Dynamic Wrinkles
Dynamic wrinkles are creases created by the repeated contraction of the facial expression (mimetic) muscles that lie just beneath the skin. Each time these muscles contract to smile, frown, raise the brows or squint, the epidermis and dermis are mechanically folded at right angles to the muscle fibers. In young skin, a rich network of collagen and elastin lets the skin spring back smooth as soon as the muscle relaxes.
Over time, however, the loss of collagen, elastin and hyaluronic acid (HA) in the extracellular matrix means the skin can no longer fully recover. Dynamic lines that have been present for years gradually etch into the dermis and become static wrinkles, which remain visible even when the face is completely at rest.
At Haute-Derma, we treat dynamic wrinkles on the principle of "precise anatomy, targeted micro-relaxation, natural expression," using botulinum toxin type A combined with mesotherapy to rebuild the underlying skin.
Facial Expression Muscles and How Dynamic Wrinkles Form
The direction and shape of dynamic wrinkles depend entirely on the position and fiber direction of the underlying expression muscles:
- Forehead (horizontal frontalis lines): Caused by contraction of the frontalis, the only muscle that lifts the eyebrows. Its fibers run vertically, producing parallel horizontal lines across the forehead.
- Between the brows (glabellar frown lines): The corrugator supercilii pulls the brows inward and down while the procerus pulls the central brow down. Together they create vertical "11" lines and horizontal lines across the bridge of the nose.
- Outer eye corners (crow's feet): The lateral part of the orbicularis oculi contracts when you smile or squint against the sun, creating lines that fan out like spokes from the corner of the eye.
- Nose (bunny lines) and around the mouth: The nasalis produces diagonal lines on the upper nose, and the orbicularis oris causes vertical lines around the lips (smoker's lines).
Dynamic vs. Static vs. Volume-Loss Wrinkles
| Dynamic Wrinkles | Static Wrinkles | Volume-Loss Folds (Atrophic / Gravitational) |
|---|---|---|
| Visible only with expression (smiling, raising the brows) | Present all the time, even with muscles at rest | Fixed, deep hollows that sag with gravity |
| Contraction of superficial expression muscles attached to the skin | Long-term breakdown of dermal collagen/elastin | Loss of deep fat pads, facial bone resorption, SMAS laxity |
| Forehead, glabella, eye corners, bridge of nose | Deep forehead lines, eye corners, neck lines, cheeks | Nasolabial folds, marionette lines |
| Botulinum toxin type A (Botox/Dysport) | HA/PDRN mesotherapy + picosecond laser / RF | HA filler / SMAS thread lift / biostimulators |
Anatomical Assessment and Botulinum Toxin Injection at Haute-Derma
- Dynamic facial analysis: The doctor asks you to make a series of maximal expressions (raise the brows hard, frown tightly, smile as widely as possible) to gauge muscle strength, the extent of each muscle and any left-right asymmetry.
- Personalized injection points and doses (micro-dosing standard)
- Glabella: 3–5 points into the belly of the corrugator and procerus (10–20 U Botox).
- Forehead: 4–8 superficial points along the frontalis, staying at least 2 cm above the upper orbital rim to avoid eyelid drooping.
- Crow's feet: 3–4 superficial micro-points outside the orbital rim (8–12 U per side).
- Ultra-fine 34G needles: A dedicated 34G needle reduces stinging, keeps the risk of bruising to a minimum and places the product precisely at the target depth.
Combined Multi-Layer Treatment for Dynamic and Static Wrinkles
When dynamic lines have started to settle into static wrinkles, Haute-Derma uses a multi-layer approach:
- Muscle layer (superficial and deep): Botulinum toxin type A relaxes overactive muscles and temporarily removes the mechanical pull on the skin surface.
- Dermis (cellular structure): Two weeks after Botox, micro-injections of polynucleotide (PDRN) mesotherapy with non-crosslinked HA stimulate fibroblasts to produce collagen and fill in the creases.
- Epidermis (skin surface): Picosecond laser or RF microneedling renews the epidermis and smooths out fine, shallow lines.
