Defying Gravity

Picture this. A woman stands in front of the mirror, looks at herself for a few seconds, and then, using both hands, pulls back the skin on either side of her face to make it look taut and… well, more youthful.

Sound familiar? Well you’re not alone. As all of us face the inevitable process of ageing, it’s only natural that we start thinking about ways to address the laxity in our skin.

“Over time, we start to lose volume in certain areas of our face and the collagen and elastin in the skin,” explains Suzie Hoitink, Founder of Clear Complexions. “This leads to a domino effect of gradual sagging and less definition.”

Where once surgery was the only option to remove excess skin, there are now some remarkable treatments available to stimulate deep collagen, tighten the skin and restore lost volume. Here we look at two options:

Thermage®

This popular non-surgical treatment has many celebrity fans, including Oprah Winfrey and Gwyneth Paltrow, who after a session proclaimed, “I feel like it took five years off my face.”

Thermage® is a clinically proven radiofrequency treatment that can improve the appearance of sagging or loose skin1. Its popularity is due to the fact that it yields results in just one treatment with little to no downtime.

The results typically manifest between six to twelve months after treatment and although the effects of Thermage® aren’t permanent, they last for two to four years—sometimes even longer.

So how does Thermage® work?

The Thermage CPT system heats the skin at a depth of around 3mm, in the deeper levels of the skin to kick-start the body’s own natural renewal processes2. This is where the structural collagen, or ‘scaffolding’, is produced. When we are young, we have plenty of this type of collagen to provide support and strength for our skin. With age, and an unhealthy dose of UV exposure over the years, we lose this collagen and our skin becomes more lax and crepey, resulting in jowls, deep lines and thinner skin.

By gently heating your skin, Thermage® tightens and contracts your existing collagen and stimulates the production of new collagen, resulting in more gradual tightening over a period of time. This is why you tend to see the best results a few months after your session.

Thermage® is often used to treat the whole face and jaw line to tighten the skin on the cheeks, reduce the nasolabial folds (between the nose and the mouth), and to tighten and lift skin along the jaw line, define the lip and improve the appearance of fine lines and wrinkles.

It can also address other areas of the body.

By gently heating your skin, Thermage® tightens and contracts your existing collagen and stimulates the production of new collagen.

Eyelid Thermage® uses a different tip to lift the eyebrows and reduce hooding to make the eyes appear more open. Thermage® can also be used to reduce the “turkey neck” sagging skin on the neck and chest, the back of hands and to help contour loose skin and smooth bulges on the body, in particular, the arms and stomach.

In terms of what’s involved, recipients usually feel a brief sensation of heat each time the Thermage is pulsed. But the Thermage device monitors the surface temperature of your skin and applies a cooling cryogen spray, which is delivered before, during, and after the application of heat. Makeup can be applied immediately after your treatment session and you can return to your normal activities straight away.

This treatment works well for clients who are aged between 35-60 years and in general good health. But as with all medical procedures, a thorough consultation is advised beforehand to assess your suitability.

Fillers

Twenty years ago, if you wanted to get rid of sagging skin, there was basically one way to do it—going under the knife for a face-lift. But today’s advanced dermal fillers have dramatically changed the game. Skilfully injected by a practitioner who understands both the scientific and aesthetic principles of your face’s natural framework, fillers can provide a mild lifting and contouring of your facial features to provide a subtle rejuvenated effect.3 The key is finding a practitioner who can give you a natural, youthful looking result, so that you don’t look overdone and obviously “worked on”.

So how do dermal fillers work?

As we age, we lose fat and bone in many areas of our face. When the cheeks lose volume, the skin can sag, leading to the formation of nasolabial folds (the folds from the corners of the nose to the mouth), oral commissures (the folds just beneath the corners of the mouth), and jowls (the skin beneath the jawline). The result is a flatter and square appearance to the face. When volume is lost in the brows, it can expose the upper orbital rim, giving the face a more skeletal appearance. And loss of volume in and around the lips leads to thinner lips with less definition of the ‘cupids bow’.

Not exactly comforting. The aim with dermal fillers is to re-volumise the key areas where the skin’s natural collagen, fat and bone has been lost to create the structure, tone and firmness of a more youthful appearance.

Depending on your area of concern, you can treat on specific area such as nasolabial folds, cheek depressions, receding lips and even sagging hands or treat multiple areas at a time.

If placed by a skilled practitioner, even a small amount of filler can be incredibly effective. With thinning lips for example, a very soft filler is used to enhance the body and borders of the lips resulting in a slight increase to volume, decrease in the lines around the lips (no more lipstick bleed), a more youthful and upturned angle to the corners of the mouth and a defined cupid’s bow.

Nasolabial folds that appear as deep lines from the nose to the corners of our mouth, are usually the result of flattened cheeks. So rather than inject the fold, which would create an unnatural, plumped out look, restoring volume to the cheeks can achieve a natural lifting effect, resulting in diminished lines and a smoother contour of the face.4

Of course every person’s facial structure is completely different, so an in-depth consultation is essential to ensure that you are suited to the treatment and to talk you through the most effective approach.

In terms of down time, it is minimal but very much depends on the individual. The procedure takes between 15-30 minutes, and in some instances, a numbing cream or topical analgesia will be used to help numb the area. There may be some minor swelling and mild bruising after the procedure, but movement and sensation are unaffected and the results are instant and last for between 12–18 months.

So if you are spending a lot more time in front of the mirror, talk to an experienced practitioner about your options. Thermage® or dermal filler might be an option for you. 


1. Dierickx, C. (2006). The Role of Deep Heating for Noninvasive Skin Rejuvenation. Lasers in Surgery and Medicine, 38: 799–807.
2. Sukal, S. et al. (2008). Thermage: the nonablative radiofrequency for rejuvenation. Clinics in Dermatology, 26: 602–607.
3. Carruthers, J. et al. (2008). Advances in facial rejuvenation: Botulinum toxin Type A, Hyaluronic acid dermal fillers and combination therapies-Consensus recommendations. Advances in Facial Rejuvenation, 121:(5S-30S).
4. Pinsky, M. et al. (2008). Juvéderm Injectable Gel: A Multicenter, Double-Blind, Randomized Study of Safety and Effectiveness. Aesthetic Surgery Journal, 28: 17–23