Dermal Tunneling in the Treatment of Static Wrinkles and Grooves

Wrinkles become more evident when the individual has thick or oily skin, which leads this lesion to a scar condition, difficult to be reversed. The deeper and older the wrinkles, the more frustrating attempts at correction become, resulting in a therapeutic challenge. Dermal fillers, such as hyaluronic acid, offer good results in association with botulinum toxin in cases where the skin is thinner or when fibrotic beams have not yet been installed. In these cases, there is a prior need to release the bottom of these wrinkles attached to the fibrotic beams, so that the last proposed association can achieve its objectives. According to the authors’ experience, when this release is neglected, the incarceration of the filler will be observed, interspersed with the fibrosis mentioned, consequently leading to, undesirable cosmetic results. Described by Orentreich and Orentreich (1995), Subcision™ is based on the rupture of fibrotic beams and the triggering of an inflammatory response, with bleeding, which culminates in neocollagenesis. As was done for scars, we propose to perform dermal tunneling (DT) for the correction of static wrinkles. The treatment is based on the release of the wrinkle bottom and its consequent filling by blood, which results in fibrin deposit and production of a new collagen, making the wrinkle shallower and offering cosmetic improved smooth skin surface.