Lines and wrinkles form on our face for many reasons as we age.
Repeated use of facial muscles to show expression e.g. smiling and frowning, along with a loss of skin elasticity as we age, leads to creasing of the overlying skin and eventually lines and wrinkles can begin to form. This is often most apparent in the upper half of the face, particularly around, and between the eyes and on the forehead.
Facial ageing is not just about lines and wrinkles however, volume loss and changing facial proportions are fundamental components that are less easy to recognise to the untrained eye. The visible symptoms of this loss of volume are often most noticeable as sagging jowls or lines from nose to mouth or mouth to jaw. A thorough knowledge of the anatomy of ageing and the mechanics of facial structure however shows us that the ultimate cause of these lines and wrinkles is usually a loss of volume and support from higher up in the face, particularly cheeks and jawline.
The most successful anti-ageing treatments require skilled assessment using the science of beauty and ageing and careful consultation by a qualified medical professional to achieve the best results. It is important to think of the result that you would like to achieve and how you would like to feel (e.g. I want to look less angry or more youthful, I want to get rid of the lines around my eyes) rather than a specific treatment (e.g. I need 1ml of filler, or I want 3 areas of Botox.) There are many lines and wrinkles that are directly treatable, often however, a more indirect approach to treating the face as a whole is the key to addressing your anti-ageing concerns.
Treatment options fall into 3 main categories, they may each be used in isolation or are often successfully used in combination.
The youthful face has optimal support from both hard (e.g. bone) and soft tissues (e.g. fat pads and skin) to cope with the effects of gravity and maintain facial definition. With age however this structure, support and volume can be lost. This is due to several factors including fat redistribution, bone remodelling and changing tissue composition. The effects are seen as skin sagging and loss of facial definition along with lines and wrinkles.
Dermal or Hyaluronic acid fillers are a versatile gel like product containing a synthetic non animal based version of hyaluronic acid that is stabilised by cross linked molecules. They are injected under the skin in precise sequences at specific facial locations tailored to optimise each patients’ facial features. Results are seen instantly, although for some treatments the optimal effects may be seen after a course of treatments. Over time the fillers are slowly but naturally absorbed by the body. This generally occurs over a period of 9-24 months depending on the area treated and the type of filler.
Popular treatment options to achieve a more youthful appearance include the 8-point lift (or liquid facelift), cheek enhancement, jaw shaping, nose to mouth lines and mouth to jaw lines.
We use our facial muscles all the time to show expression, to squint, to frown or when concentrating. As we age skin becomes less elastic and this repeated contraction in the areas of greatest use can lead to creasing of the skin and ultimately to the formation of lines and wrinkles. Initially these will be present only when we are moving our face (dynamic lines) however in time permanent lines may form in these areas of overuse, that are present even when the face is relaxed (static lines).
Injections can be used to relax the muscles of facial expression which may lead to a reduction in the creasing of overlying skin that is seen as fine lines and wrinkles. Botulinum Toxin Type A (commonly known as Botox®) is a medication that can be prescribed and injected for this purpose. The relaxing actions of Botox® develop over around 1-2 weeks and last for around 3-4 months, after this the facial muscle strength will start to return.
Botox® has been FDA approved for both medical and cosmetic purposes for over 20 years with no evidence of long-term adverse effects. It is however a prescribed medication and will only be considered as a treatment option after thorough consultation and assessment. It is also important to stress that Botox® should only be administered by doctors and nurses specifically trained in this area to reduce the chance of any complications.
Popular areas for treatment are frown lines between the eyes (the glabellar), around the eyes (the crow’s feet or periorbital area) and the forehead.
As your skin ages, the turnover of skin cells slows significantly, throwing off the balance between the growth of healthy new cells and the sloughing of old, damaged cells. Additionally, collagen and elastin begin to break down, causing the skin to lose resilience resulting in fine lines, wrinkles and sagging. Daily exposure to UV light then accelerates this aging process and may cause uneven colouring.
Signs of skin ageing and photodamage include
Obagi Medical skin care products are the Number 1 physician dispensed skin care range in the world with over 30 years of clinically proven results. The product range has been specifically formulated to transform the skin from within, resulting in younger, healthier looking skin.
Juvederm® dermal filler products are made using advanced technology and have an established safety profile. There are potential side effects although these are mainly minor and temporary, they will be discussed in detail with you at your consultation. I work to reduce the chance of any complications by precision, attention to detail and advanced level training in this area. The dermal fillers that we use are fully reversible if you are unhappy with the effect
Botulinum toxin has been FDA approved for both medical and cosmetic purposes for over 20 years with no evidence of long-term adverse effects. There are potential side effects although these are mainly minor and temporary, they will be discussed in detail with you at your consultation. Botox® is however a prescribed medication and should only be administered by doctors and nurses specifically trained in this area to reduce the chance of any complications.
I believe that the most successful anti-ageing results are obtained only after in-depth consultation and thorough facial assessment, focussing on the results you would like to achieve. I aim to use a combination of subtle enhancements to achieve a naturally more youthful look that gives a big overall difference.
At your free initial consultation, we will discuss your concerns and the results that you would like to achieve and I will ask questions relating to your medical history, previous aesthetic treatments and lifestyle. This will be followed by a thorough examination and explanation of the best treatment options along with a consideration of your budget. This will all be entirely confidential and there is no obligation to proceed with treatment. If you do wish to proceed however this can often be done within the same appointment or a can be arranged at a time in the future to suit you.
There are a number of different dermal filler and Botulinum toxin products on the market (e.g. Juvederm®, Restylane, Teosyal, Botox®, Azzalure, Bocoture). My preferred range of products is the Allergan range, Botox® and Juvederm® as I believe it them to be the safest and most reliable products to achieve the best results for my clients. The Juvederm® range utilises two technologies Hylacross® in the Ultra range and VycrossTM. The Ultra range is an excellent product with well-established results and trusted technology that lasts around 9-12 months depending on the area being treated. VycrossTM is a premium range using advanced technology to enhance duration and enable thorough tissue integration for incredibly natural looking and feeling results that last.
Most treatments involve a series of small injections that are performed in a precise sequence at specific facial locations. I aim to minimise any discomfort during these injections by using expert injection techniques and local anaesthesia where needed. A slight redness to the skin is usually seen for a short time but bruising is uncommon and usually fades quickly. Most clients are able to continue with their day after leaving the clinic without anybody noticing. More serious side effects are rare and will be discussed with you at your consultation before any treatment takes place. Results for filler injections are usually seen instantly but the results of Botox® injections will develop over a period of 1-2 weeks. For some combination treatments the optimal effects may only be seen after a course of appointments. Treatments times vary but are generally between 20 and 60 minutes per appointment.
After your treatment you will be given comprehensive aftercare instructions and a follow up appointment will be arranged, ideally after around 2 weeks. Important things to consider are that it is advisable to avoid applying makeup, doing strenuous exercise, extremes of temperature and alcohol consumption for a short time after. We would be happy to tailor the timings of your treatment to take these factors into account.
Showing others how we feel by using facial expressions such as smiling, frowning, looking surprised or showing empathy is incredibly important in our interaction and relationships with others. As we age however repeatedly using the same muscles can lead to the formation of lines and wrinkles. Although your lifestyle and personality have an impact on how and where these lines form, a classic pattern is seen in many of us and is easily treatable. Lines at the side of the eyes or crow’s feet, lines in between the eyes or ‘11’ lines and horizontal lines on the forehead are some of the most recognisable signs of ageing. Using injections to relax these muscles (e.g. Botox®) and/or to plump the overlying skin (dermal fillers) in these areas can significantly reduce the appearance of these lines. Only after thorough consultation and assessment will your suitability for either of these treatments be considered. Retaining some movement in theses muscles along with the ability to show emotions and your personality is key however to maintaining a natural fresher look. Medical training and in-depth knowledge of the science and anatomy behind the actions and interactions of these muscles and safety zones is essential for safe treatment, avoidance of complications and a beautiful natural look.
Rounded, plump cheeks and defined cheekbones are a sign of youth and beauty. They are also key to the structure of the face, supporting the eye area and lower face and one of the first places that we lose volume with age. Carefully placed advanced dermal filler injections can be used to restore volume where it has been lost, re-plumping the cheeks, defining the cheekbones and creating a lifting effect to other areas in the face. This is one of the most popular antiaging treatments due to its incredible lifting effect on the whole face
One of the first signs of ageing that many of us notice is lines or shadows appearing from nose to mouth, often referred to as nasolabial lines. The cause of these lines and shadows is loss of volume and structure, not just from the area itself but often from supporting structures higher up in the face such as the cheeks. Dermal filler can be used to successfully treat these lines both directly and indirectly. Direct treatments involve carefully placed injections into the lines themselves to replace lost volume and smooth shadows. Another approach to treating these lines involves using filler to sculpt and lift in other precisely chosen areas, often including the cheek area or aspects of the MD Codes 8-point lift technique.
The ideal chin and jawline has crisp angles and is free of lines, shadows, curves and dimples. The perfect shape is defined by the golden ratio in relation to the proportions of your face and is different for men and women. A strong chin and defined jawline in men is one of the facial features which is most associated with masculinity and strength. In women however a tapered face with a small chin and heart shape is key to feminine beauty. Gravity and ageing can have a significant effect in these areas with skin sagging and drooping around the jawline leading to jowls. The chin can also change shape with age by lifting, shortening and dimpling. Advanced long-lasting dermal fillers can be used to build up the chin and jawline to enhance shape and definition or to improve sagginess and jowls in the jawline caused by loose or ageing skin.
Natural, youthful lips are balanced and full with defined borders and without lines or puckering. As we age however it is common to lose some of the volume, definition or symmetry we once had and to gain lines above the top lip. Skilled assessment using the principles of the golden ratio followed by careful and precise injections of advanced dermal fillers can be used to restore and redefine the beautiful proportions of your lips and to smooth lines.
The eyes are the most prominent and expressive feature of the face and beautiful eyes are key to attractiveness. There are many aspects to the area around the eyes (under eye skin or tear trough, eyelids, eyebrow and eyelashes) and each contributes to a beautiful youthful look. Aging, emotional state and lifestyle can all take their toll in this area in particular, leading to dark circles and bags, wrinkles and thinning eyelashes and eyebrows. It is a delicate and complex area, however, so requires careful assessment to identify your core concern and advanced technical skills to achieve the best results.
Tear trough fillers is a sophisticated treatment that is an excellent way to treat dark circles and under eye bags. Advanced dermal filler is precisely injected under the skin of the lower eyelid and the area under the eye leading to plumping of hollows and rejuvenation of under eye skin.
Injections to relax facial muscles using Botulinum toxin (Botox®) also give great results in the eye area. Relaxation in the area of the crow’s feet lines is one of the most popular treatments that successfully brightens tired looking eyes. More advanced applications of these injections can also be used to reduce lines and wrinkles under the eyes and to create lift in the eyebrows that can reduce sagging and creasing of the eyelid. These injections use a prescribed medication and will only be considered as a treatment option after thorough consultation and assessment.
Creams and serums can also work wonders for the skin around the eyes and for lashes and brows. My preferred products, chosen for their high quality and scientifically proven results are Obagi Elastiderm eye and the Revitalash® cosmetics range. I am an approved UK stockist for both of these ranges.
MD codestm (MeDical codes) is a cutting-edge treatment protocol devised by leading plastic surgeon Dr Mauricio de Maio, a key innovator in the field of Aesthetic medicine. This is a skilful, bespoke treatment that requires careful consultation and planning to achieve lift and facial rejuvenation in a holistic way. The result is a naturally lifted more youthful, fresh look that is often referred to as ‘The liquid facelift’.