Q: What causes wrinkles and sagging in facial skin, and what can I do to reduce and prevent it?

A: Wrinkles can vary for many reasons. The most common etiology for wrinkles is “too much muscle over too much skin.” By having too much muscle, which could be created by a certain expression or movement – or even sleep positions – that the patient does repeatedly, and over time, the muscle will become hypertrophic and start to form creases in the skin. With the hypertrophic muscle and lack of shortening of skin, a wrinkle is produced. There are many different reasons why the skin gradually stops recoiling or “snapping back.” The most common is normal aging or a normal process of decreasing collagen and elastin, which causes skin laxity. There are also environmental factors that may include sun damage, weight loss, subcutaneous fat atrophy, and smoking. The sun damages the skin via the ultraviolet light, which breaks down collagen. This can vary depending on skin type and exposure amounts. Weight loss and fat atrophy basically decrease the volume intrinsically, but the skin does not recoil. Smoking has been proven to age us with biochemical changes in our body.

— Kenneth Sumida, M.D.
1641 Creekside Drive, Suite 100, Folsom
916-984-4242, nuanceCS.com

Q: I am on a low-fat/low-sugar diet, but I love Mexican food! What should I order from a Mexican cuisine menu?

A: There are a number of things people can order and still enjoy. One thing I personally do is request no cheese or sour cream. This helps a lot! Having a salad before your meal is an effective way to help your digestive system work properly, along with plenty of water with your meal. Instead of having the refried beans, try black beans. Delicious! Be sure to ask your server for any suggestions they can offer to help make your dining experience be the best ever.

— Kathy O’Brien, Manager
Mexquite Regional Mexican Cuisine & Tequila Lounge
916-984-8607, mexquite.com