Facial lines occur because of repetitive muscle activity and skin changes as we age. These are commonly in the forehead (vertical or transverse), at the lateral orbit ( crow's feet ) and around the lower face and lips. There are several options. These include soft tissue fillers and fat injections, permanent implants and Botox injections. There are many new and exciting products coming to the USA from Europe and elsewhere. These are primarily soft tissue fillers (such as Restylane, Radiesse, Artefill, etc.) designed to fill those facial lines. In general, these products last longer than previous options, such as collagen. They may be administered in the office with local or topical anesthetic with little or no downtime. The optimal treatment is individualized to the patient. Some patients elect to undergo these injections in conjunction with a facelift.

Artefill is thought to last 5 years, according to the manufacturer, and may be permanent. It requires an easily administered skin test in the office one month prior to placement to rule out any adverse reaction to the collagen contained within the product.