Non-Surgical Face Fixers

These days, maintaining 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 non-surgical 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, this guide will help you navigate your way around the number of treatment options available – which can be an overwhelming task.

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. It’s not about just looking ‘young’; it’s about looking and feeling your best at any age. With apologies to Coco Chanel, nature gives you the face you have at 20, and it is up to you to merit the face you have at 50.

Whether it’s non-surgical skin tightening, anti-wrinkle injections or 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 anti-ageing 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. 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 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.

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 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 only one treatment is 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.

Ultraformer III is one of the latest offerings in this space, using high intensity focused ultrasound to heat tissues under the skin at specific depths. This results in a tighter and more re ned jaw line.

Non-surgical skin tightening modalities are also commonly combined with other treatments for a more holistic approach to rejuvenating an ageing face.

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 differentfillers 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 con dent 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 appearance of the face and help reverse a prematurely 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.

A few tiny injections are administered into the correct muscles just under the skin, reducing nerve stimulation to the targeted muscles. The procedure usually takes about 10 minutes, but this can vary depending on the number of areas being treated.

The effects are not obvious immediately after treatment and, over the next few days, the muscles remain in a relaxed state, and it often takes around three to four days for nal results to become visible, normally reaching their full results by one week. For example, after treatment for lines on the forehead patients are physically unable to frown, preventing the dynamic wrinkles that are usually present.

It is important to note that anti-wrinkle injections are gradually reabsorbed by the body over time; so repeat injections are necessary about every three to ve 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. Regen PRP and EmCyte PRP, which both use your own blood to regenerate your skin, are our top picks in this space.

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 ne 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 and there is no risk of permanent structural damage, sun sensitivity, skin colour loss or hyper-pigmentation. There is usually minimal discomfort and local anaesthetic cream is usually applied before the procedure.

After treatment, the skin is red and swollen for around one to two days, with a light graze-like scabbing effect forming over the treated area on day two of recovery. Most patients are able to return to work and normal activities within 48 hours of treatment.

Multiple treatments are usually necessary to achieve significant improvement in the appearance and depth 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 be safely carried out on all skin types and colours.

Microdermabrasion

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 ne lines, sun damage and scars, and creating a more even tone and texture on the skin.

There are a number of different types of microdermabrasion. Generally the procedure is carried out via jets that blast ne 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.

Crystal dermabrasion works by blasting the skin with microscopic crystal particles; diamond microdermabrasion uses a diamond head to lightly abrade the skin’s surface; and organic microdermabrasion uses medical-grade baking soda or milled grains that are gentler than crystals and more suitable for sensitive skins. A handpiece is used to vacuum up the stripping agent and skin particles during and after treatment.

The treatment is generally well tolerated and can be compared to a more intense exfoliation. Some microdermabrasion treatments are accompanied by oxygen therapy designed to enhance the results of the procedure. After treatment, the skin can feel hot and appear slightly red, but this usually settles over a few hours.

It’s generally recommended that a course of six treatments is carried out to improve problems such as age spots; but it can also be effective to treat blocked pores and blemishes with two to three treatments.

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 recommended as a course of treatments.

Sydney dermatologist Dr Phillip Artemi says, “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 aking after treatment – from ne aking to sheeting, 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.

Laser & IPL

Laser is an acronym for Light Amplification for the Stimulated Emission of Radiation and is used in the beauty industry for an array of treatments, ranging from the correction of skin irregularities, pigmentation and wrinkles to air 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 growth, 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 bene ts 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 suf cient for a more aggressive treatment.

PicoSure is one of the latest advances in laser skin treatment, using picosecond technology to remove unwanted pigment, wrinkles and acne scarring. Unlike lasers in the past, this is a more comfortable treatment with less downtime.

Another difference between laser and IPL is the size of the area that can be treated in one session. Generally IPL treatment heads are up to eight times larger than the small spot size produced by lasers; so 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.

The newest IPL addition to the Australian market is Lumecca, which is more refined in its ability to target different skin conditions.

Cosmeceuticals

The term ‘cosmeceuticals’ refers to a class of cosmetic products with pharmaceutical bene ts. 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 ne 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 in ammation, 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.

Synergie Skin, an Australian made skincare range, Teoxane Cosmeceuticals, made by Teoxane Laboratories in Switzerland and mesoestetic, distributed by Advanced Cosmeceuticals are some of the latest powerhouse skincare brands renowned for delivering healthier, more youthful looking skin. CBM