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Face Lines, Cheek Lines, and Smile Lines-New Fractional Laser Resurfacing Removal Techniques

Expecting a skin cream to remove face lines from your facial skin is like putting an aspirin on top of your head to cure a headache! (Contact Dr Seckel)


Above before and after CO2 laser resurfacing

Most face line or wrinkle removal creams cannot get into the face line to correct the skin damage that is causing the face line or wrinkle and thus achieve wrinkle removal. There are fabulous modern methods to remove face lines, smile lines and cheek lines available today but they do not come in a jar. Save yourself a lot of money, time and aggravation and read this article and learn what causes lines on your facial skin and how you can effectively remove skin wrinkles from your facial skin and rejuvenate your aging face and re-evaluate the wrinkle cure myth.

A Facial Skin Line or Wrinkle is A Surface Irregularity like a scratch on Your Facial Skin

A face line, smile line or cheek skin wrinkle is a surface irregularity. In an oversimplification (there are also folds around a skin wrinkle) it is an irregular depression in an otherwise smooth surface-like a scratch on a piece of wood. How do you perform wrinkle removal on a scratched piece of wood? One way is to sand the wood surrounding the scratch down to the level of the scratch which makes the surface smooth and wrinkle free again. This is an older method used for face line or skin wrinkle removal called dermabrasion, which is a fancy word for sanding your face, but dermabrasion is not used much anymore because it is a surgical face line or wrinkle removal procedure which requires healing, and dermabrasion for wrinkle removal can leave the skin white, thin and susceptible to injury, and the surrounding skin can be left a different color. Older CO2 laser resurfacing was very effective at removing face lines, cheek lines and smile lines, but long recovery and hypo pigmentation were common problems. Newer high tech fractional laser resurfacing skin peels and deep skin exfoliation techniques can be very effective at “sanding “the wrinkled face for face line, smile line and cheek line removal and removing face lines without damaging the surrounding skin. Most recently new fractional laser skin rejuvenation methods like Fraxel and Lux1540 erbium lasers have produced excellent results. (See Before and After Lux1540 Laser Treatment-Photo courtesy of Palomar and Dr. Dwight Scarborough)


A Face Line or Smile Line is also Caused by Volume Loss in the Dermis, The Deep Layer of The Skin and Loss of Elasticity

Think of a nice juicy plum with no wrinkles or lines, which is placed in the sun to dry. After time the nice juicy plumb becomes a dried wrinkled prune with deep lines. The plum loses its inner volume of water and the tissue volume becomes less and the plumb shrinks, the plum skin falls into wrinkles and becomes a wrinkled prune. To perform wrinkle removal on a prune you would have to restore the inner volume of the plum with water.

Our skin loses volume from the deeper layer, the dermis after years of collagen loss which is caused by the breakdown of collagen from damage by the ultraviolet rays of the sun and aging of the skin. As our deep skin layers loose collagen, the skin collapses onto the new depleted dermis and forms face lines, cheek lines and smile lines and skin wrinkles. Sun damage causes about 80% of the facial aging changes we see in the mirror. Wrinkle removal requires restoration of the volume loss caused by collagen loss in the deeper layer of the skin, the dermis.

In addition to volume loss, some of the damaged collagen in the deep layers of the dermis loses elasticity, so the skin also loosens, stretches and falls into folds which cause additional face lines, cheek lines, smile lines and wrinkles. Restoration of the skin elasticity is a very effective technique for removing face lines, smile lines and cheek lines.

Another potential method for removal of face lines, smile lines and cheek lines and facial wrinkles is to restore new volume to the dermis by adding new collagen. This method is the basis of many therapies designed to stimulate new collagen production to plump the skin for wrinkle removal. There are many examples including lasers, IPL or Photo facial, and other forms of light energy such as infrared and radiofrequency energy, all wrinkle removal methods which will be discussed below.

Modern effective face line removal requires:

1. Correction or removal of the facial line surface irregularity e.g. removal of damaged wrinkled skin surface to smooth the surface and,

2. Plumping the deep skin layers beneath the facial skin line by restoring the volume of collagen in the dermis and

3. Remodeling or tightening of dermal collagen of the facial skin to restore elasticity.


Deep skin exfoliation is the first step in any effective facial skin line removal and facial rejuvenation program. Exfoliation removes dead skin cells and helps reduce skin wrinkles and face lines. Deep skin exfoliation is in a way like sanding the skin. The irritation caused by deep exfoliation also stimulates the dermis to make new collagen which helps with facial line removal by plumping the deeper dermal layer of the skin.

There are many excellent methods for deep skin exfoliation and laser removal of face lines, smile lines and cheek lines available today. Prescription Retinoids like Retin A have this effect in topical cream form. Microdermabrasion, skin peels with Glycolic and salicylic acid and Dermasound are excellent exfoliation methods done by aestheticians and skin care professionals. The most effective deep exfoliation methods are done by newer fractional laser skin resurfacing or rejuvenation techniques such as the Lux2940 Erbium Laser Skin Peel and the Microlaserpeel which provide deep laser skin exfoliation and face line removal, stimulation of new plumping collagen growth in the dermis, and also remodeling or tightening of the skin all in one treatment with minimal down time. These new effective wrinkle removal skin exfoliation techniques are step 1 of my 6-step non-surgical facial rejuvenation program which is the most effective facial line or wrinkle removal and facial rejuvenation program available today. (See Photo Below Before and After Lux2940 Laser Skin Peel)


Plumping the deep facial skin layer by stimulating new collagen production for removal 0f face lines, cheek lines and smile lines and modern facial rejuvenation.

The second essential step for modern facial skin line removal is to restore the deep collagen volume to the skin. This is like re hydrating a wrinkled prune to make it a nice firm juicy plum again. The collagen in the dermis or deep layer of the skin is produced by a cell called the fibroblast when the skin is irritated or inflamed. This is a normal response of the skin to injury. Thus new effective methods for facial line removal gently injure the skin so that the skin will respond by producing fibroblasts which will produce new collagen which will plump the skin and help remove the facial line. This collagen producing skin injury can be caused by irritation by a skin cream like Retin A, repeated deep skin exfoliation techniques, and more commonly today by heating the deeper dermal skin layers with a laser or other form of heat produced by light energy such as IPL-Intense Pulsed Light-also called photo facial, and specially designed non-ablative fractional laser facial line removal lasers like Fraxel and the Lux2940 by Palomar.

New sophisticated fractional non-ablative lasers and IPL have specially designed cooling devices placed on the skin before the laser or other light heating device is turned on so that the collagen stimulating heat gets down into the dermis to heat the tissues and stimulate new collagen production by the fibroblasts to promote wrinkle removal without burning the overlying skin surface. This minimizes down time since a burn would cause the skin to peel and turn red. These newer collagen stimulating facial line removal facial rejuvenation therapies are called non-ablative laser and light therapies because the superficial skin is not injured or peeled-that is the skin is not ablated or removed. These new skin plumping, new collagen forming, non-ablative laser and light facial line removal therapies do work, with no down time and minimal pinkness of the skin, but face line removal using these methods takes time. There are many lasers, like Lux1540, Fraxel, and Affirm, and numerous IPL’s like Starlux by Palomar, Lume One by Lumenis, and Sciton BBL to choose from. There are many others. The wrinkle plumping new collagen production is step 2 of my 6-step non-surgical facial rejuvenation program.

After a treatment it takes 6 weeks for the fibroblasts in the dermis to start making new skin plumping collagen for face line removal and this process goes on for many months. Expect at least 4-6 months to see beneficial visible skin plumping and face line removal from these high tech laser and light therapies, but the good thing is that you are forming new collagen in your skin, which should last if you take care of your skin, eat healthy, and use sun block.

Remodeling or tightening of dermal collagen to restore elasticity, remove face lines, cheek lines and smile lines, and rejuvenate your face.

The most recent new face line removal facial rejuvenation technology is the deep dermal collagen remodeling methods commonly referred to as “skin tightening” or non-ablative skin tightening. Skin tightening involves the same heat injury induced new collagen production used to plump the skin for face line removal, but the elastin collagen fibers which control skin elasticity and tightness reside in the deeper layers of the dermis. Thus new technology has been required to get heat deep into the dermis without damaging or ablating the overlying skin surface while heating the deep layers. This has required the development of very effective skin cooling devices and the employment of new types of skin heating energy, infrared and radiofrequency energy as opposed to laser and IPL Photo facial energy.

Infrared and radiofrequency energy have much different wavelengths and are able to penetrate the skin more deeply than lasers and IPL thus they can heat the much deeper layers of the dermis and injure the deep elastin containing layers to remodel elastin and collagen to plump and tighten the skin for wrinkle removal. These new machines have very powerful skin cooling mechanisms to prevent burn injury to the skin, and treatments produce only minimal redness and down time. Newer skin tightening devices are LuxIR by Palomar, Aluma by Lumenis, Thermage, Titan by Cutera, and Refirme by Syneron. Skin tightening is the 6th and final step of my 6-step non-surgical facial rejuvenation program.


Above Photo -Before and After LuxIR Skin Tightening-(Photo Courtesy of Palomar and Dr. Kenneth Rothaus)


From the above you can see that effective, modern facial skin line removal for facial rejuvenation is a complex scientifically sophisticated process and not something that can be achieved by a cream purchased over the counter or on the internet. Laser skin rejuvenation techniques have improved dramatically in the past few years and new laser skin peels provide effective wrinkle removal with faster recovery and less side effects.

For effective, modern wrinkle removal of face lines, cheek lines, and smile lines and facial rejuvenation you need the advice of an experienced board certified doctor, usually a board certified plastic surgeon or dermatologist to help you remove and prevent facial lines.

You need to be an informed consumer, there is so much misinformation on the topic of face line removal and facial rejuvenation and billions of dollars are spent each year on “wrinkle cures” that simply don’t work. If you have knowledge you have power, so educate yourself on what causes facial lines and what are the proven methods for effective face line removal and facial rejuvenation that are scientifically proven to work. An excellent place to start is by reading my book on facial rejuvenation entitled Save Your Face-The truth About Facial Aging Its Prevention and “Cure”. Also check the archives of my blogs “What’s New” and “Ask Dr Seckel” where you will find non-commercial unbiased discussions of most contemporary wrinkle removal, facial rejuvenation and facial aging topics, or contact me.

Dr Seckel


Boston, Massachusetts

Concord, Massachusetts