As we age there are many processes in our body that start to slow down. Although these changes are going on internally, the outward manifestation of them can be seen in our skin and face. Starting in our 30’s we ALL experience a gradual deterioration in bone density, a reduction in collagen production, changes in fat distribution and a decrease in skin elasticity. The rate at which these factors occur depend on sun exposure, quality of diet, lifestyle choices, stress levels, hormones, and genetics. All these contributors to aging are within our control, with the exception of genetics and to a certain extent, hormones. We are completely in charge of the rate at which aging shows on our faces and body – we just need the right formula for our skincare regimen, fitness and diet program, and healthy lifestyle choices.
First let’s look at how aging effects our bone density and how this can be seen from the outside. Starting in our 30’s and especially prevalent during menopause (for those of us that are female), the rate at which bone is broken down far exceeds the rate at which it is built. Physiologically speaking, the osteoclasts (cells that break down bone) are more active than the osteoblasts (cells that remodel bone). This can be reflected in the face with the following visible changes:
- bone around our eyes widens, leading to eye hollows and flattened cheeks
- the bones of the central face and jaw degrade causing a sinking back and downward effect.
- loss of upper lip support and size due to decrease in bone underneath (maxillary bone). Also evident with upper lip wrinkling
Second, let’s examine what happens to our collagen and elastin, which are proteins in our skin that are responsible for elasticity and firmness. Think of them like scaffolding, or the foundation of a building. Starting in our 30’s the rate of collagen degradation is approximately 1% per year, depending on lifestyle choices. While this may not seem like much, by the time we are 50 years old we have lost at least 20% of what is responsible for keeping our skin tight and firm. Couple this with the underlying bone loss and we have a recipe for sagging skin with the face sinking down and forward with gravity (especially so if we are side-lying sleepers who sleep on our face).
Finally, let’s learn what happens to the fat underneath our skin as we age. When we are younger we have a balanced distribution of full fat pads right underneath the skin as well as deeper and closer to the bone. These fat pads result in a well-rounded landscape, characterizing a youthful appearance. With aging, there is a loss of fat fullness around the eyes, temples and upper third portion of the face. The mid and lower face experience a hypertrophy (enlargement) of fat pads resulting in fat accumulation and sagging around the mouth, jaws and neck.
So given all this information, what are some things we can do to prevent these things from occurring, or to bring back the youthfulness we had when we were younger? Keeping with the changes listed above that occur from aging with regards to bone, collagen/elastin, and fat tissue, here are some great tips, products and procedures to turn back the hands of time:
BONE DENSITY LOSS/RESORPTION
- ensure adequate Vitamin D and calcium intake/possible supplementation
- weight training for increasing bone density and strength
- Hyaluronic acid filler injections with a higher G prime (more viscous as opposed to thin) close to the bone to volumize areas where bone loss occurs (cheeks, sides of nose, chin, jawline)
- correct estrogen deficiency in post-menopausal women and some men
REDUCTION IN COLLAGEN/ELASTIN
- for the face: starting in your 30’s begin using a topical over-the-counter Retinol (vitamin A) cream at night to prevent fine lines, sun damage, and enhance skin firmness and elasticity. For the body: mild exfoliation, topical lotions with alpha-hydroxy acids to stimulate skin rejuvenation (Amlactin, Eucerin are some good brands).
- SUNSCREEN – always and forever
- for the face: starting in 30’s or 40’s begin using prescription strength Vitamin A tretinoin (Retin-A) at 0.025% and increasing strength as tolerated. This is the powerhouse, gold standard for anti-aging creams
- procedures such as microneedling with appropriate hydration and anti-aging serums or cocktails stimulate collagen and elastin production because the needling effect makes the skin think it has been injured, thereby increasing circulation, oxygenation and regeneration to the tissue. Microneedling must be performed monthly, or somewhat regularly, to keep up with the benefits. Topical lidocaine can be applied for deeper and more aggressive needle depths (+2 mm) for more drastic results such as acne scarring, sun spots and deeper fine lines.
- Hyaluronic acid filler injections with a lower G prime (less viscous, more thin) to plump areas that have experienced a decrease in plumpness, such as the lips
CHANGES IN FACIAL FAT DISTRIBUTION
- hyaluronic acid fillers to lessen the depth of wrinkles and folds around the nose and mouth from fat enlargement and drooping in the mid face
- hyaluronic acid fillers to restore volume to the chin, cheeks and jawline that result in a tightening of the overlying skin
- thread lifts in the cheeks or along the jawline to lift the skin and pull backwards
It is never too late to take control of the aging process with simple changes in our habits, and use of appropriate cosmetic and skincare regimens. What is of the upmost importance is being consistent with the right regimen and routine based on your goals, age and starting point. If you are using the wrong products, too many products, under or over-doing cosmetic procedures, etc you will not get to your goal and will also be wasting a lot of time and money in the process. More is not more in this case – it’s better to work smarter than harder. If you would like a personalized consultation for your program I am always here to help. Contact me for further information – HERE.
