How does the face age?

How does the face age?

We all hear about ‘ageing’, but what does it really mean?

Although most of us think of wrinkles as the main culprit of ageing, the reality is far more complex. The entire structure of the face, including skin, subcutaneous fat, muscles and bones change over time.

Before you read on – this post is not meant to shock or shame. The reason it’s important to understand the science behind ageing is because once understood, it allows clinicians to tailor clinical interventions to the root cause.

By using a scientific approach to ageing and combining synergetic modalities, we are getting vastly better outcomes and can achieve natural-looking results non-surgically.

What causes ageing skin?

Collagen

Collagen is the mesh-like component that makes up around 75% of the skin. It gives skin structure and support and holds the landmarks of the face in position. With age, the number of collagen fibres decreases, and the ones that remain become less organised, weakening the tissues. This results in stretching of the skin, pores become larger, wrinkles, and sag.

For women, collagen loss is accelerated in the years around menopause, when up to 30% of collagen is lost. This is compounded by the a tendency of skin to thin out and become more dry in the latter stages of perimenopause, due to reduced oestrogen This is why some women come to us feeling they have “aged overnight”, and why having a collagen inducing treatment in perimenopause is so important.

Clinical interventions that increase collagen include: wearing sunscreen, using retinol, peels, and collagen induction therapies such as dermal needling, Tixel (for skin), and High-Frequency Ultrasound (for skin sagging and laxity). Last on the list are surgical modalities such as a facelift or neck lift. surgery, make sure you see a qualified plastic surgeon, not a cosmetic surgeon, as plastic surgeons are regulated and recognised as specialists (anyone can call themselves a cosmetic surgeon - beware!)

Fat

All faces have fat, and these areas of volume help support the skin and keep us looking healthy, particularly in the midsection (cheek and lower eyelid regions) of the face.

Unfortunately, as we age, or due to other factors such as weight change, medical illness, or medications, these fatty areas reduce in volume which leads to deflation, and sunken, tired-looking eyes.

Don’t ask me why we lose fat on the face and put it on in the middle! There is no justice! Catherine Deneuve famously quipped that “at a certain age, you have to choose between your face and your arse” …and to some degree this is true!

Clinical treatments that improve fat pad loss include judicious use of dermal fillers, fat grafting, and plastic surgery. These procedures should be done AFTER skin tightening (the adage “lift then fill”) to minimise overfilling and bloating the face. Despite what the filler companies may tell you, fillers do not lift… they fill.

Ligaments

Skin is anchored to the facial skeleton via ligaments. As we age, these ligaments slacken and gravity pulls them down, causing the face to descend, forming jowls and an uneven jawline.

Currently, the best non surgical intervention to improve ligament laxity is HIFU (High Frequency Focused Ultrasound). This where the Ultraformer 3 is in its element, and the reason why we love it so much. The Ultraformer 3 has revolutionised the HIFU world with the introduction if the 4.5mm cartridge, that heats and tightens the aponeurosis and ligaments that sit above our above our facial muscles,

Although the gold standard treatment for laxity is a surgical facelift, for most people, this is not attainable due to the cost. However, the Ultraformer 3 is a viable alternative for mild to moderate skin laxity, especially when used early and regularly. Most plastics surgeons have a device like Ultraforrmer, which again is a testament to the validity of the technology, and many surgeons will advocate an annual treatment to maintain surgical results.

Bones

Just like the bones in our hips and back, our facial bones shrink and become more porous with age.On the face, this is most notable around the eye socket, the base of the nose, and the chin. This contributes to the look of “tired eyes”, drops the tip of the nose, and pulls the mouth and chin downward.

There are several interventions to manage these issues such as dermal fillers to disguise volume loss, and neuromodulators (“Botox” or “Dysport”) to reduce overactive muscles in the lower face. Make sure you see someone who knows what they are doing if they are treating the lower face as these are tricky areas.

If you want to talk or learn more about your skin and ageing, please book a consult. Having a consultation with an experienced practitioner is THE most important aspect of any treatment, as it will allow us to formulate a bespoke plan based on your concerns, your clinical issues, and your budget.