Concern · Lines & wrinkles
Are all wrinkles treated the same way?
What you may be noticing
Lines that appear when you smile, frown or raise your brows. Lines that are visible even when your face is still. Both get called "wrinkles," but they don't necessarily come from the same place, and they don't necessarily call for the same treatment.
One concern, several possible origins
A line at rest can have a different origin from one created by expression.
Lines develop through repeated muscle movement, changes in skin quality, loss of facial support, photodamage and structural aging. A dynamic line — one created mainly by movement — and a static line — one visible at rest — are different findings.
What Dr. Lancho assesses
- Dynamic versus static appearance
- Skin quality
- Depth and location
- Facial movement
- Volume/support
- Proportion and surrounding anatomy
- Previous injectable or energy treatment
Clinical reasoning
Which is actually creating this line?
Movement
Lines created mainly by repeated muscle activity — often the first thing to soften, and the first thing to reappear if movement alone is what's driving them.
Surface
Skin quality and photodamage change how a line reads even when movement isn't the main driver — a different treatment logic from movement-related lines.
Structure
Loss of support or volume changes the surrounding anatomy that a line sits within — treating the line itself won't address a structural change underneath it.
Treatment approaches
Not every line needs to be erased.
Depending on which of movement, surface or structure the assessment finds is contributing, an approach may draw on neuromodulation for movement-related lines, or firming and lifting treatment where skin quality or support genuinely plays a role. Expression is part of facial identity — the goal is a considered change, not the removal of all visible movement.
When combination treatment makes sense
Movement, surface quality and structural support can all contribute to the same line at once. Where more than one genuinely does, Dr. Lancho may consider a staged approach, with each treatment given a defined role rather than one product asked to address every origin.
What treatment can — and cannot — change
Results depend on which origin is actually present, the treatment selected and individual biology. Movement-related treatment softens lines created by expression; it does not address lines whose primary origin is skin quality or structural support, and the reverse is also true.
Related treatments
Neuromodulation for movement-related lines — Considered when repeated muscle activity is the primary driver — a controlled change, not the removal of all expression.
Botulinum Toxin
Where firmness or skin laxity contributes, ultrasound- or radiofrequency-based treatment may also be considered, and resurfacing or remodeling treatment where the surface component is significant.
Before your consultation
Bring the line, not the assumption about what caused it.
You don't need to arrive knowing whether the answer is movement, skin quality or support. That's what the assessment is for.