ADVANCED FOUNDATION BOTULINUM TOXIN TRAINING COURSE

The superficial skin starts to become thinner, more dehydrated, and progressively loses its elasticity. Subcutaneous adipose tissue becomes reduced. Muscular hypotony joins fatty hypotrophy in contributing to skin impairment. According to the depth of wrinkles, they can be differentiated into fine lines (wrinkles) and grooves (furrows). Fine wrinkles are initially isolated and discrete, then converge and become multidirectional. They are sometimes associated with repeated contraction of the muscles of the face and neck; they then become deeper and are called expression wrinkles (mimic lines), such as ‘crow’s feet’ in the orbit temporal region. When expression wrinkles extend to the dermis, they are called grooves (skin furrows) or glabellar wrinkles (frown lines). When the skin starts to slacken, it can be redundant in the form of excessive creases appearing on the upper eyelid. Main reasons for this is due to loss of elasticity of the dermis (dermal elastosis), which depends on genetic makeup and sun exposure, and repeated contraction of the muscles of the face and neck. You will need to learn to distinguish between fine wrinkles, expression wrinkles, and grooves, as well as creases, in terms of treatment. Fine wrinkles can be treated by laser resurfacing and expression wrinkles and grooves by filler products or botulinum toxin, but creases usually require surgical intervention.