In the course of life, due to various factors, wrinkles on the face and body begin to appear. As different as the causes of wrinkles are, so are the treatments. Depending on the cause of the wrinkle, a dermatologist experienced in aesthetics, like Dr. Hero Schnitzler in Zürich Enge, can provide the perfect treatment for natural, beautiful results that do not look obvious or overdone.


1. What are Wrinkles?

Wrinkles can be described as raised excess skin. They can occur from the most differing causes.

Wrinkles appear as skin ages:

Aging skin is a natural biological process, which is characteristic to changes in human skin.

With this, the forms of aging are also differentiated:

  • Chronological aging describes the process of time passed.
  • Intrinsic aging describes the disposition of the reduction of specific regeneration factors of the skin.
  • Extrinsic aging describes the environmental factors such as UV-rays which influence the aging process of the skin.

Signs of skin aging begin between 20 and 30 years of age. Small lines start to appear and then later wrinkles, loss of elasticity and firmness and the breakdown of fat-pads beneath the skin.

2. What are the different kinds of wrinkles and how to they develop?

2.1. Mimic Lines

Mimic lines develop from the extra skin above underlying facial expression muscles which are excessively used.

These are most common in the upper third of the face and include for example, frown lines, laugh lines, crow’s feet and fine horizontal lines on the forehead.

The first choice for smoothing these wrinkles is neuromodulators.

2.2. Static Wrinkles

Static wrinkles develop as the skin loses its elasticity (elastin). This is particularly due to the loss of hyaluronic acid in the skin.

The skin becomes droopy or saggy in the lower third of the face and for example, marionette lines and nasolabial folds appear.

These winkles respond very well to hyaluronic acid fillers.

2.3. Fine Lines and Creases

Fine lines and creases appear on the skin’s surface due to loss of substances in the epidermis.

They are most noticeable as fine vertical lines on the upper lip, often referred to as lipstick lines. However, these small lines and creases can also develop on the cheeks (laugh lines) as well as the neck and décolleté.

Smoothing these wrinkles with a laser is the best choice of treatment. However, these fine lines and creases can also be treated with low viscosity hyaluronic acid injections.

Every wrinkle is different and needs its own suitable therapy!
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2.4. Sagging Folds

Sagging folds are for example:

Double chin: the accumulation of extra fat in the facial fat pad under the chin creates the extra fold. This can be treated with the Anti-Fat Injection.

Sagging jowls and lax jawline are caused by decreased elasticity in deep connective tissue and can be treated with facial threads (Thread Lift).

Loss of youthful fullness in the fat pads of the cheeks can be restored with hyaluronic acid filler injections.

Droopy eyelids are the result of skin laxity and mostly due to years of excessive use or movement.Plasmage Therapy is a non-invasive option to tighten and lift droopy eyelids.

Sagging folds, stubborn excess fat and cellulite that also develop with aging in other areas of the body can also be consulted.

3. How are wrinkles treated?

3.1. Neuromodulators

Mimic lines such as frown lines between the eyebrows, vertical lines on the forehead and fine lines around the eyes (crow’s feet) are best treated with neuromodulators. Excessive, repetitive activity of the underlying muscles causes these wrinkles. Neuromodulators reduce muscle contractions and the wrinkles in the overlying skin fade away.

Dermatologist Dr. Schnitzler takes the utter most care to achieve natural, subtle results after treatment without the “frozen” look.

Treatment results can last up to one year.

Neuromodulators have been used worldwide, in Switzerland and in Zurich for decades in aesthetic medicine without side effects.

How to remove forehead wrinkles crowfucking smile lines - Dr. Schnitzler - Zurich-Enge
Neurotoxin frown lines wrinkle treatment

Injection of a neuromodulator in a wrinkle inducing muscle

3.2. Wrinkle Treatment with Hyaluronic Acid Filler

Static wrinkles are injected with hyaluronic acid, a filler identical to the body’s own connective tissue building blocks. Hyaluronic acid filler injections are optimal for filling deep wrinkles and rebuilding lost connective tissue in the face and lip areas. Hyaluronic acid fillers are matched to the skin- and wrinkle type and applied under the skin with ultra-fine needles or blunt tip cannulas.

The effects of hyaluronic acid filler are instantly visible.

Here at the derma competence center in Zurich Enge, we use long established, high quality hyaluronic products. Their effects last from several months up to years. Just after a treatment, slight redness or mild swelling may occur but is very temporary.

Wrinkle Treatment Hyaluronic Acid Filler Dermatologist Dr Schnitzler Zurich Enge
Wrinkle Treatment Hyaluron Hyaluronic Filler

Injection of the nasolabial fold with hyaluronic acid filler.

3.3. Wrinkle treatment with Facial Threads

Sagging areas of skin, elastosis in sagging jowls and deep nasolabial folds can be treated with the use of resorbable, dissolving threads. At the derma competence center in Zurich, Enge, we use German branded products. Under sterile conditions, the threads are inserted under the skin and secured with a gentle tug.

The regeneration of connective tissue after insertion of the thread supports the long-lasting result.

The lifting effect from the Thread Lift is immediate. The body’s natural healing process reacts to the inserted thread which leads to a strengthening of the connective tissue. The smoothing, lifting effect lasts up to several years. The thread lift is practically pain free though sometimes slight bruising may occur.

Thread lifting threads neck lift double chin treatment
Put thread nice chin line define thread lifting

Insertion of re-absorbing threads to lift and contour the jawline.

3.4. Anti-Wrinkle Laser

With wrinkle treatment by laser, the fractional laser therapy, tiny micro-thermal channels are beamed into the deeper layers of the epidermis by means of a highly precise erbium: glass laser (at the derma competence center in Zurich Enge, manufactured by Selas).

Lasers are especially effective in treating fine lines and wrinkles!

The protective top layer of skin is not damaged. The healthy underlying skin around the micro-channels is not affected. Fresh, new connective tissue is quickly restored, and collagen production increased. The total appearance of the skin is improved; the skin is tighter, the texture is smoother – fewer fine lines, fewer upper lip wrinkles, pores are refined and smaller, and pigmentation is more balanced. Wrinkles under the eyes also respond well to laser treatment.

Wrinkle treatment with laser, fractional laser, is done several times at monthly intervals and is relatively painless. There may be slight redness and mild swelling after treatment but is normally very temporary.

0:05 – Avoid UV rays
0:49 – Have done in cloudier, cooler seasons
1:27 – Come to the appointment without make-up
2:02 – Skin care after treatment
2:29 – Be mindful of medications taken before treatment
3:03 – Lasers can be used on all skin types
3:30 – During pregnancy

Fractional laser and laser therapy for smoothing wrinkles and pore refining around the chin.

3.5 Platelet Rich Plasma (PRP); Vampir-Lift

Rejuvenation of the skin with a vampire-lift – treatment using the body’s own thrombocyte-rich plasma (Platelet Rich Plasma, PRP).

Vampire-Lift, the cell renewal therapy against wrinkles!

Platelet rich plasma (PRP) is obtained from the patient’s blood by special centrifugation. The PRP is then injected into the skin using ultra-thin needles or with Transdermal Application (TDA). In contrast to anti-wrinkle creams, the PRP penetrates deep into the skin and induces a regeneration effect. The growth factors in the PRP trigger stem cells and leads to an increased stimulation and production of collagen and elastin. Several sessions are necessary for maximum results. With injected PRP, minor bruising or redness may occur. After the regeneration phase, the skin renewal, the final desired result is visible.

PRP is very suitable to treat wrinkles under the eyes and on the neck.

EPRP is also a successful therapy to treat hair loss.

Information on Platelet Rich Plasma, Vampire-Lift, Cell Renewal Treatment

*TDA: Transdermal Application is the infiltration of active substances into the skin. In contrast to the HydraFacial®, TDA does not use water so there is no “plumping” effect as with the HydraFacial®.


The patient’s blood is taken to retrieve the thrombocyte rich plasma (Platelet Rich Plasma, PRP)

Special ampoules and centrifuge system to obtain PRP from the patient’s blood.

Reinjection of the thrombocyte rich plasma to smooth wrinkles and skin regeneration.

3.6. Radio Frequency Therapy for Smoothing Wrinkles

Treatment with a combination of magnetic pulse and multi-polar radiofrequency creates a homogeneous heat matrix (heating of the skin’s deeper layers). This leads to strengthening and building of new collagen, connective tissue cells are stimulated, and fat cells broken down.

Radiofrequency Therapy induces a thorough skin tightening. This method is especially recommended for treating wrinkles on the face, neck and décolleté. The result is a reduction in wrinkles and improved texture and contour of for example, the jawline.

Even sagging skin on the upper arms, stomach, legs and butt can be tightened with this treatment. Circumference and appearance of cellulite is also improved.

Several sessions for this painless and relaxing therapy are recommended for best results.

0:03 – What is Radiofrequency Therapy?
0:39 – What is the Radiofrequency Therapy procedure?
0:58 – Which areas can be treated with Radiofrequency Therapy?
1:18 – Who are candidates for this treatment?
1:29 – How long does the treatment take and how often does it need to be repeated
2:11 – What risk and side-effects are there with radiofrequency Therapy?
2:39 – What should be observed after treatment?
2:57 – How long do the results last?

Radiofrequency Therapy Appliance, facial treatment for skin firming as well as body contouring and cellulite treatment.

3.7. Fat pad treatment with the Anti-Fat Injection

With the Anti-Fat injection (Lipolysis) stubborn unwanted fat pads, along with fat pad induced wrinkles for example, double chin, flabby cheeks, love handles, and belly fat are permanently eliminated.

Lasting effects are achieved with this gentle, almost pain-free therapy. Depending on the location and thickness of the fat pad, it usually takes several treatments at about 4-week intervals to achieve the best results.

Lipolysis Injections, the injection to eliminate unwanted fat pads!

At the derma competence center of Dr. Schnitzler in Zürich, lipolysis injections based on a natural soybean extract are used. The active substance destroys the fat and the fat cells are eliminated naturally by the body.

The long-lasting results from this method can already be seen two months after the last treatment.

Fettwegspritze double chin treatment Dr Schnitzler dermatologist Zurich Enge
Double chin lipolysis treatment fat pads
Fat pad removal syringe dissolve belly fat dermatologist Dr Schnitzler Zurich Enge

Injection Lipolysis (Anti-Fat Injection) to treat a double chin and unwanted fat pads on for example, the belly.

3.8. Carboxytherapy for Smoother Skin

Carboxytherapy is the injection of medical-grade (CO2) carbon dioxide into the area to be improved. Carboxytherapy is especially effective in treating wrinkles under the eyes, cheeks and neck as well as, dark circles under eyes and stretch marks.

Injection of the medical-grade CO2 gas increases circulation and collagen production. The increased circulation leads to elimination of retained water, breaks up fat cells and reduces cellulite.

Carboxytherapy, medical CO2 gas for treatment of wrinkles, dark circles under the eyes and cellulite!

Carboxytherapy can be repeated multiple times until the desired result is achieved. Each application is usually scheduled at two to four -week intervals. There is no down-time, and patients find this therapy to be only mildly uncomfortable with minimal pain.

Treatment dark circles eye bags - carboxytherapy Co2
Carboxy device Co2 against fat skin dents Tired eyes

Carboxytherapy for smoothing wrinkles under the eyes, treatment of dark circles and long-lasting improvement of cellulite and stretchmarks.

3.9. Plasmage for sagging eyelids

With Plasmage, the therapy using plasma (material in the 5th state of aggregation) tiny points of plasma are applied to the skin’s surface. This leads to a direct retraction of the outer skin in the areas where the plasma is applied. The sum of all plasma points results in an immediate tightening of the skin. The triggered reaction leads to an ongoing tightening process which after about three months is complete.

Droopy eyelids successfully treated without an operation!

The results are long-lasting and there in only minimal downtime. Plasmage therapy is especially effective in treating droopy eyelids and lid lifting.

Plasmage appliance for generating plasma and treatment of droopy eyelids, application of plasma points to tighten and lift upper eyelids.

3.10. High-intensity focused ultrasound (Hifu)

Treatment with the high-intensity focused ultrasound (Hifu) is an alternative to the classical face and neck lift, as well as skin tightening of the décolleté and body. Facial recontouring (e.g., the jawline) can be achieved and droopy eyelids, sagging brows and baggy eyes can be improved.

Alternative to Facelift

Hifu treatment generates points of heat in the deep layers of the skin and the SMAS (superficial musculoaponeurotic system), the fibrous network that connects the facial muscles with the skin). This leads to targeted shrinking of the tissue and at the same time, stimulates the production of new collagen. The results are more natural and in most cases, more suited to the patient’s age. The cost is significantly lower than the cost of an operation.

3.11. Monopolar Radiofrequency Needling

The method of radiofrequency needling is a highly effective approach that combines the benefits of radiofrequency and microneedling treatments, significantly enhancing effectiveness.

During the treatment, isolated needles are gently and precisely inserted into the skin, reaching the deep layers of the epidermis. Radiofrequency waves are delivered directly to the surrounding skin, resulting in heat generation while reducing the size of sebaceous glands.

After 2-4 sessions, the result is noticeably tighter skin with reduced fine lines on the face, neck and décolleté. Sebaceous glands and larger pores are minimized, giving the skin a radiant, younger and fresher appearance. Moreover, both adolescent and adult acne can be significantly improved with this therapy.

While the therapy is not entirely painless, it is very well tolerated after the application of a numbing cream prior to the actual treatment.

There is no downtime for the patient, although some irritation of the treated skin areas may be visible for about 1 day.

4. Where to the different therapies have an effect on wrinkles and aging skin?

Skin layers and their treatment options

5. Overview of facts on the types of wrinkles and the corresponding treatment.

Autor - Dr. med. Hero P. D. Schnitzler

I am Dr. Hero P. D. Schnitzler and founded the derma competence center in Zurich Enge in 2015, which I have been managing with heart, soul and professional competence ever since.

I am a member of various Swiss and international professional societies and a long-time lecturer for aesthetic laser medicine (D.A.L.M.) at the University of Greifswald, and for the Swiss skills program FMCH laser treatments of the skin.