Soften Facial Creases and Wrinkles


Many patients come to me interested in improving their skin quality and soften wrinkles and facial creases without surgery. Everyone likes to have beautiful skin! I have a global and individualized approach to improve the skin quality and collagen production by topical treatments, injectables and skin resurfacing.

What types of procedures can be done to soften facial wrinkles?
If there is discoloration and fine lines, I will prescribe some home care products and recommend aesthetic treatments from our medical spa for gradual but consistent skin health. If there are wrinkles and creases due to strong muscle action, we can soften that with botulinum treatment injections. When there are permanent lines and creases, soft tissue atrophy, loss of facial fat pads, we can use a variety of different dermal fillers for volumization and collagen production, fat grafting, chemical peels, lasers. However, sometimes the BEST treatment for natural results without an overfilled and distorted looking face is surgical procedure to tighten the tissues and correct laxity.


An individualized approach to improve the overall skin quality and collagen production is ideal for the treatment of wrinkles and facial creases.
GABRIELE MIOTTO, plastic surgeon in Atlanta.


Is Botox / Dysport / Xeomin the best treatment for wrinkles?
Neurotoxins work by relaxing the muscles of facial expression, softening dynamic facial wrinkles. It does not work alone to improve deep permanent wrinkles, or sun damaged leathery looking skin. The most popular areas for Neurotonix injections are the lines/wrinkles that appear when we make certain facial expressions such as frowning (the “elevens” in the middle of the eyebrows), the forehead lines or the “crow’s feet” on smiling.

I am a good candidate for fillers?
Dermal fillers are wonderful tools for improving deep lines and folds, for contouring the face and for bio-stimulation of collagen in the skin. There are different types of dermal fillers, and the most common and safe products we use are made of hyaluronic acids (Juvederm, Restylane). Other fillers we use hyper diluted for collagen stimulation are fillers made of calcium hydroxylapatite (Radiesse) and Poly-L-lactic acid (Sculptra). Fillers reshape the face and “lift” the tissues, improve facial symmetry and highlight facial contours. They are commonly in the lips, jaw line, dark circles, tear troughs, nose, temples and cheeks. Results usually last for 6-12 months. For collagen bio-stimulation, the results can last for 12-24 months.

How can I improve fine lines and skin health?
You need to have your skin evaluated to define your goals and areas of concern. There are effective, medical grade skin care products that we can recommend to get you started on improving your skin health and glow. There are also low-downtime skin care procedures such as light treatments, chemical peels, lasers, micro-needling, growth factor infusion that we offer at our medical spa to improve skin texture, discoloration and skin aging.

How can I get started to learn more?
If you are interested in improving facial wrinkles and deep creases, but also improve your skin health in general, it would be my pleasure to see you in the office for an in-person consultation. We can talk about what you want to achieve, go over the specific areas you are looking to improve and, I will answer any questions you have. Contact us to schedule your virtual or in-person appointment

Plastic surgery through a woman’s eye

GABRIELE C. MIOTTO MD, MEd, is a Brazilian-American plastic surgeon in Atlanta, specialized in aesthetic surgery and minimally invasive aesthetic procedures of the face. She is known and recognized for her beautiful and natural results. Call or email our office to schedule your appointment!

Preparing for facial injections and procedures to avoid unwanted bruising:

  1. DO NOT take any aspirin for 7-10 days before your scheduled procedure. Please contact the office if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP). Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before injections. You may take Tylenol (Acetaminophen) if needed for aches or pains.
  2. Discontinue Vitamin E 7 days before injections.
  3. Avoid the following herbal supplements for 7 days before your injections: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
  4. Stop Smoking. The harmful effects of smoking cause a lot of wrinkles and skin damage!
  5. Alcohol can promote bleeding, so it is best to avoid alcohol intake for at least a few days before the injections.
  6. Start oral anti-bruising supplements with Arnica Montana / Bromelain the day before or the day of your injections and continue for 3-5 days after the injections. Fresh pineapple is rich in Bromelain, so add it to your diet.
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