Treating Facial Wrinkles that Appear at Rest, and Those that Appear in Motion Separately

One woman said she had lines under her eyes that formed when she smiled and relaxed. He wanted to know if he would benefit from Botox and fillers.

Dr. Amiya Prasad is a board certified cosmetic surgeon. He is a trained oculofacial plastic surgeon which means that his background training is first in eye surgery before he specializes in cosmetic and facial and facial reconstructive surgery. Eye aesthetics has been very important in practice in Manhattan and Long Island for the past 20 years.

Dr. Prasad explains that the lines that form when a person smiles are due to muscle activity, called dynamic lines. There is also a line that appears at a break called a static line. In addition, there are other lines that appear while smiling and skin rising. While smiling, he squeezed other lines that triggered rippling on the skin, which Dr. Prasad referred to as the effect of accordion.

When Dr Prasad discusses options with his patients, he thinks of short-term and long-term solutions. In the modern world where there are so many options and so many people offering the latest devices, he sees many people bouncing from one doctor to another to try to keep up with what is happening with their changes.

Skin changes are caused by many factors such as: genetics, heredity, environmental factors such as sunlight and smoking, as well as stress and hydration. The skin around the eyelids is about half a millimeter thick, so it's very thin and practically transparent. Trying to build collagen around this area and trying to improve this look should be done in a very good way.

The gold standard for dynamic lines is to use neurotoxin types such as Botox® or Dysport to reduce the muscle activity that causes these lines. The bottom line associated with the vertical lifting of the cheek cannot be filled with fillers. Such fillers in the hyaluronic acid family are too thick and make this area look swollen.

In the practice of Dr. Prasad, because the static line is essentially a function of collagen loss, he is trying to stimulate new collagen. The traditional method has always been about different types of heat energy devices and he is a big user of fractional CO2 lasers and Pellevé radiofrequency devices. He is not against thermal devices, but opposes too much. Many people have come to Dr. Prasad after they have been heated to the point where the skin becomes thinner and crêpey.

Dr. Prasad has been very successful in using platelet-rich plasma (PRP) derived from the patient's own blood plasma. It has the healing and growth factor needed for wound healing. Through strategic placement over time, PRP can build collagen on the skin. Dr. Prasad customizes this treatment based on the individual patient's response. There are some people who respond better than others.


People have wrinkles under the eyes and skin often, they have swollen bags or under holes. Dr. Prasad often combines PRP with a hyaluronic acid filler for the lower eye area. This combination is actually very effective in undergoing eye surgery and is something that her patients appreciate.

To address the issue of cheek volume, Prasad increases the volume in the areas of the constant, submalar and cheek. It is not to exaggerate but to restore the volume and continuity of the area with the lower eye area. People in their 20s and under the sun all the time have a lot of wrinkles under their eyes, but they still look good because they have a lot.

Dr. Prasad suggests that he finds the right doctor he is comfortable with and will guide him through this very difficult landscape. People who jump from one place to another spend a lot of money and don't get good results. Botox®, Juvederm and others are tools for skilled doctors and not their own solutions, so they are not a commodity. Different fillers can be used in many ways, and get comparable results depending on the concept of the patient and the doctor having the desired result.

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