By Amina Abdul Salam CAIRO, April 2, 2018 - Facial wrinkles usually appear in people at the age of 40 when several changes occur in the human body such as the skin losing its elasticity and vitality and the muscles of the face gradually weakening. The face and hands, also, are the parts of the body on which wrinkles appear most due to their exposure to the sun. According to Dr Gamal Abdel Azeim, Consultant in Plastic Surgery, smoking is one of factors that contributes to the appearance of wrinkles. Recent studies showed that smoking increases facial wrinkles in smokers four and half times more than those of nonsmokers. This is due to chemical substances present in the nicotine of cigarettes that constrict the blood vessels in the skin making them narrow and decreasing the amount of oxygen that enters the skin cells, helping to keep them alive, healthy and vibrant. In addition, exposure to the sun, especially ultra violet (UV) rays, causes significant damage to the DNA cells responsible for cell division and regeneration. Dr Abdel Azeim pointed out that wrinkles appear on the face also as a result of facial expressions, whether through laughter or anger and in the long run they help to form permanent facial lines that never fade. He said that collagen is naturally present in the skin and works mainly to maintain the skin's freshness and cohesion. With age, however, the stock of collagen in the body is reduced gradually and the skin's elasticity disappears, causing wrinkles. In order to get rid of wrinkles in the face, Dr Abdel Azeim said that it is important to inject the areas on which wrinkles appear using collagen material to compensate for the original amount of collagen which has disappeared. This procedure should be done at specialist clinics, under the supervision of a cosmetic surgeon. He added that the injection process doesn't cause pain as it is done using very thin needles. There were, however, some limited side effects of this treatment, represented in redness and swelling of the skin in some cases. This disappears, however, in two days.