Wrinkles and Fine Lines


  • As we age the skin becomes thinner, drier and less elastic and as a result of repeated facial muscle movement lines, wrinkles and creases form in the skin.
  • Wrinkles and Lines initially are present with muscle movement (Dynamic wrinkles) and then become present without needing muscle movement (Static wrinkles).
  • The commonest sites for wrinkles are between the eyes (Frown lines), sides of eyes (Crows feet), forehead (Worry lines) and around the mouth.
  • Fine lines and skin texture can be improved with skincare, prescription creams, peels, microdermabrasion, skin needling and laser toning.
  • Wrinkles caused by movement can very effectively and safely be treated with anti-wrinkle injections.
  • Wrinkles, creases and folds present at rest require volume replacement which can be achieved with Dermal Fillers
  • Non injectable treatments with laser resurfacing and fractional radiofrequency can give long lasting results.


When a cosmetic doctor looks at a patients face to assess wrinkles it is usual to think of the face as being in three areas: Top third (Eyes to hairline), Middle third ( Eyes to mouth) and Lower third ( Mouth to neck). This is useful as the top third is the area that usually responds best to anti-wrinkle injections, the middle third usually requires volume replacement with dermal fillers whilst the lower third often needs a lifting effect.

The 10 commonest facial wrinkle sites that patients want treated are

FROWN LINES: When someone frowns or concentrates the central area between the eyes usually forms a single line or double line (“number 11”) depending on anatomy. This is the commonest wrinkle area that patients request treated because it is perceived as a negative appearance giving an angry or unhappy look. Thankfully this area responds particularly well to anti-wrinkle injection treatment. Some Dermal filler can be needed as well if these lines have been longstanding and there are deep lines present at rest.

CROWS FEET: The lines on the outer corners of the eyes are called ‘crow’s feet’ as they resemble the pattern of a crow’s foot. They are very common and can start developing in the 20’s. They are disliked because they give an aged appearance and are often regarded as making someone look tired and not relaxed. Very good results can be achieved with anti-wrinkle injections. An injection can also be placed in the outer eyebrow to give a brow lift and help open up the appearance of the eye.

FOREHEAD LINES: Also referred to as ‘Worry Lines’ because they give a concerned appearance. Common in both men and women and especially common in people who spend a lot of time outdoors for work and/or sport. Care needs to be taken when treating low down on the forehead with anti-wrinkle injections especially just above the outer eyebrow as it can result in a brow droop. Dermal fillers can also be used effectively.

WOLF/BUNNY LINES: The lines on the nose next to the inside of the eye are often called ‘Wolf lines’ when they occur in women and ‘Bunny lines’ when they occur in men. These lines can be softened with anti-wrinkle injections but can be difficult to completely remove. These lines are typically present but not always noticed by a patient until they start to have other facial treatments and more closely examine their own facial appearance.

UNDER EYE LINES: The lines under the eyes can be very challenging to treat. Sometimes the best option is a topical cream such as ELASTIDERM. Anti-wrinkle injections can help in some patients but if there is any skin laxity this needs to be done cautiously to avoid possible weakness to the lower eyelid and causing sagging. Dermal needling and PRP in the right patients can give significant improvement. If there is an associated loss of volume in the tear trough then dermal fillers are important.

CHEEK LINES: If lines and wrinkles high up on the cheekbone are caused by the lower fibres of the muscle around the eye (Orbicularis oculi) they are more Crows feet and can be improved with anti-wrinkle injections. If they are caused by the cheekbone muscle (Zygomaticus) they do not respond well to anti-wrinkle injections and trying to treat them can result in an uneven smile. If related to underlying volume loss then dermal fillers will improve these lines. The INFINI and PRP can be helpful in this area.

SMOKERS LINES: The vertical lines especially on the upper lip are not necessarily caused by smoking but are more common and severe in smokers (and ex-smokers). When the lines are not present at rest low dose anti-wrinkle injections can help slow the rate of these lines deepening. When the lines are present at rest dermal fillers can help but when they are deep and longstanding there is often associated scar tissue and laser resurfacing can be the best option.

MOUTH FROWN: The ‘mouth frown’ refers to when the corner of the mouth starts to curve and pull downwards. It is due to a combination of overactivity of the muscle on the outside of the lip (called the DAO) and loss of volume in the lower face. Treatment of the DAO muscle with anti-wrinkle injections can reduce the severity and slow the rate of deterioration. This is often treated in combination with relaxing the chin muscle which can be contributing to the downward pull of the lower face muscles.

MARIONETTE LINES: ‘Marionette lines’ refer to when vertical folds develop between the outer lip and the chin. Medically this is called the mentolabial fold. These lines give a grim and dissatisfied appearance. Combined treatment with anti-wrinkle injections and dermal fillers is needed. With aging the skin can sag along or sink below the jawline, which is then termed ‘jowls’ and whilst early on skin tightening treatments such as the INFINI can help when significant sagging has developed a surgical lift procedure is usually needed.

ACCORDIAN LINES: These are also sometimes referred to as ‘smile lines’ or ‘laugh lines’ and are the curved vertical lines situated outside of the corner of your mouth that become more prominent when smiling. Anti-wrinkle injections do not work too well on these lines and whilst Dermal fillers can be helpful, it is a difficult area to achieve great result with fillers alone. Very good longer term results can be achieved with radiofrequency energy through the INFINI device. PRP either alone or in combination with skin needling is also a good option.


Basic skincare with use of a gentle cleanser, moisturiser and sunblock remain important fundamentals for skin health and help with slowing the rate of wrinkle formation irrespective of your age. Good lifestyle choices with avoiding smoking, excess sun and excess alcohol are also important to prevent premature skin aging.

Vitamin A, which can be applied to the skin in various forms and in various strengths, can be effective in softening wrinkles and lines and stimulating collagen formation. Topical Vitamin A, as 0.05% retinoic acid, requires a prescription and has been shown in clinical studies to be beneficial in wrinkle reduction.

Dermal treatments such as microdermabrasion and skin needling can be very effective in targeting fine lines. Improved results with skin needling can be achieved by combining skin needling with PRP (Platelet Rich Plasma) where a patient’s own blood is used to enhance the collagen stimulating effect.


Injections to treat unwanted wrinkles involves very fine needles to inject a protein based product that can produce tailored results so the skin looks smoother and less wrinkled.

The use of anti-wrinkle injections to relax muscles to remove or soften wrinkles is a safe fast non-invasive method that typically last 4-6 months.

To find out more about Anti-wrinkle injections visit this page


Dermal fillers enable volume to be replaced as the skin ages. Dermal fillers are particularly important around the eyes, around the mouth and in the cheeks to replace age related loss of facial fat. The safest dermal fillers are based on the naturally occurring sugar Hyaluronic acid. There are now several brands of products using Hyaluronic acid available in Australia. There is clinical data from over 20 years of use with Hyaluronic acid fillers enabling a good understanding of the benefits and limitations of this class of Dermal fillers.

To find out more about Dermal Fillers visit this page


Many different types of lasers can be used to treat fine lines and wrinkles. Laser toning using the REVLITE laser is a very popular treatment which has minimal discomfort and downtime and a series of treatments can give a smoother healthier complexion. Laser Peels combine microdermabrasion, peel and laser toning in the same treatment for faster results than Laser toning by itself. Picotoning using the PICOSURE laser can improve skin texture, reduce pore size and reduce fine lines as well as target unwanted skin pigmentation. The BBL device can target the signs of aging and sun damage as well as stimulate skin rejuvenation at a cellular level in a treatment protocol known as ‘Forever Young’ which can help maintain the skin to look up to 10 years younger than would otherwise be the case.

Deeper lines and wrinkles can also be treated with lasers and typically these require what is called laser resurfacing. This involves removing the surface layer of the skin so new skin can form. There is downtime with resurfacing procedures but the advent of fractional technology has significantly reduced side effects and downtime.


The big advance in using radiofrequency energy for non-surgical skin tightening and reduction of wrinkles was when it was combined with skin needling. It had long been known that skin needling could cause a skin healing response and stimulate new collagen so a logical progression was to combine skin needling with radiofrequency energy.

The INFINI device accurately delivers radiofrequency energy through micro needles to the required level below the surface (up to 3.6mm). The needles used in the INFINI are insulated which spares the surface of the skin from heat damage. The energy is delivered in a fractional manner which also allows for minimal downtime.

The INFINI seems particularly effective on Accordian lines and cheek lines that are otherwise quite difficult to treat. It also helps with lower face lifting or what is referred to as a non-surgical facelift.

For more information on the INFINI visit this link.

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