Lines & Wrinkles

Every treatment here works on one of four things: the muscle that folds the skin, the support underneath it, the surface of the skin itself, or the deeper layer that has gone loose. The first family works on the muscle. Botox, Dysport, Daxxify, Jeuveau, and Xeomin all do the same basic job. A few precise injections quiet the repeated contractions that fold your forehead, the frown lines between your brows, and the crow's feet at your eyes. The skin above finally gets to rest, and motion lines soften or disappear entirely. Choosing between the five is often a personal decision based on your goals and your injector's experience and preference, though there are real differences. Dysport spreads a little more, which suits a broad forehead. Daxxify tends to last longer between visits, where the others generally run three to four months. Jeuveau is the newest option of the five and has its strongest data on the frown lines. Xeomin is stripped of the accessory proteins the others carry, which is the reason to try it if a neurotoxin that used to work well has stopped.

Etched lines need the second layer, the skin itself. Morpheus8 drives radiofrequency energy through microneedles to the depth where collagen has thinned, prompting your skin to rebuild the scaffolding that used to hold the line open. Fraxel resurfaces from above, replacing creased surface skin with new tissue. Both are controlled injury that your skin answers with repair, which is why results build over months rather than appearing overnight.

The rest of that family sits on a ladder of depth, and the honest way to choose along it is by how much recovery your life will absorb. Microneedling is the gentlest rung: fine needles make controlled channels that prompt collagen without removing surface skin, which suits early lines and costs a day or two of looking flushed. Clear + Brilliant is the lightest of the lasers, enough to smooth lines that are only just appearing and to keep them from setting, and it is done as a series rather than as an event. Venus Viva puts radiofrequency through a nano-fractional tip and treats uneven texture and fine lines in the same pass, which helps when the complaint is as much about the surface quality of the skin as about one particular line. ProFractional Laser is the deep end: it removes narrow columns of skin so the edges of a set line can heal down, and it asks for real downtime in return. Deeper is not better, it is only deeper, and a shallow line does not need it.

Fillers occupy a different position entirely. Where a fold has deepened because the face lost volume above it, relaxing a muscle will not help and resurfacing will not either. Restoring the support underneath is what lifts the fold, which is why treatment often runs along the crease and into the adjacent areas of volume loss in the cheek. Dermal Fillers is the category, and the products inside it are not interchangeable. Juvéderm is hyaluronic acid: soft, effective the same day, and reversible if the result is not what you wanted, which is what makes it the sensible first one. Radiesse is firmer and holds structure where the lower face needs an edge, and it stimulates your own collagen as the gel carrier is absorbed. Sculptra works by prompting your own collagen over a series of sessions rather than simply adding volume, so lines soften across months rather than on the afternoon you were treated. Bellafill lasts years rather than months and is preceded by a skin test, which makes it a choice for people who already know exactly what they want kept.

The fourth family is for lines that arrived with laxity rather than with creasing. Heat the deeper layers and existing collagen contracts while new collagen builds, which firms the surface those lines sit on. Ultherapy uses focused ultrasound at the depth of the fibrous layer under the skin, the one that actually lifts, and the change appears over three to six months rather than at the visit. Thermage heats a broader field with radiofrequency and is the better fit for crepey skin spread across a large area, in a single session with nothing to recover from. ThermiSmooth is the gentle version, warming the surface over several short visits, and it goes where the others are too aggressive: the thin skin around the eyes and the mouth. None of the three erases a line on its own. They change the quality of the canvas the line is drawn on, which is a different and more modest claim.