20 years old with wrinkles a wrinkle in time

Year after year, Germans spend many millions of euros to eliminate the signs of aging. They cream and peel, have injections made, treat themselves with lasers or even have them lifted by a plastic surgeon to look young for longer.

But the widely advertised anti-aging creams already show that there is no such thing as a miracle cure for wrinkles. Most substances that are supposed to smooth the face do not penetrate into the deep layers of the skin where the wrinkles appear. They only reach the epidermis, some even the underlying dermis. After all, you can sometimes make your face look smoother and firmer.

Many creams promise more than the last.
Hyaluronic acid does this by forming an air-permeable layer on the skin that binds moisture. This causes the skin to swell slightly and appear smooth. Collagen also coats the surface of the skin with a film that can temporarily tighten small wrinkles when dry. Collagen also makes the skin appear smoother.

According to experts, skin care products can at best delay the aging of the skin – but hardly eliminate existing wrinkles. And skin care alone cannot prevent wrinkles either. Above all, a healthy lifestyle is important. This includes a vitamin-rich diet and sufficient sleep, little alcohol and stress – and by no means excessive sunbathing and cigarettes.

The real reason for skin aging has long been misjudged: Today, researchers assume that up to 80 percent of the signs of aging on the face are caused by sunlight. Its UV-B rays are mainly responsible for sunburn; the UV-A rays of light penetrate to the connective tissue and damage the cells that produce collagen. This substance gives the skin firmness.

Through UV-A rays, the body increasingly breaks down collagen. The elastic fibres atrophy and clump quickly, the skin loses its elasticity. Deep furrows develop. Of all the ingredients that manufacturers mix in care creams, UV protection is therefore the most effective way to prevent wrinkles.

For many additives of care creams, scientific proof is still missing that they actually help against wrinkles. However, some substances have been well studied, and researchers have shown that they really make the skin look firmer. Some of the most important ingredients are:

Vitamin A
Vitamin A – also called retinol – smoothes wrinkles and makes the skin more elastic. Retinol stimulates collagen formation and inhibits collagen degradation. This makes the skin thicker. Make sure that day creams with vitamin A also contain a UV filter. Otherwise, UV rays will block the effect of vitamin A.
Among the most important antioxidants are vitamins C and E and coenzyme Q10. They can render aggressive oxygen particles, so-called free radicals, harmless and prevent these particles from causing cells and tissue to age more rapidly. Free radicals are produced in the body during metabolism, but also by sun and smoking, for example. Vitamin C also ensures that collagen and elastin function properly in the skin and makes the cells in the epidermis grow faster. Vitamin E inhibits the breakdown of collagen and helps the skin to bind moisture. It can penetrate deep into the skin and smooth out small wrinkles. Coenzyme Q10 supports the metabolism of the cells.
Omega-6 fatty acids
These fatty acids help the skin to build up a protective barrier. They protect the skin from drying out and keep it elastic.
There are many different substances that specialized dermatologists use to inject wrinkles. As a general rule, the injection site can redden and swell after each injection. Sometimes a bruise can also occur. And some substances can trigger allergies. The most common active ingredients are:

No other smoothing agent is as well known as botulinum toxin, or Botox for short. The poison of the bacterium Clostridium botulinum has been used in medicine for more than 20 years to combat strabismus or eyelid cramps, for example. As wrinkle killers, doctors inject botulinum toxin into the muscles of the face to calm them. The muscles can then no longer contract. This smoothes wrinkles. Often the steep wrinkles above the nose and the smile lines in the corners of the eyes are softened. The full effect occurs after two to twelve days and lasts for three and a half to seven months. In Germany, botulinum toxin is approved for certain diseases of the nervous system and for treating the glabellar fold between the eyebrows. In the case of other wrinkles, a doctor may only inject Botox if he informs you of this fact. Side effects are rare. The injection site can be changed after the injection.


This protein is found in humans and animals. For cosmetic treatments, it is obtained from bovine collagen. It is well suited for superficial wrinkles. Allergies are common, so it is better to have it tested beforehand to see if you can tolerate it. The effect lasts three and a half to seven months.
Polylactic acid
Polylactic acid is a synthetically produced endogenous substance. Doctors often use it to reduce wrinkles at the corner of the mouth and nasolabial folds running from the wing of the nose to the mouth. It is also used to pad the cheeks. Allergies are not known. Polylactic acid should be injected twice at intervals of one to two months – and then smooths for about twelve months.
Own fat
Treatment with your own fat is a complex procedure because a doctor must first suck fat from you. This operation is performed under local anaesthesia. Allergic reactions to autologous fat are not known. It is often used against rings under the eyes and a sunken forehead. The effect of autologous fat lasts three and a half to seven months.
Doctors warn against permanent wrinkle fillers
Some substances injected against wrinkles cannot be broken down by the body. These include silicone, acrylates and polyurethane. Once injected, they remain in the skin forever. Since these so-called permanent implants can slip, trigger allergies or form knots, the Gesellschaft für Ästhetische Chirurgie Deutschland (GÄCD) advises against these wrinkle fillers. And another reason speaks against permanent filler material: the subcutis loses fatty tissue over the years. This makes the face look different. Permanent wrinkle fillers, however, do not adapt to the changed facial features. That’s why after some time they can attract attention and protrude from the face.

Laser and chemical peelings
In so-called laser skin resurfacing, a wrinkle treatment with a laser, the energy beam evaporates the upper skin layers. This tightens the skin because it stimulates the cells to form new collagen. In addition, the skin can bind more water. Deep wrinkles become smoother, small wrinkles even disappear completely.

Laser treatment is a serious procedure: you will be locally anaesthetised or given a general anaesthetic. In addition, the treatment wounds your skin and makes it very susceptible to inflammation. In order to prevent germs from penetrating and scars from forming, the skin must be cared for very carefully and initially checked regularly by a doctor. After laser skin resurfacing, the skin needs two to three weeks to heal. After that it is reddened for another six to twelve weeks so that doctors recommend applying a covering make-up and avoiding the sun. If you have allergic skin diseases, pigmentation disorders, neurodermatitis or even very sensitive skin, get detailed advice as to whether this method is really suitable for you.

Chemical peelings hurt
A chemical peeling burns the upper layers of the skin. The body repels them and recreates fresh, smooth skin layers. This procedure takes about 28 days. With a chemical peeling, the dermatologist usually wants to remove superficial pigment spots, severe cornifications such as acne, sun damage or scars. But wrinkles can also be removed with it.

Doctors mainly use acids for peeling – such as fruit acid, salicylic acid, vitamin A acid or trichloroacetic acid. If you have a peeling with low doses of fruit acid, the doctor does not necessarily have to anaesthetise you. Otherwise, a local anaesthetic is sufficient to treat individual skin areas. For a chemical peeling of the whole face, the doctor will put you into twilight sleep or general anesthesia so that you can bear the pain.


In the first days after the treatment the face hurts, the skin tightens. There is a risk of germs getting into the wound and causing an infection. During a deep peeling, doctors recommend a hospital stay of two to three days. But only after more than a week does the scab detach from the wound and a pale pink new layer of skin appears. You then treat them with a wound or healing ointment. After a week at the earliest, the skin has healed to such an extent that you can go public again. The skin remains reddened for a few weeks. However, make-up is only allowed after three weeks. And you must not expose yourself to strong UV radiation for at least three months. This is because one of the most common complications is brown spots that occur when you go into the sun or a solarium too early after the exfoliation.

Caution: Fine injuries and inflammations can lead to the fact that a peeling burns deeper skin layers than intended. This causes scars.

Over the years, the skin loses elasticity and its lower fat tissue becomes thinner. As a result, parts of the face and neck can sag and we look old. During the so-called facelift, a cosmetic surgeon lifts these areas again and simultaneously tightens the skin. In the past, lifted faces often had something mask-like solidified about them, because too much tightening took away their mobility. Today, a completely wrinkle-free face is no longer the goal of the procedure. Rather, it is a matter of preserving their natural appearance. And such an operation can actually rejuvenate a face by eight to twelve years.

To make the result look natural, the surgeon does not just tighten the skin. He also intervenes in the deeper structures of the face and corrects muscles, fat and connective tissue. To achieve an even result, the surgeon often combines a face and neck lift with a forehead lift. He lifts sunken eyebrows and weakens very active muscles in the forehead and eyes. It also pushes up sagging cheek fat and tightens the muscles that lift the corners of the mouth and upper lip. And it can also tighten the flat neck muscle to strengthen a sagging neck. Once the deeper structures have been brought into shape, the doctor spreads the skin over them again and sutures them.

Of course, you will always be anaesthetised for a facelift – depending on the size of the operation, a twilight anaesthetic or a general anaesthetic. The operation takes between two and five hours. It can be performed in a clinic or doctor’s office.

After the operation you will wear a head bandage. During the first few days, your face is swollen and tight. Five to ten days after the operation, the doctor pulls the stitches. After one to two weeks, swelling, bruising, spots and numbness will subside. These symptoms should disappear three weeks after the facelift.

The most important thing now is to spare yourself! Avoid alcohol, nicotine and blood-thinning drugs such as acetylsalicylic acid. Do not exert yourself physically – do not exercise again until after two to three weeks. And don’t go into the blazing sun for the first three months.

These side effects have it in themselves!
The greatest risks of a facelift include paralyzed muscles and permanent numb spots on the face. Such complications can occur when an inexperienced surgeon injures larger nerves when lifting the connective tissue from the muscles. After a facelift, the facial expression can be severely restricted and the face can lose its individual character. Another danger is that the scars on the scalp will no longer grow hairs. And a facelift is an operation with all the risks of such a major medical procedure: you can get bruises, the wound can become inflamed and bleed again.

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