We investigate the de-ageing Alternatives to going under the knife

In the quest to undo the signs of time on their appearance, women are ironically turning to procedures that require ever less time to perform and to recover from. And, says Jo'burg-based cosmetic surgeon Dr Loredana Nigro, this is done at 'an earlier age to manage ageing in the most graceful way possible'.

Description: Sarah Koopman investigates the de-ageing Alternatives to going under the knife

Sarah Koopman investigates the de-ageing Alternatives to going under the knife

Until now, most anti-ageing treatments have taken the form of fillers that aim to restore the skin’s volume and firmness. Botox that freezes the muscles under-neath the skin to stop them from moving and causing wrinkles and light or laser treatments that tighten and smooth and brighten the appearance of skin. These treatments, which mostly act on the skin's upper layers, gained popularity for delaying more invasive procedures such as surgical facelifts as well as for their almost immediate results.

What these procedures on the upper layers of the skin cannot do effectively is treat the delicate eye and neck areas, making surgery the only option. It is this gap that new treatments are filling: de-ageing treatments that propose to reverse the appearance of ageing skin by resurfacing it instead of freezing the ageing process with the concomitant telltale 'tight' look of facial surgery. 'The focus has shifted from pure damage control to prevention,' says Nigro of this new approach.

How It Works

Many of the new treatments make use of laser and light therapy that in effect causes heat damage to the skin and collagen cells, thereby triggering collagen's natural repair response. Because the new collagen is thicker and firmer, the result is tighter skin. 'Active collagen-building essentially builds up the skin, retarding ongoing ageing,' explains Nigro.

Now this same treatment is being used under the skin with promises of even greater firming effects. Whereas laser and radiofrequency treatments penetrate skin for no deeper than four millimeters, thus tightening skin on the surface only, these new methods work two centimeters below the skin’s surface, enabling doctors to target previously untreatable sagging skin and reducing the need for surgical intervention. Patients are therefore able to undergo extensive skin resurfacing with real results and with little recovery time and no scarring. As these procedures take place in the doctor's chair, they are done under local anesthetic, which also speeds up recovery time.

No Surgery Required

Basically, when the treatment device made up of micro-needles, touches the skin, it briefly cools the area before creating a deep heating sensation that is followed by another cooling sensation. The feeling of heat indicates that the deeper layers of the skin have been reached and thermal damage has been induced.

This procedure is not entirely without downsides though. Side effects include redness, swelling and bruising for a few weeks after the procedure as well as pain immediately after the anesthetic has worn off. Itching, blisters and bruising are possible too. 'There is [also the chance of] negative psychological effects if the procedure does not turn out to be what [a patient] anticipated,' says Dr Craige Golding, a specialist physician in anti-ageing medicine.

Not everyone qualifies for these treatments either, and the severity of the sagging will determine whether or not the procedure will work for you.

All doctors stress, however, that it is most important to maintain the youthful condition of your skin from an early age to keep signs of ageing at bay. 'Don't wait too long,' cautions Nigro. 'It is easier to look 10 years younger if you're not actually wishing to roll back [the clock] 20 years'.

Treatment Options

Internationally, de-ageing treatments have gained popularity with a range of trademarked treatment options. In SA, the two most popular procedures are Fraxel which, according to Fraxel.com, works for fine lines and wrinkles, surface scarring, pigmentation, sun damage and actinic keratosis, a common pre-cancerous skin condition; and Thermage, which Nigro says ‘uses radiofrequency to build collagen and non-surgically reverse sagging'.

Cosmetic surgeons suggest a combination of treatments as the best approach for anti-ageing. 'In reality,' says Nigro, 'anti-ageing and preventative aesthetic treatments can begin as soon as one is beyond adolescence and continue deep into advanced age.'

While some say the best way to achieve optimum results is to alternate surgical and non-surgical treatments, thereby changing the skin's appearance as well as how the muscles and fat in it operate, others suggest a holistic approach that includes a balanced diet and a combination of topical treatments. It is important to bear in mind, Golding says, that skin 'is a living organ and therefore should be under constant treatment.

Inside Out

'Good nutrition and supplementation, which should include Omega-3 fatty acids, and staying hydrated are essential for healthy skin,' says Golding. By incorporating essential vitamins such as vitamin C in your diet it is possible to assist your skin's anti-ageing campaign from the inside out. Vitamin C in particular helps to eliminate free radicals that play a large role in the aged appearance of skin. (See our story on the benefits of vitamin C overleaf.)

Topical care is vital too. In between any kind of cosmetic treatment, a thorough skincare regimen is necessary. Serums and creams that contain hyaluronic acid, an acid naturally present in skin and that helps with keeping it smooth and soft, are essential for its general maintenance. Cosmetics ranges such as Elizabeth Arden's Ceramide products and Revlon’s Age-Defying products stimulate collagen production from the outside and will assist in delaying the ageing process between treatments. ‘Staying out of the sun is essential,' says Golding as sun damage is a large contributing factor in skin's ageing.

While we have all these options available to us, it is ultimately up to us to determine the best course of action to keep both ageing and invasive procedures at bay. Collagen holds the key to reversing the appearance of ageing skin and the best options currently available are laser and radiofrequency treatments. Whether or not treatments like Fraxel and Thermage offer any real alternative to facial surgery is determined by how much excess skin needs to be removed in order to achieve the desired outcome.

De-Ageing As Your skin ages

20S: This is when your skin starts to show the first signs of ageing with the appearance of fine lines, particularly around the eyes and the corners of the mouth. From about 25, the collagen in the skin starts to break down and skin becomes drier as pore size increases. Develop good skincare habits - include sunscreen in your daily routine, use creams containing vitamin A and make sure to use a day and a night moisturiser. Add fruit acids and antioxidants to your diet.

30s: Collagen, elastin and hyaluronic acid levels continue to drop. Start using vitamin C as a topical antioxidant that facilitates collagen synthesis and UV protection. Use fruit acids to exfoliate the top layer of the skin.

40s: The continued decrease in collagen, elastin and hyaluronic acid causes skin to sag and reduce elasticity. More prominent lines and wrinkles also start to appear. This is a good time to consider dermal filler treatments and dermal stimulator treatments. Use deageing treatments to stimulate collagen repair and combat sagging before the collagen breaks down too much and skin becomes too saggy to be treated non-surgically.

Description: De-Ageing As Your skin ages

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