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Gravity is the enemy here, and we all know it. Above a certain age, few amongst us would have never looked in the mirror without wanting to finger lift cheeks and forehead to see how we would look with a surgical lift.
But first, it's worth talking here about prevention. The prevention of sagging is all about maintaining collagen strength and integrity whilst controlling the weight of tissue under your skin.
In youth, controlling the weight of excess fat in the face will help reduce the risk of future sagging - diet and exercise. Those with localised areas of fat in the lower face and in the neck, out of proportion to the fat deposited throughout the body, should ask us about mesotherapy with phosphatidylcholine. Then again, older patients with excessive facial fat can find that losing weight can have a deflating effect on the face, which may appear to make folds and sagging worse. The approach here must be to lose the weight that must be lost from the body to optimise health, then deal with facial fat issues via injectables such as Sculptra or via fat transfer.
Maintaining collagen strength involves firstly maintaining adequate nutrition to the skin, particularly with Vitamins A and C, and secondly reducing collagen-damagers like cigarettes, alcohol, unfiltered sunlight and other sources of free radicles. Thirdly, collagen strength can be improved via treatments such as microdermabrasion, peels, IPL, Omnilux and lasers. Such treatments stimulate fibroblasts through light, heat, chemical or mechanical action. These treatments are likely to help prevent future sagging as well as help reverse current sagging.
In terms of treatment, probably the simplest way to significantly reverse sagging is via a treatment we label "Agent S", which works to powerfully stimulate new collagen formation under the skin. As this new collagen contracts, a lifting and thickening effect is produced in the skin.
The Agent S suspension is injected under the skin in the area requiring treatment. It has to be evenly and diffusely spread over this area and so the treatment requires more injections than is the case with say Agent B. A potent anesthetic cream is applied to the skin prior to treating, and after all the injections the treatment area is thoroughly massaged to ensure the suspension is uniformly distributed .
We like patients to continue to massage the area several times a day for several days, to ensure this evenness of effect. See our treatment section for more information on Agent S.
For more lifting and more immediate effects, a direct structural approach is required. Of such treatments, thread lifts with APTOS threads and/or Contour threads are established and the least invasive and most straightforward way to physically and permanently bring about a lifting of skin.
These "threads" resemble short fine lengths of fishing line and are composed of the same material often used by surgeons and other doctors to suture skin wounds, but the fine monofilament thread is in this case modified by the cutting of many tiny notches into the side of the thread to create little barbs that grab onto strands of connective fibres as the thread passes through subcutaneous tissues. In the case of APTOS threads, along the sides of the thread the barbs are arranged like French quotation marks, so that the ends of the thread can attach to create a suspension-bridge structure under the skin: a suspension bridge that we use to hold up the target sagging skin and tissues in the centre.
Contour threads are arranged similarly but the approach is somewhat different. The barbed ends are used to hold the target tissue needing a lift, whilst the centre of the thread is placed at a fixed point under the skin from which the target tissue can be supported.
Either way, extensive cutting is not used, knots are not used, skin is not lost, and if a patient really needs to have the treatment reversed at some future time then the threads can always be removed.
Useful to lift brows, cheeks, jowls, jawlines and necks, APTOS and Contour threads give you a natural look with a definite, cost-effective improvement. Again, have a look at the treatment section.
From middle age, sagging of body skin and tissues can be partly explained by age-related reductions in prevailing levels of hormones such as growth hormone, DHEAS and testosterone. Natural hormone replacement therapy can help reduce saggines of skin, in combination with a correct diet and exercise program. Ask us about this in consultation.
Recently, the sagging of facial skin tissue has been treated with a process called "Thermage". This process involves heating the subcutaneous tissues with unipolar radiofrequency, with a view to causing collagen to shrink and thus skin to lift. However, the medical papers we have seen have demonstrated only modest and inconsistent improvements with Thermage, and with treatments in the $5000 range, it seems to us that patients can achieve better results by other methods.
That's why we have introduced into the practice ReFirme treatments, using ELOS technology from Syneron. Like thermage, ReFirme is a radiofrequency device that induces new collagen below the skin surface, leading to firming and tightening as this new collagen matures and contracts. But treatments are a fraction of the price of Thermage.
ReFirme is our least-down-time way to get skin tightening.
Ultimately, skin can be lifted by surgery. At Peach we like to try to help our patients avoid surgery but if surgery is your best option we will tell you so and refer you to the right surgeon. If you are agreeable, Dr Mahony likes to take the opportunity to assist with such surgery whenever the chance arises. |
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