Peeling Back the Layers: an In-Depth Look at Facial Ageing, Including Causes, and the Treatments that Actually Work

While we can all recognise when a face is beginning to show signs of ageing, what those signs are, beyond the obvious lines and wrinkles, can be challenging to identify.

But if we want to treat something, we need to know what it is we're targeting. Let's take a look at what exactly those signs of ageing are, starting from the inside and working outward, before considering the causes of ageing and, finally, what we can do about it.

Layer one: ageing and our bone structure

The bones of the face are constantly changing – from adolescence onwards, the craniofacial skeleton undergoes continuous shifts and remodelling. As we get older, however, bone resorption begins to occur; this is when bone tissue gradually breaks down and gets reabsorbed into the body, resulting in:

• Reduced definition around the chin and jawline

• Facial imbalance, as proportions shift between the middle, upper and lower face

• A sunken appearance

The areas of the face most commonly affected by bone resorption are the temples, jawline, and chin. Unfortunately, this reduction in bone structure also has a knock-on effect on the other layers of the face

Layer two: facial fat and the ageing process

As the bones of the face begin to shrink and ligaments weaken, the fat pads in the face also begin to shift. Facial fat consists of 'deep' fat, which is anchored to the bone and therefore immobile, and more mobile fat pads, which are subject to dynamic changes of the facial muscles (for example, when smiling forces cheek fat upwards). It is these fat pads which tend to shift over time as the underlying bone structure becomes too weak to support them and gravity pulls them downwards. This can result in:

• Under-eye hollows

• Flat cheeks

• Sagging around the jaw

Layer three: facial muscle changes with age

The muscles of the face are responsible for what are known as 'dynamic' wrinkles – that is, those lines that are the result of repeated facial expressions, such as:

• Laughter lines around the eyes (crow’s feet)

• Frown lines

• Forehead lines

• Smile lines

• Lip lines

While the facial muscles do weaken as we age, they do so at a slower rate than some of the other layers of the face, which means their pull becomes greater, which can result in what is known as 'hyperdynamic expressions' – where a smile becomes more of a grimace, or the resting expression is a permanent frown.

Layer four: skin ageing changes

The skin is the layer we pay most attention to. It is the most obvious representation of the ageing process, as it is affected by the physiological shifts occurring below the surface as well as changes occurring within the dermis itself.

Collagen and elastin are proteins that form the primary fibres in the extracellular matrix. Collagen is responsible for providing strength and support, while elastin contributes to skin elasticity. The levels of collagen and elastin in the skin decrease due to ageing and other factors, which we'll discuss below.

This results in many of the changes we associate with ageing:

• Skin sagging

• Fine lines and wrinkles

• A rough, dry texture

• Age spots and discolouration

• Broken veins

What causes skin ageing?

There are two categories of skin ageing: intrinsic ageing and extrinsic ageing. Your genes are responsible for intrinsic ageing, which, sadly, is inevitable (although we can slow it!) The good news, however, is that only 10% of premature skin ageing is intrinsic. The remaining 90% is extrinsic, meaning it is caused by external or lifestyle factors, which can include:

• Sun damage

• Smoking and alcohol consumption

• Poor diet

• Stress

• Lack of sleep

• Hormonal changes

  
  

This means that, if you're not yet showing signs of facial ageing, it might not be too late to slow the process down by making some positive lifestyle changes like using SPF 50 every day (yes, even if it's a cloudy day!), avoiding smoking and alcohol, and improving your sleep hygiene.

I take a holistic approach to ageing and will always discuss these lifestyle factors that should be addressed for optimal rejuvenation.

Even if your face is showing some wear and tear, these changes will help slow the process down. However, we also offer a range of treatments that can help reverse some of the visible signs of ageing.

What treatments REALLY work to slow the ageing process?

The first step is to establish a good skincare routine. Not only will this help to get your skin in peak condition, slowing down any visible signs of ageing, but it will also help to maintain the results of any anti-ageing treatment you choose to undergo.

Once a skincare routine is established, I then offer my patients a thorough consultation to determine the best treatment for them, based, of course, on their ageing profile, but also their lifestyle and personal preferences. I only offer anti-ageing treatments that I know to be effective, such as:

Wrinkle relaxing injections

It will come as no surprise that wrinkle relaxing injections remain one of the most popular aesthetic treatments available, as they are an effective way to combat some of the visible signs of ageing. They work by freezing the muscles that cause those pesky dynamic wrinkles, such as crow's feet or frown lines, leaving your complexion smoother and softer.

Platelet Rich Plasma injections

Platelet Rich Plasma (PRP) treatment works by withdrawing blood from the patient, harvesting the platelet-rich plasma using a centrifuge, and then injecting that plasma back into the patient's skin. Plasma contains growth factors that help stimulate the body's wound-healing response, speeding up collagen production and resulting in plumper, more youthful skin.

Polynucleotides

These are molecules of highly purified fish DNA, which are injected into the skin to reach the fibroblast cells, which produce collagen. As with PRP, Polynucleotides helps to plump and firm the skin, effectively reversing some of the effects of fat loss and leading to a rejuvenated appearance.

Secret Pro

This wonder treatment combines two proven anti-ageing treatments in one: radiofrequency microneedling and CO2 laser fractionally ablative resurfacing. This treats all layers of the skin, stimulating collagen production and improving the appearance of scars and wrinkles.

Exosomes

Exosomes are applied topically, so they are ideal for the needle-averse patient who still wishes to combat ageing effectively. ASCE plus Exosomes are derived from rose stem cells. When applied to the skin, they activate dormant skin cells, stimulating them to regenerate, leaving your skin brighter and rejuvenated

If you are concerned about the visible signs of skin ageing and would like to discuss any of these treatments in more detail, or book a consultation, please contact us.