Ask the Dermatologist: ‘I’m 45 and my face is sagging. How do I tighten my face?’

MEET THE EXPERT

Professor Caitriona Ryan, consultant dermatologist, co-founder of The Institute of Dermatologists and an Associate Clinical Professor at University College Dublin.

You’re not alone! Sagging skin is something all of us notice as we age, as our collagen and elastin decline. With the onset of menopause, there is a rapid decline in collagen production, with a 30% reduction in the collagen content of skin during the first five years, and then approximately 2% per year going forward. The great news is that there are now fantastic, non-surgical ways to lift and tighten skin that are both effective and minimally invasive.

The best treatments to tighten the skin are those that dramatically increase collagen production within the skin – particularly CO2 resurfacing, radiofrequency microneedling, Ultherapy, polynucleotide injections and Sculptra, the collagen-stimulating dermal filler.

My absolute favourite powerhouse treatment to aggressively tighten lax skin and reduce lines and wrinkles is the Secret Pro combination treatment of CO2 fractionated laser and radiofrequency microneedling. The CO2 greatly increases collagen production and resurfaces the epidermis while radiofrequency microneedling stimulates deep dermal collagen production and tightens the skin. It is the ultimate treatment for full skin rejuvenation to tighten but it is intense and comes with the price of downtime, with significant swelling and scaling for approximately five to seven days.

Deep ultrasound therapy with Ultherapy can also help tighten the lower face and neck through collagen production. Ultherapy is a non-invasive, focused ultrasound treatment that stimulates the production of new collagen and elastin in the deep structural layers of the skin without disrupting the skin’s surface, to lift the skin of the upper and lower face, the neck, under the chin, the eyebrows and reduce wrinkles of the décolletage and chest. This is incredibly popular in our clinic for women in their 40s and older.

Polynucleotide treatments have become incredibly popular in our clinic for their effectiveness in facial rejuvenation with minimal downtime. Polynucleotides, natural DNA polymers, are advanced bio-stimulating agents that promote fibroblast activity, collagen and elastin production, to help improve the texture and tone of the skin, provide intense hydration and reduce inflammatory activity to help promote overall skin rejuvenation. This produces a plumping and tightening effect on the treated area. The skin is rejuvenated and rehydrated and wrinkles are reduced resulting in a healthy, regenerated glowing complexion that looks smoother and more youthful. In our Institute, we use three different forms of Philart polynucleotides for different cosmetic concerns. Philart Next combines low molecular weight hyaluronic and polynucleotides to help promote overall skin rejuvenation. PhilArt Eye is a concentrated polynucleotide treatment to tighten skin around the eyes, while PhilArt high concentration polynucleotide is used for targeted intense production of collagen – great for wrinkled skin around the mouth and neck and to treat acne scarring. Typically a course of three treatments are needed, two to four weeks apart.

Strategically placed subtle dermal fillers can help restore volume and reverse the structural changes in the ageing face. Sculptra is my favourite filler to tighten the skin. It is a biostimulating dermal filler which enhances collagen production throughout the face while gently restoring volume to tighten and strengthen the skin and underlying tissues. It is the only filler I use in my own face as I am so wary of the over-filled look that can occur after years of hyaluronic acid fillers.

While in-clinic treatments are powerful, don’t underestimate the role of at-home care. A skincare regimen targeted to cater to mature skin can combat the changes in skin texture, tightness and tone seen with menopause while building collagen. This should include a physical zinc-containing sunblock, a topical retinoid at night, topical vitamin C or antioxidants, peptides, and moisturisers or serums with a high content of hyaluronic acid and ceramides. After sunblock, I still believe that retinoids are king! Retinoids should be the cornerstone of every perimenopausal skincare regimen and are the most effective at increasing collagen production. My absolute favourite retinoid is Skinbetter Alpharet Overnight Cream. This has been shown to be as powerful in its effects as prescription strength tretinoin, but with minimal irritancy because it is formulated with hyaluronic acid, niacinamide, antioxidants, and hydrating ingredients, making it perfect for mature or sensitive skin.

It is also important to nourish your skin from the inside out! Oral hydrolysed marine collagen is another great option to consider. I recommend at least 5mg per day of oral marine collagen to my cosmetic patients; multiple randomised-controlled trials have shown that hydrolysed collagen supplementation improves skin hydration, elasticity, and reduces wrinkles. Marine collagen has shown superior efficacy and I recommend at least 5g of marine collagen per day for optimal results.

All of these options are available at the Institute of Dermatologists, where we’ll help guide you toward a solution that fits your skin and goals. With the right combination of treatments and a tailored skincare routine, you’ll notice that subtle lift and glow that can be so confidence-boosting!

To make a booking at The Cosmetic Suite at The Institute of Dermatologists, call 01 912 3030 or email info@instituteofdermatologists.ie. See The Institute of Dermatologists website for more information.