What is facial rejuvenation?

Facial rejuvenation is any cosmetic or medical procedure used to increase or restore the appearance of a younger age to the human face. These procedures include the non-invasive use of topical treatments (e.g. skincare products), the minimally invasive non-surgical treatments (e.g. dermal fillers, skin peels) and the invasive more permanent cosmetic surgery procedures (e.g. eyebrow lift, eye bag removal). They aim to restore facial geometry and skin appearance which are typical of youth.

They all have their place in facial rejuvenation and the most successful results may be attained by using a combination of procedures and treatments.

What Causes the Appearance of Ageing?

When we look in the mirror on a daily basis, there are rarely any sudden changes in what we see, yet if we take a photo from, say 5 years earlier, it is quite apparent that we have aged.

What has happened to alter our appearance?

It is widely agreed that there are several factors which contribute to the aging process causing the change in our facial appearance with age and some of these factors accelerate the process.

The natural aging process involves slowing of the production of collagen within the skin and elastin (which gives the skin its stretch and bounce) becomes less springy. Cell turnover slows down meaning the dead cells are shed less quickly and the skin loses its glow. Natural aging is thought to start in our 20’s, but the subtle changes which are occurring are rarely that noticeable until our 30’s.

These changes result in fine lines and thinning of the skin.

The skin becomes dryer, hair loss occurs along with unwanted hair in other places and changes occur within the nails which can lead to ridging and brittleness.

Bone loss occurs in the facial bones and there is a shifting of bone structure (remodelling).

In 2008 a study by some members of the American Academy of Dermatologists produced clinical evidence of facial bone remodelling occurring as we age. They used CT scans to demonstrate that facial bones remodel their shape with age.

In women the glabellar area (the area between then the eyebrows and top of the nose) decreases and the area under the rim of the eyebrows recedes. These changes combined with the loss of fat underlying the skin leads to the sagging of the eyebrows and deflated appearance of the eyelids. In men the glabellar angle decreases and changes are even more noticeable around the maxillary area (the area which provides support for the cheeks). This loss of support results in the malar fat pad (the tissue responsible for cheek fullness) sliding down the face and causing an increase in the creases around the nose and mouth (naso-labial area), resulting in a jowled appearance. There is also bone recession at the opening of the nose which causes the appearance of elongation of the nose and results in drooping of the surrounding area, affecting both men and women.

Genetics determine how quickly these natural aging processes occur and there is little we can do to alter the process. Other factors may accelerate facial aging.

External factors: exposure to sun, wind, excessive heat and cold. Most premature aging is caused by sun exposure. Other external factors that prematurely age our skin are chemical and biological pollution, repetitive facial expressions, gravity, sleeping positions, and smoking.

Internal factors: hormonal changes, poor diet, lack of exercise, medical conditions which may produce scarring such as acne.

Sun damage is responsible for the majority of premature skin aging. Without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick wart-like, rough, reddish patches of skin), and skin cancer can all be traced to sun exposure. This type of sun damage is referred to as photoaging. Certain skin types are more susceptible to these effects. Most at risk are those with fair skin that burns easily. Photoaging occurs over a period of years. With repeated exposure to the sun, the skin loses the ability to repair itself, and the damage accumulates. Scientific studies have shown that repeated ultraviolet (UV) exposure breaks down collagen and impairs the synthesis of new collagen. The sun also attacks our elastin. Sun-weakened skin ceases to spring back much earlier than skin protected from UV rays. Skin also becomes loose, wrinkled, and leathery much earlier with unprotected exposure to sunlight.

Can we reverse the effects of the sun?

Unfortunately not. However, there are a variety of treatments which are designed to rejuvenate skin quality and the Palomar Photofacial is a specific treatment for sun damaged skin and suitable for most people.

Other particularly good treatments for skin quality are Palomar 1540 non-ablative fractional laser; AccelaFuze™ medical microdermabrasion with infusion, and chemical peels. Restylane™ Vital improves skin quality and reduces creeping it is particularly good for the décolletage, and hands. Epionce® skin products are designed to renew and fortify the skin and have been clinically proven to repair damaged skin.

Facial rejuvenation treatments, whether non-surgical or surgical are designed to restore a more youthful appearance to the face using the principles discussed above.