Asian Aesthetics, At A Glance
- Best Results1-3 sessions
- Treatment RecoveryImmediate
- Procedure Time30 minutes
- Skin SpecialistDermatologist, Davin Lim
- Duration of Results12- 48+months
- AnaestheticNil required
- Back to WorkSame day
The Asian face has unique anatomical features specific to age & culture. This requires a different approach to facial rejuvenation & enhancement compared to Western counterparts. Dermal fillers can correct volume deficiencies on cheeks, chin, nose & temples. Muscle relaxants can reduce facial width, giving a more V shaped face. With injectables & threads I can reshape most faces for a more harmonious profile.
FactsFacts on Asian Facia Rejuvenation & Contouring
- There are unique cultural & anatomical differences in the Asian face
- Injectables including fillers & muscle relaxants should be employed accordingly
- Facial slimming & filler rhinoplasty are commonly performed procedures
- Medial cheeks fillers can provide support for the undereye area
- Tear troughs can be corrected with dermal fillers or fat transplant
- Lasers can decrease dark circles
How do I approach Asian facial aesthetics?
Aesthetic treatments should be bespoke, addressing not only individual & age associated changes, but also ethnicities. Rejuvenation & enhancement should keep these factors in mind, whilst at the same time respecting cultural anatomical differences.
Read more to find out how I approach injectables & skin treatments across the ages.
What procedures are common for Asian patients in their 20s to 30s?
Younger patients will benefit from procedures that address race associated anatomical deficiencies, whilst at the same time preventing UV associated collagen loss & unwanted pigmentation.
The most frequent area I treat in this age group is the medial cheek & tear trough areas. Dermal fillers can provide support to the lid cheek junction, in turn decreasing shadows that give rise to dark circles.
What procedures are common for Asian patients in their 40s to 50s?
A typical program is to correct, then maintain. This applies to volume, wrinkles, skin quality & skin tone.
Volume replacement is important in this decade as we go through age related changes including reducing of fat, collagen & bone. Conservative use of dermal fillers will not only enhance but maintain.
Skin tone can be improved with non-surgical devices including HIFU (High Intensity Focus Ultrasound) & RF (Radiofrequency). Threads can also provide lifting, especially in combination with heating devices.
Skin quality & luminosity can be improved & maintained with lasers such as Fraxel, LaseMD, Clear & Brilliant, Picoway/Picosure & dermal toning.
What procedures are common for Asian patients beyond 50?
Above all, skin tightening. In general, Asian patients hold their collagen quality for longer, however post-menopausal there is a marked decline of collagen production & contraction, leading to jowls, eye bags & wrinkles.
Skin tightening can be achieved with Thermage, Ulthera – Ultherapy, & Pelleve – Tempsure. I prefer Tempsure as I can heat the dermis for longer, with added safety. This procedure can treat skin laxity on the eyelids, jowls, jawline & neck area. If jowls are heavy, my choice is Ultherapy.
Dermal fillers along the jawline, & cheek can displace & volumize, diminishing jowls. Skin quality & pigmentation can be improved with lasers, peels & clinical creams.
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Why are dermal fillers unique in Asian enhancement?
Eastern aesthetics in general are different from the traditional dermal filling in Westerners. Some examples of commonly performed dermal filling procedures include-
- Tear trough fillers for dark circles and medial lid-cheek enhancement
- Liquid rhinoplasty to define the nose
- Chin & jawline shaping (most often in combination with facial slimming)
- Fat transfer is another alternative to dermal fillers
How does facial slimming work?
Asian aesthetics are unique, namely the aim in most cases is to elongate & slim. Asian women are typically broad faced, with strong jawlines & sharp angles. The aim is to soften facial outlines to more of an oval shape, rather than ‘boxy’.
The most commonly performed method to slim the face is to Botox the masseter muscle just in front & below the ear. This slims the face, whilst dermal fillers to the chin can elongate, giving a nice subtle taper. Chin projection can also be achieved with dermal fillers.
What non-surgical procedures can shape the Asian nose?
Dermal fillers can reshape the nose, creating a better front & side profile. The most common area to enhance is the nasal bridge. Dermal fillers in this area can give a perception of projection & definition, reducing the ‘flat’ look commonly seen in Asian patients.
Dermal fillers in this area typically last around 12-14 months. For nasal contouring I always use hyaluronic acid fillers for two reasons- safety & reversibility.
What can be done to reduce dark under eye circles?
It is important to address the underlying causes of dark circles. In Asian ethnicities one of the major contributing factors is tear trough related, coupled with maxillary hypoplasia or lack of anterior projection). By building up & supporting the mid-cheek area, shadows contributing to dark circles can be diminished.
Dermal fillers are the preferred treatment of choice for creating volume, structure & improving aesthetic deficiencies. I occasionally use fat transfer in this area (pros & cons discussed elsewhere).
Other causes of dark circles include vascular, or prominent capillaries & veins. Simple vascular laser or IPL-BBL can help. For increased pigmentation due to melanin or post inflammatory skin colour changes, pico or nano lasers can help.
Cases such as pigmentation demarcation lines & constitutional physiological pigmentation are difficult to treat as these are genetically & racially determined. The use of precise skin care & sun protection can marginally improve these conditions (at best).
Skin care is super important. Hyaluronic acid creams can hydrate, retinol & peptides can increase collagen, whilst ascorbic acid, tocopherol, ferulic acid & green tea can protect from UV & environmental oxidation. Caffeine & tranexamic acid can modify blood vessels that contribute to dark circles.
Why are Asians prone to hyperpigmentation?
The number of pigment cells, known as melanocytes, are the same across all races & ethnicities. They occupy the basal layer of your epidermis. The activity of these cells are controlled by ethnicity, UV exposure & hormones. Asian patients have a higher activity of melanocytes compared to Caucasian counterparts. This increased activity accounts for post inflammatory hyperpigmentation.
Hyperpigmentation can be treated with chemical peels, lasers & prescription skin care. Addressing the cause of pigmentation (most often acne) is paramount in preventing further darkening.
Can skin lightening procedures be conducted on the same day?
In most cases I combine lasers for skin lightening, energy devices for skin tightening with injectables on the same day.
Lasers I employ for skin lightening include picolasers, dermal toning laser, Fraxel, Clear & Brilliant as well as vascular lasers. Skin tightening can be achieved with devices such as Ultherapy, Tempsure & Thermage.
How can I improve skin laxity?
Non-surgical skin tightening procedures are more effective in Asian patients as collagen bundles & production is exaggerated in ethnic skin (the flipside is that ethics are more prone to overproduction of collagen, namely keloid & hypertrophic scarring). Treatments include-
- Ultherapy or HIFU: uses high intensity focused ultrasound to tighten.
- Thermage: uses RF or radiofrequency in short bursts.
- Tempsure – Pelleve: uses RF in longer bursts to stimulate collagen production.
- Threads- include monofilament & suspension MINT threads.
How are muscle relaxing injections different in Asian patients compared to Caucasian counterparts?
In general, Asian patients compared to Caucasian counterparts are less expressive, this means that less muscle relaxants (Botox, Dysport, Xeomin) are required to get the end result. This especially applies to forehead wrinkles & the frown line.
The flipside is that masseter activity (chewing muscle) is more active in Asian ethnicities, especially in Chinese & Korean patients. This accounts for the wider Asian face. Accurate placement of muscle relaxants can slim down the face, in turn improving facial aesthetics.
Davin’s viewpoint on Asian aesthetics
In aesthetic medicine it is important to respect & understand anatomical, physiological & cultural differences across different races & to apply treatments, including injectables, appropriately.
In general, Asian patients have strong jawlines, in particular the masseter muscle. This gives breath & projects a ‘boxy’ appearance. In aesthetics we seek soft oval curves. Botox the masseters, coupled with dermal fillers to the chin can soften the female face. Anterior projection of the maxilla can reduce the perception of ‘flattening’, improving the side & oblique profile.
In middle aged ethnics the aim is to ‘lift’ & tighten. Collagen stimulation & tightening can be achieved with treatments such as Thermage, Ultherapy & Tempsure. Volume replacement with dermal fillers can treat sagging skin.
In the context of skin, Asians are more prone to post inflammatory hyperpigmentation (PIH) & melasma. Additionally, acne scarring is more common as this ethnic group has the propensity to over produce collagen (hence why skin tightening devices work better in ethnics). Treatment of inflammatory dermatoses has to be more precise & aggressive to prevent PIH as this can take 6-18 months to fade. Recent studies have shown that nearly 50% of PIH persist after one year.
By applying the fundamentals of skin care with topicals, lasers, energy-based devices & injectables, we can effectively manage skin throughout the ages.
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