As we mature our skin ages as well. How we age and how our wrinkles appear are the result of genetics, time and cumulative environmental damage, most notably Ultraviolet (UV) radiation from sun exposure. In younger skin, skin color is even, and the skin’s surface is smooth acting as a barrier against water, bacteria and environmental assaults.  Collagen provides the skin’s firmness, and elastin provides skin elasticity and rebound.  Hyaluronic acid, a natural sugar, keeps the skin hydrated.

The anatomy of wrinkles

Intrinsic aging (chronological aging) is a natural process that occurs beginning in 20s. After age 20, we produce about 1% less skin collagen each year. The production of hyaluronic acid also decreases. Elastin production decreases and the skin thins and becomes more fragile, and can no longer bounce back. Fat volume is lost with age increasing skin wrinkling. The result is the skin folds upon itself creating static wrinkles.

Extrinsic aging is due to the sun (photoaging) and environmental damage. Photoaging is excessive exposure to UV light which accelerates the deterioration of collagen and elastin, increasing static wrinkles, and producing freckles, age spots, sun spots and uneven skin tone.

Repetitive muscle contractions that create facial expression pull the skin over years resulting in dynamic wrinkles, those deep forehead creases, crow’s feet and smile lines, called nasolabial folds that run from the corners of the nose to the corners of the mouth.


Neurotoxins reduce the formation and deepening of dynamic wrinkles. Botox® Cosmetic belongs to a family of medications known as neuromodulators. Other popular drugs in this class include Jeuveau®, Dysport® and Xeomin®. They are commonly used on frown lines, the 11s between the eyebrows, forehead wrinkles, and wrinkles around the eyes (crow’s feet). They work by temporarily paralyzing the muscle movements that cause dynamic wrinkles.  The result is relaxed and softened wrinkles and lines. In the hands of an expert like Dr. Farhang, neurotoxin injections can produce amazing aesthetic improvements beyond the smoothing of dynamic wrinkles.

Dermal Fillers

Injectable fillers offer the opportunity to add back lost volume, correct surface irregularities, smooth wrinkles and restore more youthful contours. They work by literally filling in the wrinkles from underneath the skin. They have a temporary effect because the materials they are made from are absorbed by the body over time. To retain the effects, maintenance treatments are needed.

Many fillers also contain lidocaine (a numbing agent) to decrease discomfort during injection. Combinations of the different types of fillers can provide subtle yet noticeable changes in your appearance. Results are almost immediate with minimal risk and no down time.

The results of dermal fillers are technique dependent which is why an expert injector like Dr. Sheila Farhang can deliver the most personalized beautifying results. She will evaluate your skin and customize treatment to your needs and desired effect. Fillers can last anywhere between 3 months and one year or more depending on the depth of the lines and creases, the type of filler used, and where on your face the filler was used.

Laser skin rejuvenation

Laser skin rejuvenation is the use of various lasers to improve skin tone and texture, tighten skin, reduce wrinkles, age spots and acne scars. The result is renewed skin and new contours for a rejuvenated appearance. The lasers target the superficial layers of the skin. The most cutting-edge resurfacing lasers are fractional. This means the laser creates thousands of tiny wounds in the skin which stimulates the skin to repair itself with new unblemished skin. The treatment also encourages the body to produce new collagen and elastin for firmer, tighter skin.

Laser skin rejuvenation can treat static wrinkles, dynamic wrinkles, skin discolorations and sunspots, freckles and hyperpigmentation. It can also reduce acne scars, visible broken blood vessels and loose skin due to weak structural support from collagen and elastin fibers. Dr. Farhang uses a variety of tools including Forma, a treatment that stimulates collagen and elastin growth.

RF Microneedling

The InMode Morpheus8 is a minimally invasive skin rejuvenation procedure for the face and body. Popular areas include the face, jawline and neck. The device couples microneedling with radiofrequency energy to remodel collagen on the face and body to improve the appearance of aging features. Treatments can tighten the skin, reduce fat, smooth wrinkles and rough, uneven skin texture, acne scarring and hyperpigmentation.

PDO Thread Lift

A PDO Thread lift involves the use of temporary sutures to produce a subtle but noticeable lift suspending loose skin with a stitch. The threads are a foreign body which stimulates production of new collagen to naturally lift and firm the skin.  This procedure provides immediate and advanced facial rejuvenation. The threads are made of biocompatible materials that are reabsorbed by the body, as the new collagen is formed.

Chemical peels

Chemical peels refresh your appearance improving skin clarity, tone, and texture. A peel will remove skin imperfections due to sun damage, acne, aging and the normal buildup of dead skin cells that make your skin look dull, wrinkled, and blotchy. They will also diminish fine lines and wrinkles.

Dr. Sheila Farhang offers full service cosmetic surgery and nonsurgical rejuvenation. All treatments are customized to each patient’s specific needs and goals. People in Tucson (Oro Valley) are fortunate to have an expert in Dr. Farhang who can work her magic to provide you with the most natural looking enhancements, so you look good and feel good.