Progression of Aging

The aging process is inevitable. We all grow older and hopefully wiser.
With aging the facial topography is affected due to loss of bones, fat pads, and muscles that lead to folds and shadows in the face.

The skin envelop also becomes thin due to decreased collagen & elastin. It is covered with brown spots/wrinkles due to sun damage/aging and is sunken in appearance due to volume loss from all the above structures.

Note changes such as:

  • Loss of skin plumpness
  • Bags or hollow under eyes
  • Drooping eyelids
  • Nasal labial folds
  • Sunken cheeks/temples
  • Thinning lips & downturn corner of mouth
  • Loss of jaw line definition

Crepey skin of neck & body

The Esthetic Plan

The esthetic plan is to use a combination of treatments to even out skin tone, reduce wrinkles and volumize the face. The goal is to bring back the youthful fullness of a younger face without looking distorted, overfilled or alien like. The amount of treatment needed will depend on how much “aging” has occurred in the individual.

Think of the face as a pillow.
The skin is the pillow case which need to be clean and wrinkle free.
It should have enough “filling” in it to look soft and proportional, not too much and not too little. 

Therefore, careful assessment is needed to devise a rejuvenating treatment plan with regular scheduled treatments so the patient will look young and refresh for his or her age group. Basically looking AGELESS.

The Skin Envelop

Clear smooth skin with minimal pigmentation, redness, breakouts, and wrinkles is the foundation of a youthful appearance.

The skin is an organ and the texture/wrinkles can be improved with devices such as CO2/Erbium lasers, RF/Ulthera, derma needling or a combination of them. For pigmentation/redness/acne/large pores we use peels, IPL, laser genesis and carbon peel.

The use of quality cosmeceuticals or skin care products, daily sun protection & regular skin treatments such as facials/peels are also important to maintain the results of more invasive procedures.

A sun damaged complexion is also an aging look that will distract from other rejuvenating treatments such as fillers & neuromodulators.

Advances skin care treatments now incorporate regenerative products such as Platelet Rich Plasma (PRPs) and Growth Factors from Exosomes to help with skin healing and rejuvenation especially after more ablative treatments.

Neuromodulators

Prevention is the key and neuromodulators such as Botox and Dysport are great in preventing movement wrinkles from becoming etched in wrinkles.

It is best used for the upper face however lower face treatment can also benefit from neuromodulators

A new technique called MICROBOTOX is becoming popular to address difficult to treat areas such as forehead and cheek wrinkles.

Unfortunately, etched in wrinkles or furrows will need a combination of toxins, fillers, and/or lasers because neuromodulators can only prevent lines from getting deeper, but cannot erase lines that are already there without movement.

Dermal Fillers 

Fillers are the core of facial volumization and they include Hyaluronic Acid (HAs) such as Juvederm & Restylane while collagen stimulators include Radiesse and Sculptra.

HAs are often use in the cheeks, lips and under eye areas while collagen stimulators are best for temples and lateral facial support.

Model had 7 syringes over 2 visits. Visit 1 on 4/19/2019 (2 syringes)  Visit 2 on 11/09/2019 (5 syringes)  17 months post with NO additional fillers. Photos post with permission

Photo taken from Allergan training video

HAs & Radiesse give immediate results while Sculptra builds collagen over time which requires patience as it is a gradual process. Sculptra/Radiesse is now being used in body areas to reduce neck/chest wrinkles, crepey inner arms/stomach skin and Buttock Shaping

HOW much fillers do you need?

We lose an average of 5cc of volume a year after the age of 30. Therefore, we will ALWAYS need volume filling as we are replacing what is lost yearly

The initial amount of filler needed may be higher in the beginning as we need a certain amount to fully correct the loss of volume however the yearly maintenance amount is usually lower.

It is not just HOW MUCH but WHERE fillers are placed to maximize their use and to achieve a NATURAL looking result.

Suspending Devices

In aesthetic medicine the latest products to combat aging is PDO, PLLA or PCL Threads. They are similar to the dissolvable threads used in surgery while Silhouette Instalift is composed Poly L lactic acid cones which is the same component as Sculptra.

They are best used to firm and contour the lower face, jawline, and neck as the use of fillers to reduce skin laxity may widen the lower face which is not a desired effect.

Sample design

Cat eyes thread lift

Mid & lower face

Therefore upper & mid face is often treated with fillers and neuromodulators while threads are preferred in the lower face or neck area.

Non-surgical rejuvenation is most effective in patients with mild to moderate skin laxity or volume loss. Excessive loose skin will require a surgical procedure while a highly depleted face may need augmentation with fat.

BEST results are usually a combination of energy-based procedures, toxins, fillers & threads to provide a synergistic effect with regular skin care and sun protection to MAINTAIN results.

A consultation is recommended so contact us to book your complimentary Personalized Aesthetic Plan TODAY!!