Fine lip wrinkles & lines can respond to skin laser toning & dermal fillers. Fillers can restore loss volume in and around the lip area, & provide a more youthful appearance.

Severe lip lines & wrinkles can be erased by laser resurfacing, most often using a combination of erbium and fractional lasers. Occasionally I perform deep chemical peels including Croton -Oil & Phenol, or Jessner TCA with or without fractional CO2 lasers.

Jowl lines & marionette lines occur due to poor skin tone around the cheek and jawbone areas. This can be treated with –

• RadioFrequency to key areas. This treatment stimulates collagen over time improving skin tone.
• CO2 Fractional laser can be useful, especially if skin tone and texture needs to be addressed. This can be done as part of a laser face lift. 
• Threads can give good, but short term results to some patients. 
• Mini-S- face lifts are indicated if jowl lines are pronounced- this can give instant, long lasting lifts, that look natural. Deep plane face lifts gives the longest ‘lifting’ procedure. 
• Fillers can temporarily hide jowl lines, but are especially useful for marionette lines. 

Non-surgical face lifting of the mid and lower face can be achieved using RF- Radiofrequency. This is a non-invasive treatment that can tighten collagen over time, reducing cheek wrinkles and lines. 

CO2 Fractional laser is a step up from RF, and directs more heat into the skin, this results in better improvements of cheek lines, wrinkles and skin texture. 

Fillers can be an excellent method to add volume, reduce lines, and provide a more balanced and youthful appearance. 

For severe wrinkles, sun damage and marked loss of skin tone, laser face lifts & mini-s-face lifts give outstanding and natural results. 

Treating and preventing wrinkles in younger patients is not a problem, however as one ages, getting the balance correct is very important- this is known as facial harmony. Facial harmony balances skin texture, tone & volume.

Lasers & ways to improve wrinkles are largely predictable in my hands, what I really struggle to convey, is the balance of facial aesthetics, namely patients over look volume. Volume can not be addressed with lasers, or surgery. Fat transfer or dermal fillers gives good, predictable results for addressing volume. 

Having a Specialist understand all aspects of ageing, including lifting skin, volume replacement, and of course wrinkle treatment is important for the very best, but natural results. 

Yes, to a limited degree. I do think there are more effective options available. My clinical team do provide this option as it is ‘mainstream’ treatment. My opinion? By the time you have 4-5 microneedling PRP treatments you would have spent enough coin to have had a straight forward fractional laser with my clinical nurses. Lasers give predictable decreases in wrinkles & improves skin quality.

For more information on the pros & cons of PRP & microneedling vs lasers, book a consult with my nurses. I am a firm believer of providing treatments that work. 

In theory, yes. So can battery acid. There are safer & more predictable ways to treat wrinkles. I do think that a simple Jessner – TCA peel performed by an expert aesthetician is far, far safer & more effective than plasma pen. I see way too many side effects such as permanent scarring from this device.

Yes. I do perform ‘dissolvable barbed’ or conical threads such as Silhouette Soft & Mint Threads, however it is important to know that even though results can be good, thread lifting does not last beyond 6-8 months at best. 

My most commonly used threads are PDO monofilament , performed in specific key vectors. My position & density of these treats are very different in comparison to injectors as I tightly pack PDOs in a small area (high density PDOs). I also use cogged thread in suitable patients; namely thick dermal layer.

The key to successful thread ‘lifting’ & wrinkle removal is to keep the momentum with neocollagenesis. This means combined treatments, with the first session aimed at treating between 2 to 3 levels in the skin. This is then followed by no-downtime treatments aimed at deep stimulation of collagen. Most commonly I use radio frequency or HIFU-Ultherapy.

This will depend on what treatments are employed. Clinical findings & your end goals are important to understand. 

For simple rejuvenation procedures such as muscle relaxants, dermal fillers, & fractional lasers, my clinical team of nurse can assist. 

For complex rejuvenation including fully ablative lasers, complex fillers, fat transfer & surgical modalities, please book a consultation with myself. Hope to help you out someday!

HIFU is a treatment that requires a great deal of caution & candidate selection. This treatment is ideal for those who have mild to moderate wrinkles involving the lower 1/3 of the face. An ideal candidate should have a thick dermal layer & adequate fat.

Most often I use this treatment to tighten the fibrous tissue in the fat layer. Occasionally I use it to ‘melt’ fat (more like ‘controlled’ lipolysis or apoptosis of the subcutaneous layer.

If you have significant sun damage, HIFU will not work for you because your elastin & collagen bundles are fragmented.

Skin care prevents, it does not reverse wrinkles. Even with super strength retinoids, the effects on wrinkles are marginal. Sorry to break this to you, but the wonderful results from retinol is actually the base working as a moisturiser. 

A simple but effective anti-wrinkle skin care program goes this this:

AM: Antioxidants, followed by sunscreen.

PM: Retinol or retinoids, with AHA serum once every 7 to 10 days.

Other skin care ingredients with anti-wrinkle activity include-

Argan oil; used in the Middle East as a powerful antioxidant, it may have anti-wrinkle effects. 

Ethnics including Asian skin types usually respond better to wrinkle removing treatments such as Pico lasers, RF, HIFU, dermal filler & threads. There are 4 main reasons for this-

1. Genetics, as discussed above.
2. Pigmentation protects the underlying dermis from sun damage & collagen fragmentation.
3. The dermal layer is thicker in ethnics, allowing for more contraction. 
4. The cells called fibroblasts are more reactive in ethnic skin, meaning more collagen laid per area, as compared to lighter skin.

It’s not all good news for darker skin, as they scar & pigment much easier.

Fact: ethnic skin types age less, & in general exhibit wrinkles a decade later than fair skin counterparts. Reason? Genetics & physiology. The lasers I use in fair skin types is different for ethnic skin. A typical wrinkle reducing program goes like this-

• Picosure or Picoway laser; 2-3 sessions.
• NuEra RF or HIFU.
• Profhilo bio-stimulatory Hybrid dermal fillers, 2 sessions

Yes but it takes forever to get good results. I have the erbium side of HALO known as the Sciton Joule; expect HALO has 1/15 the power. With our portfolio of lasers, we can get the job done faster & with less overall down time at a fraction of the cost. 

It depends on your clinical findings. A low downtime- no downtime treatment is a combination of collagen stimulating Hybrid dermal filler (Profhilo) as well as a non-ablative laser like the Alma Hybrid. We can add no-downtime devices like deep HIFU & RF.

My staff & I will guide you as to the best combinations, taking into account your goals & limited time. 

Genetics & environmental factors. Your ability to stimulate collagen is based on a bell curve, much like height, weight, & IQ. The lucky few who can generate & contract collagen efficiently lie on the right side of the curve, whilst some lie to the left.

Factors such as smoking, diet, stress, UV exposure & more come into the mix. Another well known variable is outlined below, namely ethnicity. 

I have covered this in another section, however this is a summary. 

Microcurrent: I was sceptical at first, but I do think it works well in some people. Microcurrent does not remove wrinkles (as advertised), it can however improve your skin’s firmness by immediate collagen contraction though current. 

Skin needling: can be useful as a DIY for wrinkles & enlarged pores. Use a 0.2 mm roller, concentrate on the technique. Don’t go deeper, it is counter productive.

Chemical peels: DIY peels are not a good idea, but some will try, hence this advice. I do believe that low strength TCA is easier to modulate & safer to use compared to say, glycolic acid (which requires neutralising agents). Stick to TCA 8% two to three coats. Apply monthly. This can reduce pigment as well as fine wrinkles – especially wrinkles around the eyes. 

Home lasers: there are some companies that make home lasers for the treatment of eye wrinkles. These devices are non-fractional lasers with a max output of 3 mj/cm2. You need to use them daily for at least 3 months. Each session takes 4-6 minutes to perform. 

Healthy living: Don’t underestimate the value of the diet, sleep, photoprotection, & self-worth. You know the drill, don’t smoke, alcohol in moderation, reduce stress, etc…