Static Wrinkles Research Articles

Voltage-programmable liquid optical interface

Recently, there has been intense interest in photonic devices based on microfluidics, including displays1,2 and refractive tunable microlenses and optical beamsteerers3,4,5 that work using the principle of electrowetting6,7. Here, we report a novel approach to optical devices in which static wrinkles are produced at the surface of a thin film of oil as a result of dielectrophoretic forces8,9,10. We have demonstrated this voltage-programmable surface wrinkling effect in periodic devices with pitch lengths of between 20 and 240 µm and with response times of less than 40 µs. By a careful choice of oils, it is possible to optimize either for high-amplitude sinusoidal wrinkles at micrometre-scale pitches or more complex non-sinusoidal profiles with higher Fourier components at longer pitches. This opens up the possibility of developing rapidly responsive voltage-programmable, polarization-insensitive transmission and reflection diffraction devices and arbitrary surface profile optical devices. Voltage-programmable liquid surface profiles with large amplitudes resulting from dielectrophoresis are demonstrated. The oil interface formed can be ultrastable and static, or rapidly switchable, as shown in the case of a modulated diffraction grating. The scheme provides the possibility for responsive and polarization-insensitive transmission and reflection devices, and for optical interfaces with arbitrary surface profiles.

Novel Topical BoNTA (CosmeTox, Toxin Type A) Cream Used to Treat Hyperfunctional Wrinkles of the Face, Mouth, and Neck

The methods used in this study are excellent, and the results are well presented. The interpretation, in agreement with the objective, describes a significant improvement in facial aging lines, particularly the hyperkinetic wrinkles and folds attributable to facial expressions and excessive muscle activity. The two groups, 20 patients in group 1 treated with CosmeTox and 20 patients in group 2 treated with placebo, are sufficient to demonstrate efficiency. The patients apply cream (1 ml) containing 2 international units (IU) of BoNTA to their faces every night for 4 to 7 weeks. The evaluation is both objective (photos and assistant experts’ review) and subjective. Both doctors and patients appreciate the results. According to the subjects’ global assessment, facial improvement of static lines and hyperkinetic wrinkles started during the 2-week period for all the patients in group 1 (25 to 50% improvement noted) and reached 85% improvement after 4 weeks for all the patients in group 1. Improvement persisted over a 12-week period. No improvement was seen in placebo group 2. In Europe, two brands of cream containing BoNTA are sold. CosmeTox seems particularly more efficient and could meet the expectations of needle-phobic patients. For other patients, it also could maintain and eventually prolong the relaxation effect for the entire face, especially the forehead, between BoNTA injections, producing a more relaxed look. The authors choose the minimum efficient dose (2 IU) for application as a topical cream every night to avoid an over-relaxing effect as well as antibody formation, which is known to be dose and frequency dependent. It would be interesting to check whether constant use of topical BoNTA cream favors the appearance of antibodies. Although eyelid ptosis is impossible with such a dose of topical BoNTA, it could nevertheless be imagined that an excessive dose might result in asymmetric eyebrow ptosis, which is totally reversible anyway. There also is the question of effective longevity with respect to the 2 IU of BoNTA. Are they still efficient as a topical cream prepared in a single 1-ml unit stored at room temperature, and for how long can it be stored in these conditions? Selection of the group 1 patients was methodical and cautious to avoid the smallest complications. The only intolerances noted were skin tightness and dryness, which were logical and predictable. I think it might be difficult in everyday clinical practice to take the necessary time and precaution before prescribing a topical cream. Another problem is the necessity of applying this cream every night and the relative impossibility of adding any other active cream containing vitamin A or C or hydrating agents during this time. An equally pertinent question concerns the cost for this type of treatment compared with well-spaced injection sessions. In conclusion, it is obvious that topical BoNTA creams cannot be superior to well-dosed and spaced BoNTA injection sessions in the right place, but my overall impression is that topical BoNTA cream (Cosmetox) will be particularly interesting for needle-phobic patients and for maintaining clinical results between injection sessions.

A triangular pattern for botox forehead rejuvenation

The authors contend that their triangular pattern of Botox administration provides reproducible correction of both static and dynamic forehead wrinkles with minimal risk of brow and upper lid ptosis. Further, by varying dosage and injection technique, mimetic function may be preserved or obliterated.

A3. The role of botulinum toxin and alphahydroxy acids as agents to prolong the effects of skin rejuvenation procedures

The desire of ‘baby‐boomers’ to remain forever young can prove to be a tenuous goal that often eludes most of us. However, with the current popularity and availability of minimally invasive techniques of facial rejuvenation, many people with facial wrinkles and photodamage may be closer to the ideal of at least appearing youthful.Injections of Botulinum toxin (BTX) will remove many of the dynamic wrinkles of the face that denote a negative emotion and give the appearance of being old and tired or even angry and disgusted. These types of wrinkles are produced by hyperactive mimetic muscles of the face, which can be weakened by injections of BTX.The addition of superficial chemical peelings with the alphahydroxy acids (AHAs) can be used to rejuvenate the superficial surface of the face by diminishing the appearance of the fine, static wrinkles of the face, many of which are caused by photodamage and chronological ageing. Daily application of the AHAs in cream form can be used to maintain a supple, healthy glow on the surface of the skin, keeping the telltale wrinkles of the ageing process at bay.

Carbon dioxide laser resurfacing combined with endoscopic forehead lift, laser blepharoplasty, and transblepharoplasty corrugator muscle resection.

Endoscopic forehead lifting has become an increasingly popular method for rejuvenating the upper face, due to its less invasive nature and minimal scars. However, adequate ablation of frown muscles (i.e., corrugator and depressor supercili) is difficult with this approach. The frown muscles are in close proximity to the upper eyelid, and it is possible to oblate them via the blepharoplasty approach using the carbon dioxide laser. The purpose of this paper is to describe the combined approach of endoscopic forehead lifting and carbon dioxide laser resurfacing to rejuvenate the upper face. The former technique addresses the issue of brow elevation and improvement of dynamic glabellar frown lines. The latter technique deals with static wrinkles caused by sun damage. Thirty-seven patients underwent endoscopic forehead lift, transblepharoplasty corrugator ablation, with simultaneous carbon dioxide laser resurfacing of forehead skin. Twenty-eight of 37 patients (76%) achieved excellent results, while nine of 37 (14%) experienced good results. Complications were minimal, being mostly due to inadequate corrugator muscle resection with recurrent frowning. There were no instances of scarring, skin necrosis, or permanent hair loss. The combination of endoscopic forehead lifting, transblepharoplasty corrugator muscle resection, and carbon dioxide laser resurfacing is an effective and safe technique for rejuvenating the upper face, producing a natural result with minimal complications.