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The way our face ages depends on the person. Working in the field of aesthetic and anti-aging medicine, I would like to suggest a protocol of mostly non-invasive or minimally invasive treatments adapted to a particular age, helping with such issues as dehydration, sagging, a thinning dermal layer, wrinkles, loss of fat and muscle, pigmentation marks, rosacea, photo-aging etc. These changes accumulate with age.

Around the age of 30, but sometimes before, the first signs of skin sagging start to appear. The skin becomes slacker, but there is no real change to the facial contours yet. Often the skin feels dry and dehydrated. This is a good time to introduce the following treatments:

– Regular bio-revitalization with amino-acids and/or Hyaluronic Acid – a treatment designed to improve your skin texture while making it hydrated, smoother and firmer: the cells of the subcutaneous connective tissue in our skin are called Fibroblasts. Fibroblasts form collagen and repair fragile and worn out skin, ensuring improvement of skin tone and elasticity. Fibroblasts’ activity reduces over time because of aging and other reasons such as eating habits, diets, smoking, intense physical activity, long exposure to the sun. Therefore, skin gets old, loses tone, elasticity, brightness, volume which results in formation of wrinkles and furrows. Fibroblasts produce collagen by using a nutritional support: amino acids (Glycine, L-Proline, L-Lysine) which are essential to compensate the reduced fibroblasts activity. The better fibroblasts are fed by amino acids, the more vital and plentiful are the cells. Therefore, skin’s quality greatly improves;

– A gentle peel that will smooth the skin and enlarged pores;

– A session of focused ultrasound involving no downtime or side-effects with the results becoming gradually visible over three months and lasting for around two years;

– A few sessions of fractional radio-frequency (RF) which will tighten the skin.

Around the age of 40, the first hint of jowls appears, with the changes in the oval of the face. We notice the following lines and wrinkles:

  • Nasolabial folds – nose to mouth grooves
  • Horizontal forehead lines
  • Peri-buccal lines – these are the lines that some of us call “bar code”. They appear over time and are exacerbated by smoking and sun exposure.

Also, the skin around the eye contour becomes thin and very sensitive. It deteriorates when exposed to UV rays and tobacco toxins and wrinkles around the eyes become more prominent.

First and before any other procedure, the sagging skin should be treated with a session of focused ultrasounds. An alternative option, although more invasive, is the threadlift (insertion of resorbable barbed threads) which gives optimum results after about a month and should last between 12 and 18 months.

Next step is to improve the skin condition and texture, correct lines and wrinkles using hyaluronic acidwhile minimizing forehead lines, crow’s feet and marionette lines with injections of botulinum toxin. Fragile skin around the eye contour must be re-densified. It is highly recommended to avoid carrying out these injections before the ultrasound treatment, because, due to the heat the ultrasounds give off, they may adulterate the injected products.

Regular sessions of bio-revitalization with amino-acids, hyaluronic acid or equine collagen should be kept up.

Around the age of 50, sagging becomes more significant: the face loses its volume, the pores drastically enlarge, and the skin starts to crumple. Consider the following protocol:

– Start by treating the sagging skin using either focused ultrasounds or threads.

– To restore the face’s volume in cheekbones, temples and lips, go for a volumizing dermal filler. Depending on the treatment area, it can be either a Hyaluronic Acid dermal filler or Calcium Hydroxylapatite (CaHA) filler that are usually applied with a cannula for a more natural result or a Poly-L-Lactic Acid filler.

– Fill in the tear troughs (hollow under-eye shadows) with hyaluronic acid that can also re-densify the delicate skin around the eye area saving the botulinum toxin – Botox, Vistabex, Vistabel, Dysport, Azzalure, Xeomin, Bocouture – for forehead lines, crow’s feet and marionette lines.

– Do not forget to renew the skin’s surface by rehydrating the skin with bio-revitalizing mesotherapy: for optimum results stick to a protocol of 3 to 4 sessions, spaced two weeks apart, twice a year.

– Use a TCA or glycolic peel providing you don’t mind taking some downtime post-treatment.

– Do the micro-needling sessions followed by a hydrating hyaluronic acid nappage.

– Book fractional radiofrequency sessions, followed by LEDs – a relatively-new treatment which, in exchange for a bit of temporary redness, completely resurfaces the skin, densifies the dermis and boosts new collagen synthesis.

– Treat fine lines around the lips with superficial injections of hyaluronic acid.

After the age of 50, we may also need to treat:

  • Pigmentation marks using depigmenting peels or pulsed light, coupled with LEDs
  • Rosacea and vascular marks using pulsed light therapy and Yag lasers, either alternately or combined
  • A double chin with 1 or 2 sessions of cryolipolysis or deoxycholate injections

After the age of 60, treatments are carried out case by case, bearing in mind that the surgical alternatives to aesthetic medicine treatments such as face lift, liposuction, blepharoplasty should also be considered at this stage.

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