Enhancing your looks has never been easier. We bring you the advancements, techniques and trends of minimally invasive cosmetic procedures.
The desire to refresh the face through subtle rejuvenation has made nonsurgical cosmetic procedures a familiar part of today’s beauty arsenal. This reflects a preference for less-invasive procedures, with shorter downtime and a lean towards the ‘less in more’ attitude.
If you’re looking to turn back the clock or enhance your natural beauty, this guide will help you navigate your way around today’s treatment options.
It’s important to read widely and research thoroughly before deciding to undergo any kind of cosmetic enhancement treatment, even if it doesn’t involve surgery. Make sure it’s for the right reasons and not in the impossible pursuit of perfection.
Whether it’s non-surgical skin tightening, anti-wrinkle injections or dermal fillers, the modern approach to cosmetic enhancement involves tailoring a procedure or combination of procedures to each patient’s individual requirements and goals.
Non-Surgical Skin Tightening
Non-surgical skin tightening treatments are becoming increasingly popular for those who want to combat the signs of ageing without going under the knife.
While a facelift is still considered the gold standard in tightening and lifting sagging, crepey skin, many may not be ready either psychologically or physically for such invasive surgery, or simply want to involve the costs and risks associated with surgery.
For suitable candidates presenting with a small to moderate degree of skin laxity, non-surgical skin tightening modalities can offer an effective, natural-looking improvement and postpone or even negate the need for surgical procedures.
Non-surgical skin tightening typically involves minimal discomfort and downtime, meaning you can continue with your daily routine as quickly as possible after treatment.
These modalities utilise radiofrequency, ultrasound or infra red energy to target deeper levels of the dermis and induce new collagen formation and remodelling. This improves skin texture and reduces sagging skin, as well as offering subtle contouring of the jaw line and softening wrinkles around the mouth, eyes and forehead.
Skin tightening devices typically use radiofrequency or ultrasound technology to target the skin’s deeper dermis and subcutaneous layers, tightening the underlying tissue structure without damaging the outer layers of skin.
This heating of the skin’s deep dermis and sub-dermal layers damages collagen in a controlled way, causing instant collagen contraction and promoting the body’s own healing mechanisms to produce new collagen over the ensuing months.
It is commonly used to lift the brow and forehead, the under-eye area, cheeks, mid-face, jaw line and neck. This type of treatment is best suited for patients with mild to moderate sagging facial tissues, usually those in their mid-30s to 50s, and can be used on any skin colour. It is not suitable for those with more extensive redundant and loose skin.
Results are typically long lasting, depending on skin condition and severity of facial ageing and usually 1-3 treatments are required. There is a small risk of swelling, redness and mild short-term blistering; however in skilled and experienced hands, these complications can be minimised and most patients experience little or no downtime.
Non-surgical skin tightening modalities are also commonly combined with other treatments, such as anti-wrinkle and filler injections for a comprehensive rejuvenation approach.
Dermal Fillers
The ‘radiant glow’ associated with being young and healthy is often put down to the fullness and smooth, plump contours evident in the upper, lower and mid-face regions. In seeking to restore this glow, practitioners often call on one or more of a variety of dermal fillers that can be injected under the skin to smooth and fill deep folds and lines.
Dermal fillers are gel-like substances injected into these areas to plump out wrinkles and smooth the face. They are also used to restore volume to the face where tissue has degenerated with age, or where lipoatrophy (fat loss triggered by disease) has caused the cheeks to collapse.
Fillers can also be used to fill pockmarks and acne scars, contour or reshape facial features, add volume to lips and cheeks, and as an adjunct to botulinum toxin injections for a cumulative and complementary result.
More permanent fillers can even be used to reshape the nose and jaw line, to create a more balanced and harmonious face shape.
There is a multitude of different fillers on the market that range in longevity, composition and viscosity, and this can be quite confusing.
While a cosmetic doctor is the best person to advise on the most suitable filler for specific needs, it’s important to educate yourself before the consultation. This will ensure you feel more comfortable and confident when it comes to discussing options.
Anti-Wrinkle Injections
Anti-wrinkle injections are an effective non-surgical alternative for reducing lines such as frown lines and wrinkles, to rejuvenate the face and help reverse an aged appearance.
As a muscle relaxant, botulinum toxin is commonly used to treat frown lines between the eyebrows (glabellar lines) and the worry lines across the forehead, as well as crow’s feet around the eyes. In addition, it can be used to produce the effect of a brow lift by relaxing the muscles that drag down the brow and can even sculpt the jaw or create the look of a lip lift.
A few tiny injections are administered into the correct muscles just under the skin, reducing nerve stimulation to the targeted muscles.
The procedure takes about 10 minutes with only slight discomfort during treatment for most people.
The effects are not obvious immediately after treatment. Over the next few days, the muscles start to relax and it often takes around five days for results to become visible, normally reaching their full results by two weeks. For example, after treatment for lines on the forehead patients are physically unable to frown, preventing the dynamic wrinkles that are usually present.
Anti-wrinkle injections are gradually resorbed by the body over time, so repeat injections are necessary about every three to five months in order to maintain results. With continued use, the effects may start to last longer because the targeted muscles have ‘unlearned’ the response that originally contributed to the development of the lines.
Platelet Rich Plasma
Platelet Rich Plasma (PRP) therapy can be used to treat overall loss of volume in the face and an ageing complexion. A PRP treatment involves the use of your own blood plasma to rejuvenate a tired complexion. Platelet Rich Plasma contains certain growth factors that are central to tissue regeneration and repair, and also take part in stimulating new blood vessel formation and connective tissue (collagen and elastin) repair.
The treatment involves several injections of 10 to 20ml of your own plasma, which is taken via a blood sample and centrifuged to separate and concentrate the platelets from the blood.
The whole treatment takes approximately one hour, with results taking about three months to appear.
Skin Needling
Skin needling is a treatment used to improve the appearance of wrinkles, scars, stretch marks and skin texture by creating tiny punctures in the skin to stimulate the skin’s natural healing response. It is usually performed using a roller embedded with very fine needles that make multiple pinpoint puncture wounds in the dermis, stimulating the production of new collagen and elastin.
The dermal damage created leaves the epidermis primarily intact; so the healing period is rapid. A topical anaesthetic cream is usually applied before the procedure so there should be little, if any, discomfort.
After treatment, the skin is usually red and swollen for around one to two days, with a light graze-like scabbing effect forming over the treated area. Most patients are able to return to work and normal activities within 48 hours of treatment.
A series is recommended for noticeable improvement in the appearance of lines and scars. Treatment effects are cumulative and can be seen six to eight weeks after the initial treatment.
In comparison to the prolonged recovery time required by laser resurfacing and chemical peels, the short recovery period makes skin needling an effective alternative method for improving lines and scars.
Modified skin needling rollers that do not require anaesthetic cream or recovery time are also available for home use, to extend the effects of a professional treatment.
Skin needling can also be used to help deliver other products containing active ingredients to cells in the dermal layer of the skin. As well as this, it is suitable to treat sensitive areas such as the neck, backs of the hands and under the eyes, and can used on all skin types.
Micro And Hydradermabrasion
With age, the rate at which our skin expunges dead cells slows down dramatically, which leads to a build-up of hardened cells on the top layer of the skin. Microdermabrasion removes the outer layer of the corneum stratum (outermost layer of the skin) to aid this process, improving the appearance of fine lines, sun damage and scars, and creating a more even tone and texture of the skin.
Generally the procedure is carried out via jets that blast fine crystal particles onto the face to dislodge hardened skin cells, although a wand can also be used on the skin’s surface to create the same effect. A handpiece is used to vacuum up the stripping agent and skin particles during and after treatment.
Traditional microdermabrasion treatment is generally well tolerated and can be compared to a more intense exfoliation. After treatment, the skin can feel hot and appear slightly red, but this usually settles over a few hours.
Hydradermabrasion is a newer technique of microdermabrasion, combining water and oxygen to remove impurities from the pores and maximise blood flow to the skin.
HydraFacial is the most well-known type. This gentle in-clinic treatment is a step up from your standard facial and microdermabrasion.
What makes this treatment stand out is its special combination of exfoliation, acid peel, extractions and antioxidant infusions (including hyaluronic acid), to thoroughly cleanse, nourish and brighten the complexion. After just one treatment, skin feels clean, smooth and hydrated, with a refined texture and smoother, clearer complexion.
Peels
Peels are solutions applied to the surface of the skin to strip away the outermost layers, revealing the fresh new skin beneath. Used to treat a variety of skin conditions, peels can improve problems from dryness or skin dullness to acne, rosacea and pigmentation. Ingredients range from naturally occurring chemicals and herbal extracts to synthetic chemicals, and their effects range from mildly brightening to aggressive resurfacing.
Depending on the strength, peels can be administered by dermatologists, cosmetic practitioners and skincare professionals, and are usually recommended as a course of treatments.
Peels are now so refined, the classification is no longer just light, medium or deep. There are peels specifically to treat every different skin complaint and skin type.
Natural Peels
Alpha hydroxy acid (AHA) peels are the mildest option, available in salon treatments and can be used on most skin types. They use lactic, fruit or glycolic acids to treat dryness and improve skin texture.
Beta hydroxy acid (BHA) peels use salicylic acid to speed the skin cell shedding process and improve blemished skin.
Chemical Peels
Chemical peels are higher strength solutions that use different grades of acid to strip the skin of dead skin cells and promote the production of collagen and elastin in the skin. These chemicals – ranging from alpha hydroxy, kojic and salicylic acids to trichloroacetic acid and phenol – also vary in their depth of penetration, causing them to directly target specific concerns. Typically, the stronger the strength of the peel, the deeper the penetration and the more severe the post-treatment side effects.
The treatments usually cause stinging during application and various degrees of flaking after treatment as the new layers of skin start to form. Chemical peels can be quite aggressive, so skin analysis during consultation is required to decide which peel is most suitable and whether any allergic reactions will occur.
Dryness, redness and peeling, which feels similar to sunburn, can be expected for up to a week after most peels. It is imperative the peeling skin is not picked at or rubbed, as it may cause scarring. Makeup may be worn to cover this, depending on the practitioner’s instructions.
Using an unscented moisturiser can help relieve the tight sensation of treated skin, and a mild topical steroid cream or ointment can be used to soothe temporary swelling or redness. Sunscreen should be worn at all times while outside.
Lasers & IPL
Laser is an acronym for Light Amplification for the Stimulated Emission of Radiation and is used in the aesthetics industry for an array of treatments, ranging from the correction of skin irregularities, pigmentation and wrinkles to permanent hair reduction.
Pulsed-light machines and lasers basically work in the same way. Put simply, a wavelength is selected that is readily absorbed by the target tissue. Both aim to heat the target to a temperature high enough to destroy it without damaging the adjacent normal tissue.
What’s the difference?
The difference between the two is that a laser emits a single frequency of light that is coherent. This means all the light waves are travelling in the same direction, allowing the target tissue to absorb the maximum amount of heat.
The target tissue is all-important when treating skin problems with a laser. The target tissue for pigmentation is melanin, for spider veins it is blood and for wrinkles it is water. Each of these target tissues absorbs a different wavelength of light, meaning a different laser is needed for each specific problem.
Unlike lasers, IPL devices produce a broad spectrum of light in a range of wavelengths. While IPL can be used for many different types of skin concerns, such as pigmentation and sun damage, it is not specifically designed to treat any of these conditions.
In other words, lasers tend to be very specific to the conditions they treat, whereas IPL devices are more generalist in their offering.
Intense pulsed light uses light wavelengths that target either melanin or haemoglobin in the skin.
It can be utilised to permanently reduce unwanted hair, fade brown spots and cauterise enlarged or broken capillaries and port wine stain birthmarks. Some treatments have been developed specifically to treat rosacea.
The advent of fractionated laser – where microscopic columns of skin are treated while surrounding skin is left intact – made it possible to achieve results comparable to traditional CO2 laser resurfacing (which aims to take up to 10 years off your appearance) with fewer side effects and significantly less downtime.
Fractional laser technologies break up light beams to allow columns of untreated tissue to activate healing mechanisms beneath the skin’s surface, treating skin conditions ranging from scars and birthmarks to wrinkles.
These lasers work by creating microscopic thermal injuries that trigger collagen production, stimulating cell renewal and plumping out the tissues. The anti-ageing benefits of fractional laser technology include improving evenness of skin tone and texture, reducing pore size and the appearance of lines and wrinkles, and helping to reverse the effects of sun damage.
A more mild treatment may take several sessions, while one procedure is usually sufficient for a more aggressive treatment.
Another difference between laser and IPL is the size of the area that can be treated in one session. Generally IPL treatment heads are much larger than the small spot size produced by lasers, which means treatments are quicker, but not as targeted as laser and typically require more treatments.
What’s right for me?
When it comes to choosing between laser and IPL, it’s important to keep in mind that what works best for one person isn’t necessarily what works best for the next. An experienced practitioner will advise you what is most suited to your specific needs, and should offer a variety of treatment options to select from (including both IPL and laser devices).
It is also important to be aware that IPL systems are available in different strengths and vary in how high the energies can be set. Many IPLs in the non-medical marketplace are not capable of reaching energies necessary to treat certain conditions adequately and may even lead to burns and other avoidable complications. So always ensure you are in the hands of an experienced and accredited practitioner in a medical-based clinic.
IPL is most commonly used for:
- Superficial pigmentation, such as age spots and freckles
- Lightening and reducing redness, rosacea and spider veins
- Overall skin rejuvenation for mild to moderate sun-damaged skin
- Hair removal
Laser is most commonly used for:
- Pigmentation, including melasma
- Tattoo removal
- Acne and surgical scars
- Improving skin texture, pore size and skin firmness
- Rosacea and broken capillaries, port wine birthmarks
- Wrinkles
- Hair removal
Cosmeceuticals
The term ‘cosmeceuticals’ refers to a class of cosmetic products with pharmaceutical benefits. Cosmeceuticals are topical skincare formulations containing active ingredients, which enable them to act on the skin’s cellular structure. In some cases such as exfoliants, this action is limited to the surface of the skin, while other formulations can penetrate to the cellular level and enhance or inhibit natural activities.
Cosmeceutical products are commonly used at home and incorporated into a regular skincare regimen. They can help alleviate the symptoms of ageing such as fine lines, pigmentation, skin tone and texture. Components to look for in cosmeceutical products include antioxidants, cell-communicating ingredients, exfoliants, skin-lightening constituents and intercellular substances (that mimic skin structure). For the products to work, these need to be at sufficient concentrations and synergies to allow them to retain their active properties.
For example, antioxidants reduce free-radical damage and inflammation, counteracting cellular damage, collagen destruction and immune suppression.
Studies suggest antioxidants in combination can exert a cumulative synergistic action on the skin that is more effective than single-ingredient formulations.
Cell-communicating ingredients use receptor sites or cellular pathways to interact with skin cells to signal them to function optimally. Retinoids, which are derivatives of Vitamin A, are the best known. They act as antioxidants and neutralise ‘free radicals’ that result from exposure to ultraviolet light. In addition, they increase cellular turnover, stimulate a thickening of the epidermis and promote the removal of excess pigment.
Exfoliants encourage surface skin cells to shed, mimicking the function of young skin and increasing collagen production. Exfoliant ingredients include alphahydroxy acids (AHAs) such as glycolic and lactic acid, polyhydroxy acids (PHAs) such as gluconolactone and lactobionic acid, and beta hydroxyacids (BHAs) such as salicylic acid.
Intercellular substances are ingredients that exist naturally in skin and can be depleted by health, ageing and environmental factors. Ingredients such as ceramides, cholesterol, fatty acids and glycosaminoglycans are key to skin function and should be included in moisturisers if they are to be effective in promoting skin functionality.
Hyaluronic acid is known to hydrate and moisturise the skin from the inside, helping to smooth out wrinkles. [A]A
