Facial ageing is a composite, interrelated, 3-dimensional process involving changes to the bone, soft tissue and skin. Changes related to the ageing face include facial skeleton remodelling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. We all vastly differ therefore it is important to remember that one size does not fit all.
At 20 years of age our skin has a thickness of approximately 2mm. By the age of 90 years, the thickness has reduced by 3/4 and 90% of the supportive collagen has been lost. The desire to reverse the ageing process has an irresistible appeal.
At The Body Work Clinic, we initially divide the complete facial ageing process into 4 separate stages. Following a detailed medical consultation, you will be allocated to the appropriate stage which enables us to grade the degree of ageing requiring transformation.
Stage 1
Superficial skin changes:
textural change, discolouration, pigment abnormalities, red blemishes, very fine lines and wrinkles.
Stage 2
Superficial wrinkles:
appearing only during the movement of underlying muscles (dynamic wrinkles).
Stage 2 may also include stage 1 components.
Stage 3
Deeper wrinkles:
present when the underlying muscles are relaxed and caused by the continual folding of the skin (wrinkles at rest).
Stage 3 may also include stage 1+ 2 components.
Stage 4
Laxity and Sagging skin:
caused by loss of deeper fat cushions and bone changes.
Stage 4 may also include stage 1, 2 + 3 components.
Removal of unwanted surface blemishes, smoothing out lines and wrinkles, tightening loose or lax skin and replacing lost volume all create a more youthful appearance. Collagen is a natural protein that keeps the skin firm, toned and looking younger. As we age collagen loses strength and its ability to stand up to the effects of gravity pulling downwards diminish. With advancing years, the skin loses its snap as its elastic recoil reduces. Elastin and Hyaluronic acid, other key proteins in the skin, also deplete as we age.
Superlative results can often be achieved by combining treatment options in a stepwise approach, allowing us to make smaller more incremental changes that gradually build up to eventually create our desired final outcome.
Stage 1: Treatment options for Superficial Skin Changes Explained
Lasers are able to highly effectively treat unwanted vascular conditions such as Rosacea, Facial Thread Veins, Spider Naevi and Cherry Angiomas. PDL 595nm and Nd YAG 1064nm lasers specifically target blood (haemoglobin) in the skin without damaging surrounding tissues. The light energy is absorbed by blood inside the veins, heating up the vessel wall, which collapses and then dissolves.
Unwanted discolouration and pigmented lesions including Solar Lentigos, Freckles, Seborrhoic Warts, Melasma, Beckers Nevus and Cafe au lait spots can also be removed using Laser technologies. Because all pigmented lesions contain the light absorbing pigment melanin, Alex 755nm, Ruby 694nm and KTP 532nm lasers are utilised to selectively target pigment whilst sparing surrounding normal structures.
Superficial or medium depth chemical peels are an ideal option for treatment of unwanted sun damage, uneven skin tone, poor texture, inflammatory acne or blocked pores.
Superficial textural changes including fine lines and wrinkles can often be treated with Fractionated or Fully Ablative skin resurfacing procedures with Er YAG 2940nm or CO2 10,600nm lasers.
Skin-Tox is a combination treatment that involves Micro-needling and Micro-infusion. The treatment delivers a personalised cocktail of hyaluronic acid, vitamins, minerals and anti-oxidants into the skin through numerous mico-channels created by puncture wounds. Collagen and elastin synthesis is stimulated improving skin tone and texture. The skin barrier is nourished, strengthened and dull skin brightened.
Medical grade cosmeceuticals are often used as an adjunct to help freshen the complexion by improving skin tone and texture.
Stage 2: Treatment options for Superficial Wrinkles Explained
Botox® treatment has become an established brand name in its own right. It is one of the most popular and clinically proven anti-ageing treatments.
Forehead / Worry Lines
0 – No lines
1 – Mild lines
2 – Moderate lines
3 – Severe lines
4 – Very severe lines
Glabellar / Frown Lines
0 – No lines
1 – Mild lines
2 – Moderate lines
3 – Severe lines
4 – Very severe lines
Laughter Lines
0 – No wrinkles
1 – Mild wrinkles
2 – Moderate wrinkles
3 – Severe wrinkles
4 – Very severe wrinkles
When skilfully placed within the upper face this neuromodulator can be used to stop the overuse of muscles that cause unwanted creasing of the overlying skin. Deeper muscles are not effected allowing normal levels of facial movement, preventing an unwanted frozen look. Dynamic frown lines, laughter lines and worry lines are softened or erased. Botox® can also treat bunny lines (sides of the nose), lip lines, reduce puckering of the chin, lines in the lower face and neck with a Nefertiti lift, or treatment to the platysmal bands.
Stage 3: Treatment options for Deeper Wrinkles Explained
Dermal fillers can be strategically placed within the lower face to smooth static lines and wrinkles. These soft tissue fillers are placed within the superficial and mid dermis and are more liquid in viscosity. This procedure is ideal for the treatment of naso-labial folds, marionette lines and upper lip bleed lines.
Naso Labial Folds
0 – No folds
1 – Mild folds
2 – Moderate folds
3 – Severe folds
4 – Very severe folds
Marionette Lines
0 – No lines
1 – Mild lines
2 – Moderate lines
3 – Severe lines
4 – Very severe lines
Lipstick Bleed Lines
0 – No wrinkles
1 – Mild wrinkles
2 – Moderate wrinkles
3 – Severe wrinkles
4 – Very severe wrinkles
Deeper wrinkles can also be addressed with fully ablative skin resurfacing utilising Er YAG 2940nm or CO2 10,600nm lasers. The shoulders of deep lines and wrinkles cast unwanted shadowing under angled light, worsening their aesthetic appearance. The skilful use of full ablation will permanently remove the shoulders and by heating the base of the line or wrinkle, collagen production is stimulated, lifting up the sunken base. This procedure is ideal for the treatment of deeper lipstick bleed lines and peri-orbital lines.
Lipstick Bleed Lines
0 – No wrinkles
1 – Mild wrinkles
2 – Moderate wrinkles
3 – Severe wrinkles
4 – Very severe wrinkles
Stage 4: Treatment options for Laxity and Sagging Skin Explained
More viscous dermal fillers injected into the subdermal (subcutaneous) tissue can highly effectively restore lost volume due to loss of deeper fat cushions. These fillers can also be placed under the muscle to lift the skin or injected along the bone, such as jawline and chin, to contour and sculpt the lower face.
Upper Cheek Fullness
0 – Full upper cheek
1 – Mildly sunken upper cheek
2 – Moderately sunken upper cheek
3 – Severely sunken upper cheek
4 – Very severely sunken upper cheek
Ultherapy – Micro-focused ultrasound is the most effective non-surgical lifting technology. By raising the temperature of the SMAS layer (a fibrous mesh that surrounds the muscles – pulled tight by a plastic surgeon during a face lift) to 60-70 degrees C, the skin can be lifted and additionally by thermally heating the dermis, the skin can also be tightened. The result is lifted, firm, tightened brows, lower face, jawline and neck.
Jaw and Jowl Laxity
0 – No sagging
1 – Mild sagging
2 – Moderate sagging
3 – Severe sagging
4 – Very severe sagging
Radiofrequency technology (Exilis Ultra 360) tightens loose and lax skin by delivering RF energy deeply into the dermis and subcutaneous layers, bulk heating the tissues to temperatures of 40-50 degrees C. The result is contraction of existing collagen and stimulation of new collagen formation over time. RF technology tightens the skin with little or no downtime.
Optimal results are often achieved by combining multiple treatment modalities in a synergistic way. These combinations are usually applied sequentially enabling you to control your clinical outcome and budget by observing smaller incremental changes until your desired look is achieved. Unlike cosmetic surgery , these treatments require little or no downtime, increasing convenience and compatibility with our ever increasing busy lifestyles.