LH Aesthetics - How We Age

The face and skin changes greatly over the years creating characteristics associated with age. It is not just that a few wrinkles appear, most people don’t mind the odd line. Unfortunately many of these changes are also associated with negative emotions and words. People are concerned that they look tired, cross and miserable. Skin is described as dull and saggy.

Understanding these changes with age helps explains how and why different treatments can improve your appearance so much. You will then be able to make better decisions about what is right for you.

Often eliminating a wrinkle that you focus on makes little difference to how well and vibrant you appear to others. A small degree of change in each area gives a much more natural yet effective improvement, than concentrating on perfection in one small feature.


What does this mean? It is important to understand as it explains why deep facial fillers and Sculptra have become so popular over recent years. Procedures, which if done with skill and a good eye are extremely effective in making you look well, without an observer being able to quite say why. For most people it is important that they replace what has been lost with time rather than over emphasising features and looking false. That said, occasionally some face shapes look fantastic with a little more cheek or jaw definition.

Over time the deep underlying tissues in the face shrink. Think of a balloon one day after a party – it is slightly deflated and the surface is more crinkles. Gravity and the muscles that pull downwards in the face take their toll and the eventually face drops.

This process takes a very long time and tends to happen in a particular pattern. The extent can vary considerably from person to person depending on their face shape and bone structure, genes and lifestyle. (Smokers and sun worshipers – that’s’ you)

The underlying tissues that shrink are mainly fat, which are divided into pockets around the face. The volume of these pockets is a little weight related – if an older person looses a lot of weight they notice it in their face, but it is not as important as you might think. Anyone who puts on weight often finds it causes a double chin before it plumps up the cheeks. Sadly the pounds go on in the ‘wrong’ place.


• This is the reason why it has become more common to have cheek enhancement. The fat pad areas are rebuilt with Sculptra® or deep dermal fillers, lifting the face to give a younger, natural look.
• This is part of the ‘non-surgical facelift’. The aim is to replace what has been lost with time rather than create overly puffy cheeks.


Collagen is the protein that forms the scaffolding of the skin. It gradually breaks down with time, exposure to UVA, the toxins in smoking and other environmental factors. This leads to the skin thinning and creasing and sagging of the face.

If the skin full of collagen can be thought of as a duvet then without it is more like a sheet. In the same way a duvet does not crease but a sheet can, the lack of collagen can lead to skin creases. Lips are particularly vulnerable to this change.


• Sun protection, most importantly from UVA rays. It is very important to always wear a good quality sun screen, makeup and moisturisers.
• Antioxidant serums, e.g. containing vitamin C,  which are essential for the formation of collagen.
• Quit smoking. Smoking has been shown to breakdown collagen in the skin, and reduces vitamin C in the body. It also reduces oxygen supply to the skin increasing damage.


• Creams containing tretinoin or retinol (vitamin A). These “normalise skin cell hehaviour”. This means that collagen productiuon is increased and pigment cells work more normally, improving patchy pigmentation.
Sculptra® stimulates collagen production in the skin.
Dermaroller can excite healing and new collagen formation, which thickens and tightens the skin.
Restylane Skin Boosters can be used as to plump up damaged areas, and are especially good in areas of fine wrinkles or “crepyness”.
Dermal Fillers can enhance lips – newer very soft fillers are available to allow gentle replacement of lip volume rather than alarming pouts.

LH Aesthetics - How Our Skin Ages

The most important fat pads that shrink and cause facial sagging are:

1. The Temporal fat pads – these are on the sides of the forehead.
Look at a picture of a much older person and see how hollow the sides of their forehead are. No one comes into the clinic and worries about their hollow temples, but if you pinch your skin and pull outwards there, you will see how your jawline lifts a little.

2. The Buccal fat pad – this comes from underneath the back of your cheekbone to the area in front of your ear. Some people do feel they look hollow or guant here as they get older. Similarly pull out the skin over the area in front of your ear, both on and below the back of the cheekbone. See how this raises your jawline and pulls up the corner of your mouth. The shrinkage and dropping of the temporal fat pad, and especially the buccal fad pad causes the face to drop down and foreward causing jowls and ‘marionette lines’ to form. They are those lines which start at the corners of the mouth and drop downwards, like a marionette puppet.

3. The Malar fat pad – this lies at the front of the cheek, the ‘apple’ of the cheek.
As it get smaller the cheeks look flatter and emphases tired hollows under the eyes. The front of the face drops and falls forward causing nose to mouth lines. The malar fat pad can separate causing the under eye hollows to extend across the cheek which makes you look exhausted.


Some surgeons replace the fat with fat from elsewhere in the body and if you have a lot of loose tissues and muscle you may wish to consider a facelift. However, for most people this is far too much to even think about and if your facial changes are mild there is no need.
Replacement of volume with Sculptra can work fantastically to lift and reshape the face. It stimulates your tissues to product collagen and so improves your face slowly to give a soft natural look.

Deep dermal fillers are gels made of hyaluronic acid, which is synthesised, but is the same as the natural hyaluronic acid present in your tissues. They can be injected deeply to lift the face. The effect is instant. They are very versatile and can be used in some areas where Sculptra is not suitable.

I can advise you and help you make your decision about which product would be best for you and some times a combination is appropriate.


As we age the skin cell turnover slows down and this can lead to the skin looking dull.


• Cell turnover can be increased will Microdermabrasion, Skin Peels and creams such as retinol.


Hyaluronic acid, which is a naturally occurring sugar, absorbs water and keeps the skin hydrated and fresh looking. As we get older, our body’s start to produce less hyaluronic acid and the skin does not get moisturised from within as effectively as it did when we were younger. This results in the skin drying and fine lines and wrinkles starting to form. Other factors including sun damage diet and smoking can also lead to the formation of lines and wrinkles.


Botox, Sculptra and dermal fillers can help to reduce the appearance of fine lines and wrinkles.


1. Brown patches can be due to increased pigmentation following sun damage.


• This can be difficult but options include prescription skin care products, Lase or IPL treatments.

2. Red thread veins and matting appear due to blood vessels dilating as the reduced collagen fails to support them.


• Laser or IPL can be very effective.
• There are many combinations of treatments that can be used for refreshing and enhancing the face. Products and procedure options are getting better and better.


Sun exposure

Excessive exposure to the sun will start to take a toll on the skin, as we get older. The face, the neck and the hands in particular will show early signs of ageing if we have spent to many years worshipping the sun.


Alcohol and even coffee can have a dehydrating effect on the skin and increase the ageing process leading to fine lines and wrinkles forming.


Smoking prevents the skin cells from being oxygenated and causes the skin to age prematurely. Additionally, repeatedly inhaling on cigarettes causes fine line to form around the edges of the mouth.

Poor diet

Not maintaining a healthy diet can cause the skin to become unhealthy and lose its natural firmness and glow. Switching to a healthier diet will help to promote the regeneration of dead skin cells.

“Ageing can be complicated so please do feel welcome to come in for a consultation. We can discuss the best options tailored to your unique and individual needs using my long experience in non-surgical treatments.”