Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Non-surgical facial rejuvenation is a phrase that describes cosmetic treatment that addresses of all the aspects of the ageing process without surgical methods. By addressing all aspects of the ageing process, a more complete result can be achieved when rejuvenating the face. The effects of ageing on the face include;
- loss of facial volume
- skin sag
- expression line formation &
- general skin deterioration, including;
These issues can be addressed by using mostly non-surgical techniques. The most common procedures performed for facial rejuvenation are anti-wrinkle injections, dermal filler and laser skin treatments.
Treatment of skin sag or laxity
Skin tends to lose its elasticity, and become more lax with time. Traditionally, this problem has been addressed with surgical procedures such as face lifting, brow lifting, or eyelid reduction surgery. However, facial skin sag, can also be addressed non-surgically;
- Dermal fillers can be used to lift the face and skin through strategic placement in the face. They can also help to smooth the transition from one facial area to another. For example, by filling the under eye hollows (or tear
troughs), the transition from the lower eyelid to the cheek is
streamlined. Smoothing facial transitions results in a more
aesthetically pleasing and refreshed appearance, and hides the effect of gravity on the skin.
- The carbon dioxide laser can be used to help tighten the skin. The heat energy imparted on the skin by this laser causes contraction of the collagen fibres, which leads to skin tightening or skin ‘shrinkage’. This is particularly evident in the eyelid skin (upper and lower), where an improvement in upper eyelid droop, and a general tightening of the lower eyelid is seen after treatment. The results, although not as significant the tightening achieved from surgery, have the added benefit of removing surface imperfections such as fine lines and brown marks, and may be better suited to those who want to avoid surgery.
- Pelleve – is a non-invasive, no downtime treatment that is used for skin tightening. It uses radiofrequency energy to heat the skin to a temperature between 39 and 42 degrees celsius. This helps to shrink skin collagen become tighter.
Treatment of facial volume loss
Loss of facial volume is one of the first signs of ageing, and can occur in areas such as the cheeks, around the eyes, brows, and lips. Replacement of facial volume can be achieved with the use of dermal fillers. Using dermal fillers, it is possible to replace the volume that has naturally been lost with time.
Dermal fillers can also be used to enhance and balance particular areas of the face, for example, it can be used to make a chin more prominent to make it balance better with the rest of the face.
For those requiring larger amounts of volume replacement, or for those looking for a more permanent result, fat transfer is an option. This involves liposuction of an area on the body, such as the inner thighs or abdomen, and transferring this fat to the face to replace any lost volume there. It is more involved than simply having some dermal fillers, and it usually causes more bruising and swelling on the face. It may be suited to those who want to improve facial volume, and were going to have liposuction anyway.
Treatment of expression lines
Expression lines are another part of the ageing process that can be addressed non-surgically. They are the result of contraction of the muscles of facial expression. With time, these can cause etching of lines in the skin, such as frown lines or crows feet. These are simply addressed with anti-wrinkle injections, which help to reduce excessive muscle activity and skin wrinkling.
For more information on anti-wrinkle injections, click here.
Treatment of the skin surface
Finally, the effects of cumulative UV exposure on the skin surface can lead to skin wrinkling, the formation of brown spots, and the appearance of broken capillaries.
Surface wrinkles on the skin that are etched in, ie they are present even at rest, are usually best treated with skin resurfacing. This is most commonly done with lasers such as the carbon dioxide laser or the erbium laser. These lasers actually ablate (vaporise) a very fine layer of the skin surface, allowing the skin to regenerate with fewer wrinkles. There is usually a week or two of recovery time, depending on the intensity of the treatment. The carbon dioxide laser also improves brown spots and general skin texture / tone.
Skin wrinkles can also be treated with less invasive methods, such as medical grade skin care (including topical retinoids) or other lasers such as the Medlite laser. As a rule, the more invasive a treatment, the greater the downtime, and the greater the results. Therefore, lasers such as the carbon dioxide laser, which produce the most profound changes in skin, take the longest time to recover from.
Carbon dioxide and erbium lasers are classified as ablative lasers as they remove a layer of skin. However, lasers such as the Medlite laser, Ruby laser and Gemini laser are non-ablative lasers as they do not remove skin layers, but instead target a certain problem in the skin such as broken capillaries or brown spots, without removing skin. Each of these lasers have a specific attraction to a certain colour in the skin. For example, the Gemini laser at 532 nanometres is attracted to the haemoglobin (red) in broken capillaries. This allows the laser to hone in on the broken capillaries, and shut them down, whilst leaving normal skin intact.
Another example of this is the Medlite and Ruby lasers. These laser can be attracted to melanin (brown) in skin. Brown spots have an excess amount of melanin, and therefore these lasers can help to remove the brown spots in the skin as they are more attracted to the brown spots in the skin rather than the normal skin. This allows for specific removal of brown spots in the skin.
The Fraxel laser 1927nm wavelength is also an excellent laser treatment to improve skin tone and texture, whilst minimising recovery time.
Case Study - non-surgical facial rejuvenation
This fit and healthy 57 year old female presented to Victorian Cosmetic Institute for total facial rejuvenation. There is one month between the before and after photo shown below.
This patient had significant potential to achieve an excellent cosmetic outcome with non-surgical procedures. She required treatments to reverse all aspects of the ageing process including facial volume loss, expression lines, and the effects of gravity and UV radiation on her skin. Also having never had cosmetic procedures previously, she was a good blank canvas to work on. The patient was given realistic expectations by us and with her easygoing nature, she was willing to go through with what was suggested. Firstly laser skin resurfacing was performed, followed by anti-wrinkle injections, and then dermal fillers. The laser skin resurfacing was complicated by a staphylococcal infection that resolved with oral antibiotics, and may account for some of the persistent redness seen in the photos which were taken about 1 month after the laser resurfacing. The anti-wrinkle injections and filler treatments were uncomplicated with no side effects and minimal bruising. The results achieved so far have certainly surpassed both our expectations and the patient’s, showing that non-surgical cosmetic procedures can sometimes achieve results that surgery alone cannot match.
The patient’s goals were;
- To improve the general quality of skin
- To achieve a general reduction in her facial wrinkles.
- To remove a few benign lesions from face (non-pigmented naevi/moles)
- To reduce expression lines, in particular her frown and forehead lines
- To replace lost facial volume. She feels her face has lost volume over the past few years, and her cheeks are less full than before
- and to avoid cosmetic surgery
To achieve her goals we performed the following treatments;
- Combined carbon dioxide (CO2) and erbium laser resurfacing of the full face – This was done under light sedation and local anaesthesic injections. Firstly treated her face using the Lumenis Ultrapulse CO2 laser. This laser has two handpieces, namely the Active Fx, and the Deep Fx. Both handpieces were used on this patient to achieve the best results. The Active Fx treats a larger percentage of the skin’s surface, but does not penetrate very deep into the skin. It is good for fine surface wrinkles, skin contraction/tightening, pigmentation treatment, and skin texture. The Deep Fx conversely, treats a very low percentage of the skin’s surface, but penetrates much deeper than the Active Fx to achieve deep tissue tightening, deep wrinkle reduction, and acne scar reduction (if applicable).
- Anti-wrinkle injections – were administered to the forehead, frown, crows feet, upper lip, and lower face to help reduce excessive contractions of muscles that lead to wrinkling.
- Dermal fillers (Liquid Facelift) – were administered to enhance cheek volume, enhance lip volume, to enhance the chin projection and to smooth transition lines (e.g in the tear trough, jowls, nasolabial folds, brow)
Case study 2 - non-surgical facial rejuvenation
This patient in her thirties presented with concerns initially about the pigmentation on her skin from freckles and sun damage. She underwent Fraxel laser treatment and Gemini laser treatment for her pigmentation. The result is show in the second picture. After this, she decided to have treatment with anti-wrinkle injections to her forehead, frown, and crows feet as well as dermal filler treatment to her under eye area.
The result is both pleasing and natural.
Why choose Victorian Cosmetic Institute as your provider of Total Facial Rejuvenation using Liquid Facelift and Laser?
Victorian Cosmetic Institute specialises in non-surgical methods to treat all aspects of the ageing process. By doing so, we achieve optimal results that look natural.
Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate