Read between the (frown) lines

There are lines that excite us (pregnancy test), lines that make us swoon (love quotes), and lines (frown and fine lines) that we want to get rid of soon!

Like most lines on the face, frown lines are often the result of age and use — especially when you’re fond of scowling, squinting, glaring or grimacing when you were younger. They develop over time and before you know it, the lines get deeper and deeper until they become permanent.

Most people put up with mild frown lines, but not Dr. Karen Tamayo. As soon as she noticed that the lines were starting to spoil her once smooth-looking forehead, she asked her sister-in-law for advice.

“Whenever my friends would see me, they'd always say I look tired even if it’s only noontime. I got bothered by it. So I sought the help of my sister-in-law who advised me to consult a licensed plastic surgeon/dermatologist to address the problem,” relates Dr. Karen.

While typical women are intimidated about getting the treatment — Botox or soft tissue fillers — Dr. Karen felt comfortable with the idea, “I had no second thoughts, because as a physician myself, I knew that it would be safe.”

Well, little did Dr. Karen know that correcting frown lines is only half the equation to make her look even better.

I CAN FILL IT

According to Dr. Jonathan Yu, a fellow of the Philippine Dermatological Society, American Academy of Dermatology, and American Society of Laser Surgery and Medicine, most of his patients — male or female — complain about their frown lines during their first meeting/consultation.

“Frown lines are actually what prompt them to see me. It’s the first thing they notice; and they feel that once I’ve addressed or corrected that issue, they will look better than before. Well, that’s not always the case,” notes Dr. Jon.

Facial assessment is key.

“It’s very important for practitioners like me to assess the patient well so that we can properly explain to him/her which areas need to be corrected and what the treatment outcome will look like,” he explains.

In Dr. Karen’s case, Dr. Jon noticed that aside from the frown lines, there’s one thing he needed to address — facial descent or what others refer to as skin sagging. Facial descent is caused by a number of factors.

“Age of patient contributes a lot. It happens when the facial fat gets bigger in some areas and drops in other ‘compartments.’ As one ages, both imbalance of fat brings about a descent. Skin laxity due to collagen loss exacerbates the descent. Bone loss and less muscle tone factor in as well,” explains Dr. Jon.

Studies have shown that as one matures, bones are slowly being “resorbed” or being broken down into its base minerals (calcium and others) and taken in the body.

“In a young individual, the growth and resorption of bone is in harmony. As one ages, the resorption â€” in certain areas in the face — is more than the growth. This is clearly seen in the eye socket area and in the cheeks. If we are not aware of this bone loss, the treatment outcome will not be outstanding,” he adds.

To address Dr. Karen’s frown lines, Dr. Jon injected botulinum toxin, and injected Juvederm Voluma with Lidocaine to bring back lost volume (due to facial descent) on her face. And to set the record straight, Dr. Jon says that botulinum toxin and fillers are definitely not one and the same.

“Botulinum toxins are used to treat lines created by movement, while soft tissue fillers like Juvederm Voluma with Lidocaine are used to address volume loss. Both procedures are safe and very effective with years of clinical research done,” explains Dr. Jon.

Soft tissue fillers are fast becoming the treatment of choice among Asians suffering from facial descent or volume deficit. Soft tissue augmentation using hyaluronic acid fillers, such as Juvederm Voluma with Lidocaine, is the second most popular minimally invasive procedure performed by plastic surgeons in the US, based on the 2012 survey conducted by the American Society for Aesthetic Plastic Surgery.

“With almost 15 years of experience with fillers, I have used several filler brands, such as Restylane, Teosyal, Radiesse, among others. In my experience, Juvederm Voluma (with Lidocaine) lasts long, and is robust. It has the ability to volumize areas effectively with the least amount of product used. Plus, it's a very safe and versatile product. It has lidocaine (a numbing agent), which makes it a relatively painless procedure,” notes Dr. Jon.

Juvederm Voluma with Lidocaine is approved by the US and Philippine Food and Drug Administration (FDA), with a prestigious company (Allergan) behind its research and development.

“There was a little bit of pain after the injection, but it immediately faded when I applied cold compress. From Dr. Jon’s clinic, I went about my normal activities. And my friends didn’t notice that I ‘did’ something on my face,” enthuses Dr. Karen, who was recently sworn in as governor of Rotary District 3810, the world’s biggest Rotary Club district. “During my induction, my fellow Rotarians asked me if I just came from a vacation because I looked fresh and younger.” She is also delighted that now, people no longer say she looks tired.

LOVE IS LOVELIER THE SECOND TIME AROUND

For their silver wedding anniversary this October, Evelyn Cheng wants to look as young and gorgeous as the first time her husband laid eyes on her. “For our special day, I wanted to feel more refreshed, more beautiful. I came to Dr. Jon to get rid of fine lines which I think make me look old.”

“Her husband is my golf buddy. So when she told me about her plans, I suggested that she should undergo filler treatment to make her ‘glow’ even more,” shares Dr. Jon.

And since Evelyn is a young patient, Dr. Jon wanted to just rejuvenate or enhance her facial features to make her look fresh and yes, younger.

“Aside from reducing the fine lines on her forehead with botulinum toxin, I also enhanced her mid face, her jawline and added volume on her chin and lips with Juverderm Voluma with Lidocaine and Juvederm Ultraplus XC. Oh boy, Evelyn was so surprised with the outcome,” relates Dr. Jon.

Juvederm Voluma with Lidocaine is so versatile. Aside from giving your face a subtle lift (just like what Dr. Jon did to Dr. Karen), it can also be used to correct areas that lack projection and areas that are depressed.

“It’s very evident what we did on Evelyn’s face. With Juvederm Voluma with Lidocaine, it’s possible to have a better nose, chin, and forehead profile. It can also be used to define areas like the jawline,” explains Dr. Jon.

After the treatment, Evelyn is as confident as ever to walk down the aisle with her beau this October.

“No one really noticed that I underwent the treatment, and I like that, because that means my face still looks natural,” she said.

With barely two months before the big day, Evelyn is looking forward to delivering and hearing the “lines” that would seal their union forever — their vows to each other.