Ageing is a complex, inevitable process that can be practically reversed these days; but the question is, should you choose non-surgical facial rejuvenation, surgical facelift or a combination of both? How we age changes the shape of our face - on the surface, we see fine lines, wrinkling, roughness, discoloration, dryness, age spots, drooping, thinning of the lashes and shortening of the eyebrow length. Underneath, we see some breakdown of collagen (support) and elastin (lasticity). We also produce lesser amounts of hyaluronic acid and experience volume loss around certain areas of the face and lips. Don't we just hate eyebags, tear troughs, jowliness and the ubiquitous double chin! The culprit? Mother Nature and Father Time obviously have a lot to do with this; so any treatment should consider factors like genetics, general health, bone structure, nutrition, and age-accelerating habits like sun exposure, smoking, alcohol intake and last but not least, stress.
Many of these procedures are referred to as "lunchtime procedures" because they can be done between 30 minutes to one hour and are minimally invasive, if at all. While some treatments are pain-free or tolerable, some clients prefer some form of numbing agent. In general, there is no downtime and can be worked into a busy schedule; something not possible with surgical procedures. There may be tell-tale signs post-treatment like minor bruising or redness but this goes away after a day or two and can be camouflaged by the skillful application of make-up. Certainly, exprctations should not be at the same as a total surgical facelift which may include blepharoplasty and eyebag surgery but the following are reasonable expectations:
- Wrinkle relaxing
- Volume replacement
- Smoothening and tightening and
- Improvement in evenness of skintone
The downside is that the effects are temporary except for Kybella, Coolsculpting, Threadlift and Sculptra which last longer.
Over at Juvly, having treated thousands over the last 3 years, what we know for sure is that when the treatment(s) are done well on the right patient, results from cutting-edge, non-surgical technologies targeting specific causes of ageing come pretty close to a surgical facelift. In fact, the so-called liquid facelift (wrinkle relaxer + filler), one of the most common "lunchtime" procedures done, does live up to its name because of the fresher, more youthful and relaxed look it achieves within days of the procedure - so unlike the longer healing process of a real, surgical facelift.
These are the most popular treatments for natural-looking, youthful and beautiful results which can be used alone or in combination for better outcomes:
1. Skin Resurfacing : Chemical Peels, Photo or Laser Facials like BBL, Microdermabasion
Chemical Peels, Laser Facials like BBL, and Microdermabrasion literally allows you to turn over a new leaf; or in this case, reveal new skin. All of these, working on different tracks, cause "small injuries" which destroys the older layers of the epidermis and encourages skin renewal as well as collagen formation.
A. Chemical Peels
Chemical peels such as the famous Obagi Blue Radiance Peel, SkinMedica Illuminize Peel, Vitalize and Rejuvenize Peels are use topically applied acids which exfoliate the older layers to reveal smoother, more radiant renewed skin. Here's a brief guide from Juvly to help you choose which one suits you best:
SKINMEDICA ILLUMINIZE PEEL
The SkinMedica Illuminize Peel is perfect to brighten and tighten your skin. This peel is ideal to combat mild skin imperfections and leave skin looking refreshed.
SKINMEDICA VITALIZE PEEL
The SkinMedica Vitalize Peel accelerates skin exfoliation to reduce the appearance of fine lines, wrinkles, and roughness. This is a must for those with mild to moderate skin imperfections.
SKINMEDICA REJUVENIZE PEEL
The SkinMedica Rejuvenate Peel is our strongest peel for those stubborn lines, wrinkles, and rough spots. We recommend this peel for those with moderate to severe skin imperfections.
OBAGI BLUE RADIANCE PEEL
Obagi’s Blue Radiance Peel gently exfoliates the top layer of skin to immediately brighten, tighten, and refresh.
ZO HEALTH PEEL
The ZO Health Peel is a perfect complement to any skin type. Its combination of exfoliants and retinol minimize the appearance of acne, fine lines, uneven texture, dullness, and oversized pores.
B. Photo Facials BBL
Laser resurfacing can be ablative or non-ablative. At Juvly, we use the BBL or the Broad Band Light (BBL) laser for our rejuvenating Photo Facials. This non-ablative laser is FDA-approved for a variety of confitions and is practically painless with no down time. BBL "uses cutting-edge technology to reverse signs of aging by altering your skin at the cellular level".
The light based BBL laser is used to correct or minimize dark spots, freckles fine lines, uneven pigmentation and blood vessels resulting to clearer skin with more uniform color and texture. Results vary but it is effective for shallow acne scars and nasolabial folds. The heat causes controlled injury and results to collagen formation.
Think of microdermabrasion as similar to "sand papering" a rough surface. Dead. superficial skin is exfoliated by using a stream of fine crystals. It i good for fine lines and wrinkles but don't expect dramatic diminishing of deeper folds and wrinkles. if you want smooth skin with a pinkish glow, this is definitely the treatment to try. It is effective for dry and sun-damaged skin and may dimish whiteheads, blackheads & acne.
Those with active cold sores, infammed pimples, healing sunburn, rosacea and warts are not good candidates. A ten-day course of anti-viral treatment may be given for those who are prone to cold sores or had a recent flare-up.
Microneedling in a nutshell is a safe and minimally invasive procedure, that creates a lot of microholes or intentional wounds on the epidermal or outmost layer of the skin to initiate what could be termed as a “cascade” of events that starts with releasing growth factors, creating a vascular network, migration of cells called fibroblasts and finally, collagen and elastin creation. The needles differ in size and and depth of puncrure; the deeper and bigger, the more dramatic the results. Even deep acne scars can be targeted.
Numerous studies confirmed what we had proven in practice: microneedling is great for the so-called rolling scars which are often are numerous, shallow to medium in depth and with sloped edges. It is not effective on pinprick scars which are small but very deep, box car scars with defined edges and hypertrophic scars. It’s main advantages over laser (if the scars are not deep) are:
- Shorter downtime (wounds are safe because these are superficial and close immediately);
- Safe for all types of skin color;
- Smoothly “blends” with untreated areas (no demarcation lines);
- Safe to use around the eyes and
- Does not cause photosensitivity because area affected is superficial. And did I mention cheaper?
3. Wrinkle Relaxer (Botulinum toxin type A like Botox and Dysport)
Botox and Dysport are still lording it as the most common lunchtime procedure. What's not to like? The changes are so dramatic yet the procedure is relatively painless and has no downtime. For a blow-by-blow comparison go to Botox-vs-Dysport. While injection points are the same, Dysport molecules are smaller so you use three times the units used fo Botox. There are pros and cons to using Botox or Dysport. Choices are made on how much area is covered.
Long story short, this neurotoxin derivative stops the muscles form moving. In a relaxed state, muscles don't pull the skin into folds so you see a reduction in wrinkles in areas like the eleven's (area betweej the brows, forehead and nasolabial folds. Called dynamic wrinkles, these are formed when we make facial expressions and having botulinum injections are said to prevent more from forming or deepening fast. Removing frown lines, wrinkled foreheads and lipstick lines may be enough fo some clients to look refreshed and youthful (in contrast to the pre-bolulinum A state when one can look angry, hararassed and tired all the time). An added bonus would be the eyebrow lift which can lift that sagging arch.
For "Botox virgins", usually 50 units is used and distributed in the following manner. It take only about 15 minutes. Effects start to set in between 2-4 days and usually stabilize by the 10th day. We like seeing patients after two weeks to see if a top-off (small amounts injected) is needed. In some patients, effects wear off after 4 months.
With ageing comes volume loss which can account for tear troughs, hollowed cheeks and a sagging face. In such as case, dermal fillers and collagen stimulators have to be considered.
4. Dermal Filler for the face, lips, cheeks and jaw (Juvederm, Restylane)
Dermal fillers such as Juvedrm and Restylane are composed of hyaluronic acid, similar to what our bodies produce. Collagen, elastin, skin fat and hyaluronic acid skin gives our facial skin structure and elasticiy. Although it is eventually resorbed by the skin, new generation dermal fillers from Restylane (Galderma) and Juvederm (Allergan) last longer. Specific formulations can provide greater structure or flexibility (e.g Restylane Defyne vs Refyne). For the longest time, Voluma was the filler of choice for the cheeks and midface area but Restylane has also come up with Lyft. When discussing your aesthetic goals, your Doctor or Provider can go through the many options and combinations suitable for you.
For tips on perfecting that pout, go to our recent blog on plumping the lips with fillers.
5. Collagen Stimulator (Sculptra)
6. Fat Removal (Kybella, CoolSculpting)
Both Kybella and CoolSculpting Mini are used to remove submental fat. In a way, it's like comparing apples to oranges since the mechanism for fat removal is different. For Kybella, it is injecting 2 ml. or so of so of deoxycholic acid, deep into the suncutanoeus fat. CoolSculpting is the non-invasive way to kill fat cells. Cryolipolysis literally "freezes to death" these superficially located fat cells.Both have comparable results and is permanent.
We were going to stop at 6 but facial rejuvenation won't make sense if you look younger in "patches". For a totally balanced look, details such as sagging of the brows, shortening of the brows, thinning of the lashes and roughening or discoloration of the skin should NOT be overlooked. Just as highlights, those tiny almost impercetible "something" rev up our haircolor or change our make-up from "okay" to "WOW", these tiny, oft-forgotten details can polish-up your transformed look. You wouldn't want perceptive ones to say, "Your slip is showing, would you?"
7. Microblading and/or Browlift (with Botox or Dysport)
8. Latisse (for thickening lengthening lashes)
9. Skin Care ( e.g. Alpha glycolic acid, Retinoic acid and retinols for daily exfoliation and collagen stimulation)
10. Last but not least, stay youthful by allowing your body to heal itself. Get enough sleep, eat nourishing food full of anti-oxidants and protein building blocks. A word to the wise: Sunblock helps but Stress-block makes it so much better!