Wrinkle reduction – General information

In general terms, there are 2 types of wrinkles. The first are wrinkles caused
by loss of volume. Examples of this type are the hollows of the cheeks and the
vertical creases that develop between the corners of the mouth and the chin
[marionette lines]. This type of wrinkle can be decreased by the use of dermal
fillers such as Restylane , Perlane and Juvederm. See our dermal filler page

The second type of wrinkle are those that are caused by repetitive muscular action. These are called dynamic wrinkles.
For example, a repetitive frowning action can lead to creases between the eyes that can make you look constantly angry,
annoyed and unapproachable. Similarly, crow’s feet are caused by repeatedly squinting.

Dynamic wrinkles can be decreased with injection of tiny amounts of muscle relaxant, such as Botox, Dysport or Xeomin
into the muscles that are causing the wrinkle. Strategic injection by a doctor that is expert in this area can reduce
dynamic wrinkles and result in a more relaxed, less tired and more alert look. It can also result in a noticeable brow lift.

The effect of the treatment begins within a week of the treatment and lasts for 3-5 months before gradually wearing off.
Repeated treatment is needed to maintain the optimal effect.

Wrinkle reduction treatment for both dynamic wrinkles and for those caused by loss of volume should always be performed by
a doctor who is well trained and experienced in this area. Dr. Shiffman performs all of the muscle relaxant treatments
himself and does not designate this task to a nurse or technician. As of December 2012 Dr Shiffman has performed over
4400 wrinkle reduction treatments using muscle relaxants. The treatments are safe, effective and cause minimal discomfort.
These treatments should be avoided in women who are breast feeding or pregnant and in those suffering from certain neurologic

If dynamic wrinkles make you look older and more serious than you would like- muscle relaxant treatment can smooth these out
and give you a more youthful and pleasant appearance.

| Wrinkle Reduction | Dermal Fillers | Laser Hair Removal | Glycolic Peels |
| Removalof Growths and Spots | Rosacea |