Facial wrinkles treatments

Author: Dr. Noviello Sergio

Date: 25/02/2019

There are areas of our face that are more difficult to treat in aesthetic medicine. For years, significant results have been obtained with the treatment, for example, of wrinkles in the upper third of the face, frontal wrinkles, periocular wrinkles or corrugator wrinkles.

The use of botulinum toxin has made it possible to attenuate wrinkles in all the aforementioned areas in an extremely effective and very natural way.

But there are still areas of our face that actually cause significant problems for the aesthetic surgeon.

Facial areas difficult to treat

The most difficult areas to treat are mainly those of the lower third of the face; without forgetting also those of the neck.

In fact, in these areas we must pay much more attention to the patient before intervening with all aesthetic medicine treatments, precisely because there are multiple variables in play in these types of situation.

Anatomy, age and tissue quality play a decisive role in the possibility of obtaining significant results.

As a result we need to make a real diagnosis; that is, an analysis of the patient in order to then be able to interpret the defect and implement a strategy that can correct it at this point.

As for the Lower Third, which then simply speaking are the areas to focus on?

Certainly the peribuccal area, all those small perilabial wrinkles that disturb many patients (and also many men), the so-called "marionette" lines, which contribute to giving a sad expression to the patient, as well as the presence of those areas close to the Lower Third of the jaw that are referred to as "wattles".

Let's not forget, as mentioned before, wrinkles on the neck.

So how can we proceed at this point and seek the most suitable solutions for these areas?

The combined action of botulinum toxin and fillers

Certainly by using – in synergistic combination – both botulinum toxin and injectable products. The main product is hyaluronic acid or perhaps, for more lasting results or better biostimulation, calcium hydroxyapatite.

There are certainly also more invasive strategies; for example the use of adipose tissue, that is of body fat that is taken from patients and subjected to simple but very effective treatments such as emulsion. This suspension makes it possible to give new plasticity to the adipose tissue which, transformed into oil, is made usable with very thin needles.

So, whether we proceed with temporary strategies or opt for more lasting strategies, in all these areas we must first evaluate the patient in order to be able to proceed and above all combine the use of botulinum toxin and that of reabsorbable fillers.

Noviello Sergio


Dr. Noviello Sergio

Medical Surgeon
Milan (Italy)

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