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November 2013

When Is “Too Early” Too Early to Start Cosmetic Procedures?

Author Affiliations
  • 1SkinCare Physicians, Chestnut Hill, Massachusetts
JAMA Dermatol. 2013;149(11):1271. doi:10.1001/jamadermatol.2013.5399

“Is it too early?” is often asked when use of an appearance-enhancing procedure is considered, such as neuromodulators, fillers, and light or laser treatments. Our feeling is that there is rarely “too early.”

The etched-in lines on the face that emerge over time are caused by repeated folding of the skin and include lines of facial expression and sleep lines. Repeated contraction of facial expression muscles eventually results in frown lines, horizontal forehead lines, and crow’s feet. The pattern of lines observed with a smiling expression in young adulthood predicts the unique pattern of facial wrinkling that will be seen without expression years later. Similarly, sleep lines are oblique facial lines caused by the recurring position of the head during sleep. They may be lessened or prevented by avoidance of the culprit sleep position or by a pillow that redistributes pressure.

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