17th October 2022

The 3 Ds of Facial Ageing: Understanding Ageing Skin

Last Modified: October 27, 2022

Here at Dr Aesthetica, we use Dr Farmah's 3D's of Ageing. We understand that facial ageing is a complex process that involves changes to the bone, soft tissue and skin.

Each of these anatomical layers undergoes its own ageing process, but there is often a combination effect resulting in overall ageing.

As a result, there comes a time when everyone's skin starts to show visible signs of ageing.

The 3D's helps to explain what is happening and why it is happening. More importantly, what you can do about it!

Introducing the Dr Farmah's 3D's

At our medical aesthetics clinic, Dr. Aesthetica, we have developed a system we call the 3Ds of facial ageing: Descent, Deflation, and Deterioration.

We believe that for skin rejuvenation to be successful and natural, it must address multiple Ds; therefore we have devised a specific treatments to address each pathway.

This approach to the treatment of facial ageing achieves attractive, natural-looking results and restores balance and symmetry to facial features (associated with youthfulness).

This can have a substantial positive impact on an individual's self-image.

The First D: Descent

Facial descent is best recognised as sagging skin. Much like an ageing human body becomes soft in places that used to be firm and tight when younger, older facial skin becomes saggy in places where it used to be tight.

Gravity takes its toll on faces, pulling the skin downward and outwards. The body's natural ageing processes increase the likelihood of facial drooping.

The most noticeable sign is the heavy-looking, hanging skin in the form of jowls under the neck, creating a drooping appearance under the cheeks and along the jawline.

The loss of underlying support and weakened skin structure (due to loss of collagen and elastin) causes fat pads to sit lower on the face.

As the skin sags, the wrinkles around the nose and mouth area deepen, giving the face deeper folds than most people.

The lips become thinner and lose fullness, causing them to look more downturned and take on a sad expression.

Over time, a general sense of heaviness settles onto the face.

Remedy for Skin Descent

When it comes to descent the goal is to reverse the sagging, and that means tightening the skin. Skin sagging is essentially caused by the loss of collagen and elastin in the skin.

So to reverse this sagging, you need to stimulate the skin to produce more collagen and elastin.

While there are many treatments that claim to be able to do this, the real litmus test is the ability to stimulate collagen synthesis while causing minimal damage to the skin. Not many treatments can do deliver on this

The Second D: Deflation

Beneath the skin is an intricate support structure consisting of bones, muscles and fat.

The facial bones form the framework for the attachment of overlying soft tissue and provide stability, structure and definition to the face.

Generally, the term "soft tissue" is used to refer to muscle, tendon, fat and/or fascia. Subcutaneous fat is the fat that lies just beneath the skin and is partitioned into different compartments.

For example, the cheeks are divided into three types of fat: medial, middle, and lateral cheek fat while jowl fat describes the deeper subcutaneous fat in the lower third of the face.

All of these different fat pads work together to give the face that "full" look and contour that is often described with terms like attractive and youthful.

The muscles that run along the sides of your face play a dual role: they suspend the facial tissues just beneath the skin and help to support and define the contours of the face.

When we are young, all these components are in an optimal level of balance and harmony. But over time, the fat pads and supportive bony structure, start to shrink, become thinner, more brittle, less firm and more prone to remodelling.

The end result is a loss of volume and a change in the shape of the face as the underlying skin structure loses its support.

The bones and muscles in the face lose their capacity to support the pockets of subcutaneous fat that help define the face shape. This can cause the fat padding to seem like they are caving in on certain areas of the face.

Facial muscles become weak and flabby and pull down the skin in the lower third of your face, resulting in fine lines, skin folds and laxity.

All these changes flatten the cheek and the angles of the face as well as cause the temples to become more hollow.

Other telltale signs include increased visibility of the bony structure under the eye socket and along the upper cheeks, resulting in a hollow, sunken appearance.

The water content of the skin also decreases over time, causing the skin to become unevenly thick, so that some parts become thicker and others thinner.

Remedy for Skin Deflation

Although the most effective way to address facial deflation is to restore the lost volume, care must be taken not to look at the affected area in isolation. A holistic approach that also takes into account the adjacent areas and their impact on the results of treatment is needed. Our Non-Surgical Full Face Lift package includes several treatments, all with one goal in mind: to treat facial deflation as a whole to achieve the most natural result possible.

The Third D: Deterioration

With age, the composition of the skin changes - mainly because the production of key elements such as collagen, elastin and mucopolysaccharides slows down.

The older people get, the more essential elements their skin cells lose. When people are young, they produce more collagen than they do as they age.

Around the age of 25, they begin to produce about one percent less collagen each year.

As they approach the age of 65, they produce just 20 percent of what they produced when they were younger.

As fate would have it, collagen -a key structural protein of the skin that gives it strength and elasticity - is made up of three proteins: proline, which gives it strength, glycine and lysine, which give it elasticity, and hydroxyproline, which gives it water-binding properties.

These three proteins are extremely susceptible to free radical damage from extrinsic factors like cumulative sun exposure (photoageing), smoking and pollution.

Smoking damages skin cells while reducing blood flow to the skin. This lack of blood flow is the cause of the pale, unhealthy appearance of a smoker's complexion.

Pollution can damage the integrity of the skin by creating free radical damage resulting in premature ageing.

But free radical damage to collagen is not the only ageing factor. Some experts argue that elastin contributes to skin deterioration as much as collagen.

Since elastin and collagen are found in the dermis, the middle layer of skin tissue, which is filled with nerve receptors that regulate sensation and muscle receptors that contract muscles, as well as veins that control blood flow, damage to this layer can have a number of adverse effects.

For instance, the skin cells regenerative capabilities are compromised. This makes it hard to revive the skin as dead cells tend to build up-causing a dull, tired look-and the skin becomes more weathered, fragile, and sensitive.

Skin also loses its ability to retain moisture. Blame it on a hyaluronic acid - the primary component in our cells' water-retention properties - which has a half-life of about 24 hours.

As we get older, this period is cut by half, causing our skin cells to lose their ability to retain moisture and giving us a parched look

Skin tone and texture are also affected. That's why ageing skin tends to look thinner, paler, and clear (translucent). Pigmented spots including age spots or "liver spots" may appear in sun-exposed areas.

The blood vessels of the dermis can also become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura), cherry angiomas, and similar conditions.

Sebaceous glands produce less oil as you age. This can make it harder to keep the skin moist, especially in menopausal women resulting in dryness and itchiness.

The list goes on and on. But this isn't meant to depress you.

Remedy for Skin Deterioration

While skin deterioration is a serious concern that can manifest in multiple ways, it's also one that can be addressed with the right approach. The goal is to keep the skin as thick, elastic and hydrated as possible. This is where our 8-Week Skin Transformation Protocol shines the most.

The good news is that our 8-Week Skin Transformation Package incorporates two safe and very effective treatments to stimulate collagen synthesis and tighten skin.

Post Reviewed by: Dr Baldeep Farmah
Medically Reviewed on: 17th October 2022
Dr Baldeep Farmah is the Medical Director and lead Doctor of Dr Aesthetica, a Medical Aesthetic Clinic.

"We want to empower everyone who walks through our clinic doors, to be able to look in the mirror and see a happier, brighter version of themselves."

For everyone that walks through our clinic doors, you may think you are alone, but you are not. Our patients all have a different story to tell but all come from a similar place.
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