The concept of aging gracefully is something I've long admired. I imagined when wrinkles (aka wisdom and experience) showed up on my face, I wouldn't mind; I would relish them. To that, I say "wishful thinking, kid." I'm only 30, and as each line and small sag begins to accumulate on my once bouncy, taut complexion, I've started to get more and more involved in treatment and prevention habits.
I do (mostly) everything right. I take meticulous care of my skin, making time for proper cleansing, serums, moisturizers—the works. I use masks every few days, peels weekly, facials monthly, and glycolic acid has become my best friend. Save for a few too many fatty foods and sugary cocktails (I know, I know), I treat my skin like a firstborn child. But that doesn't stop the aging process. Like types of fat, there are different kinds of wrinkles caused by different factors. To find out more about prevention and treatments, I tapped board-certified plastic surgeon Goesel Anson, MD, and New York–based plastic surgeon Scott Wells, MD. Keep reading for their best advice.
To put it simply, expression wrinkles are caused by repeatedly making the same expressions over and over again. "It's the action of muscles beneath the skin," Wells explains. "Facial muscles are different from all other muscles in that they attach directly into the skin, allowing us to make expressions." Think: crow's feet and frown lines. "Other than never showing expression again, there’s not much in the way of prevention," Anson says, jokingly. "The best treatment," Wells adds, "is Botox or Dysport—it helps to weaken the muscles' force directly on the skin."
Elastotic wrinkles are caused by a loss of elastic structure within the skin caused primarily by sun exposure. These crease lines are mostly seen on the cheeks, upper lip, and base of your neck, and become progressively permanent over time. "They are best prevented by a good skincare regimen, including sunscreen and an avoidance of excess solar exposure," Wells suggests. "They may also be improved by the use of fractional laser resurfacing to help rebuild the elastic structure in the skin." Anson adds, "Avoid cigarettes!"
These types of wrinkles are more directly due to the effects of gravity, caused by a deflation of the tissues above the wrinkle, according to our experts. Anson explains: "Combined with the loss of elasticity and collagen from age, gravitational wrinkles appear as sagging skin." "Because the cause is primarily deflation, correction is usually aimed at re-inflating the area using commercially available fillers or fat grafts," suggests Wells.
Compression wrinkles are the latest subset of wrinkles discovered and formed when you squish your face against your pillow while you sleep. Another good example of this are the wrinkles that occur just above the knee as the skin ages; "These can be prevented by sleeping on your back or using the patented JuveRest Pillow that alleviates pressure from your skin," Anson says. If you've started to notice the wrinkles forming on your leg, Wells suggests "a special form of laser liposuction that is able to debulk the weight of the legs and also rebuild skin elasticity in the region of the wrinkles."
Atrophic wrinkles are "similar to elastotic wrinkles in that they represent a loss of tissue structure within the skin itself," Wells says. He continues, "Whereas elastotic wrinkles occur primarily from sun exposure, atrophic wrinkles may occur from various causes like aging or the overuse of steroid cream." Ultimately, it's a loss of collagen structure and severe thinning of the skin, such as in the forehead. This is one of the most difficult types of wrinkles to correct, according to our experts, though it might be helped with a good, hydrating skincare regimen and laser skin-rebuilding procedures.
Anson G, Kane MA, Lambros V. Sleep wrinkles: facial aging and facial distortion during sleep. Aesthet Surg J. 2016;36(8):931-940. doi:10.1093/asj/sjw074
Zhang S, Duan E. Fighting against skin aging: the way from bench to bedside. Cell Transplant. 2018;27(5):729-738. doi:10.1177/0963689717725755