Our skin matures with us as we age. Through the combination of aging and sun exposure, the skin doesn’t always hold the same elasticity that it once did, the collagen can become less organized, and the skin can thin. All of these reasons contribute to wrinkles.
It’s not just aging and sun exposure. How someone smiles or frowns can cause wrinkles, with the muscle movements themselves being factors. Sometimes, wrinkles can be caused by a pillow contacting the face in a certain way every night. In short, wrinkling is complex and due to multiple causes.
Dr. Rosenbach lectures at medical schools and academic conferences about different means of treating wrinkles. These treatments require customization. What works for one person might not work for another. Dr. Rosenbach makes the assessment personally and will decide with his patients on which treatment is best. Usually, Dr. Rosenbach will make use of lasers, fillers or Botox type products, or a combination of these–to achieve natural results.
Botox type products
Wrinkles can often be caused by movement of the underlying muscles. Proteins that reduce this movement, such as Botox, Dysport, and Xeomin, work by temporarily relaxing muscles that contribute to certain wrinkles. Most patients undergo such treatments three times per year.
Dr. Rosenbach was one of the early practitioners to develop expertise in this area of medicine. When Botox was first introduced, Dr. Rosenbach was selected by the manufacturer of Botox to teach advanced injecting techniques to other physicians. He is one of the first to inject above the lateral brows, which allows for a more natural appearance in certain select patients. He is one of the first to inject into the lower crow’s feet, employing such injections years before research confirming its benefits was published.
Some types of wrinkles at rest are better treated with fillers. As a result of aging, the skin begins to naturally lose its shape and volume, which contribute to the appearance of wrinkles. While Botox and other muscle relaxers reduce the movement that can cause wrinkles, fillers can be used to restore volume to wrinkles that are present even when the face is not moving. Dr. Rosenbach primarily uses the Restylane and Juvederm family of fillers to reduce these fixed wrinkles.
Skin resurfacing with the fractional CO2 Matrix Laser
Our fractional CO2 laser, the Matrix, works best on fine lines by shrinking the skin through removing microscopic columns of skin from wrinkled areas. Thousands of such columns can be removed on the face within 15-20 minutes. Our Matrix laser is significantly more powerful than many of its competitors on the market.
Patients usually undergo 3-5 treatments spaced around 8 weeks apart with a downtime of around 4 days per treatment. Dr. Rosenbach likes to compare this laser to hiring a trainer at the gym: the results might not be immediate, but the long-term payoff is considerable.
Some patients want stronger treatments with a smaller overall number of treatments. This requires more expertise than the lighter treatments, both during the procedure itself and in guiding patients afterward. When stronger treatments are necessary, Dr. Rosenbach has considerable experience and expertise in designing and implementing such treatments.
Dating back to his laser fellowship before starting his private practice, Dr. Rosenbach has been at the forefront of laser resurfacing. He was one of the first doctors in the US to have access to a computer-generated handpiece, which places patterns of laser beams on the skin. He was also one of the first to employ cold air during more intense treatments. He continues to lecture about this procedure to this day.
At a Glance
Dr. Alan Rosenbach
- Board-certified and fellowship-trained dermatologist
- Clinical associate professor at the Keck School of Medicine of USC
- Reseacher, published author, lecturer
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