Sun damage, collagen loss, changes in bone structure, thinning of the skin and shifts in facial fat all occur gradually over time. The key to successful outcomes is understanding exactly which changes have taken place and treating them anatomically rather than chasing lines and trying to create big cheeks or lips, explains Dr Jack.
Sometimes filler makes sense
This may surprise you, but filler is a good option for someone in their 70s, argues Dr Jack. But not in the way we are used to seeing it – as a means to plump lips or cheeks.
“It is often the starting point – I generally call this my ‘deep plane’ filler approach. Small amounts of dermal filler placed directly on to the bone can replace age-related bone volume loss and restore facial support without creating the overfilled appearance people worry about, since the volume isn’t being placed superficially in the fat pads of the face,” he says.
“The aim is never to make someone look younger than they are but to help them look like a healthier, better-rested version of themselves,” he explains.
Improving skin quality matters most
Whether or not filler is an option, improving skin quality is where one will get the most satisfaction. “For patients in their 70s, I am often more comfortable using slightly more advanced laser treatments (such as UltraClear Lift) than I would be in a much younger patient, because they have significantly more collagen loss and photodamage to treat.
“I often combine this with injectable biostimulation treatments such as polynucleotides [the viral salmon DNA injectable that prompts natural collagen production gradually post-treatment], or Julaine, an injectable that can help with hollowing [its basis is poly-L-lactic acid, a synthetic biodegradable polymer that stimulates the skin cells to switch on more collagen production], which can enhance the effects of lasers.
“Fractional laser treatments, particularly when combined with injectable biostimulators, stimulate new collagen production, improve elasticity, soften lines, reduce pigmentation and significantly improve overall skin texture as well as tightening the skin over time.”