than to self-esteem) and generally not covered by insurance or Medicare.