Dr Shubhra Goel is an Oculofacial Aesthetic Surgeon- Co-founder of Clinica Fai. She speaks to S10 SafeCare on facial rejuvenation. 

It is time for new year resolutions and time to re-energize our body and soul. So why not learn how to rejuvenate our face and turn back some of the signs of ageing. Facial ageing impacts us all. The good news is many ways can help reduce signs of ageing and provide better defence against future changes. However, they can be confusing. In this blog, I will share how you can start your own anti-ageing journey and share some of my go-to items! 

Read More Dr Sushindri Sridharan aspires to build intelligent technologies

What is facial ageing? 

The shape of our face is determined by the hard tissues like bone, teeth, and cartilage. The overlying skin and soft tissues (fat, muscle, connective tissue) define youthfulness. As we age, there is an overall change in facial appearance called inversion of the pyramid. A younger face looks more like a V (or triangle of youth). It consists of high cheekbones, fuller cheeks, and a sharp, well-defined jawline

Description automatically generated with low confidence 

As we age, this V becomes inverted because of changes in our skin, soft tissues, and the bony structure (sometimes referred to as the "Pyramid of age"). The face becomes more oblong, cheeks flatten out, and jowls become more visible.Internal and external factors change the proportions, shape, and appearance of tissues, causing facial ageing. Initially appearing in the upper face followed by the lower face and neck, specific changes can be considered within three different zones: 

The upper part of the face: The eyebrows descend (brow ptosis) and create upper eyelid skin hooding. The upper eyelid tissues become weak, resulting in upper eyelid ptosis. Fat accumulation results in eyelid bags.  

Midface: Fat absorption diminishes the smooth cushioning around the cheeks, creating a look of hollowness. The smile lines deepen, and the corners of the mouth develop a downward positioning. 

Read More Dr. Rekha Karnam Srinivasan  

Lower facial zone: There is a descent of the chin and loss of the well-defined angle between the jawline and the neck. The neck muscles separate and lose tone, creating vertical bands. Fat is deposited below the chin area, leading to blunting of the neck and chin angles.In addition to the physical changes above, there is continuous ageing at the skin level. The skin becomes dry, dull, thin, wrinkled, pigmented and lax. Overexposure to sunlight and inadequate skin protection in the early years of life can accelerate this ageing process. 

So how can we tackle facial ageing?  

Facial ageing is tackled by a combination of treatments, together referred to as complete facial rejuvenation. These treatments are of three types that help restore a fresher looking face.Non-surgical components use various holistic measures to delay ageing and improve the signs like wrinkles, fine lines and various other facial changes.  

The surgical component involves putting drooping facial tissues back to their original positions.  

Let us look at each of these options in detail. 

Non-surgical options:  While surgery is always available to make specific corrections, many non-surgical options form the foundation of any facial rejuvenation journey. I always recommend exploring non-surgical options to build the foundation before venturing into the more complex world of surgery. 

Diet: It has been long said you are what you eat. And when it comes to ageing, it can't be more accurate. There are many conflicting views on what kind of diet is best for you to maintain healthy skin and reduce the signs of ageing. However, no one can deny the benefits of a diet rich in fruits and vegetables, drinking lots of water, eliminating processed drinks and food. So, no matter what treatment options you are exploring, make sure you start with a balanced diet if you want long-lasting results, especially for your skin. I personally follow a plant-based diet. It has helped me manage my hormones, water retention and other signs of ageing brilliantly. 

Fitness Regime: We all know exercise is great for your heart, lungs, and mental health. But it's important to remember that regular physical activity can also help with healthy and vibrant skin. That's because it promotes better blood circulation, which is food for younger-looking skin. Additionally, exercising reduces stress which minimizes the look for wrinkles and fine lines. A combination of cardio and strength training will go a long way in helping you feel younger and look younger! 

Supplements: Skin, hair, and nail supplements are also sometimes referred to as beauty supplements. The common ones are Biotin, Folic acid, Vitamin B5, Zinc, Vitamin C, Iron and Methionine. One must do a lab test to assess the deficiencies of these before taking them. These supplements must be taken under physician supervision. The supplements are not a substitute for a good diet and lifestyle. I take a composite supplement called "Celergen" a nutritional treatment that stimulates the human body's natural healing powers. A key ingredient of Celergen is a proprietary Cellular Marine Complex extracted from deep-sea, pollution-free marine life DNA, which has powerful anti-ageing properties. 

Skincare: This is a complex topic, but I have summarised some key points:  

Skincare needs a systematic, scientific protocol-based approach. The traditional approach to skincare is superficial, is usually short-lived, and works only for quick fixes. There is no silver bullet or fast and cheap way to get long-lasting results. 

When the skincare has protocols or is programmed, it is consistent, visible, measurable, reproducible, and achievable for any patient. Skin health should enable it to protect and strengthen itself. To elaborate more on this, unless the skin is ready to go to the next level of stimulation, correction, and stabilization, treatments will fall flat, be temporary and ineffective.  

Many patients forget the importance of getting skin ready. Unless we do warm-up exercises, we cannot perform advanced weightlifting or fat loss exercises. Similarly, suppose you don't warm up your skin and get it ready with a strong foundation. In that case, you won't be able to undertake more advanced treatments/corrections.  

Therefore I love using the ZO skincare regime, a well-researched system for the last 25 years that provides a new panoramic vision towards skincare. One can use ZO products to treat medical and general skin conditions. The products suit any individual skin type, colour and issue. Overall, the response to the treatment is quick. The product protocols can be adjusted according to the patient's needs and requirements and encompass the skin's prevention, treatment and maintenance. 

Read More Dr.Surakshith Battina

Botox and fillers:  These non-invasive options for facial rejuvenation are extremely popular. They are quick office procedures with minimal downtime and high satisfaction rates. Facial lines from ageing can be static or dynamic creases or a combination of both. Botox is most used in the upper face, while dermal fillers in the mid and lower face. Botox is often used in conjunction with dermal fillers, peels, and lasers for optimal results. 

Skin resurfacing: This treatment group involves controlled shedding of different skin layers, depending on the amount of correction required, to enhance skin texture and pigmentation.  

Microdermabrasion: A popular procedure in which a diamond tip is used to resurface the skin. Additionally, infusion of peptides and antioxidants is pumped into the skin to improve its appearance. 

Chemical peels: Peels can be used to improve skin texture and tone. Today, the cosmeceutical market carries a vast array of different formulations. Some popular brands are Obagi, Biomedics, Cellex-C, Skinceuticals, SkinMedica, and Neostrata. Selection of which cosmeceutical therapy to use for home skincare should be individualized for each patient and can be determined with the assistance of a specialist. 

Lasers: Laser resurfacing is one of the fastest evolving modalities in the cosmetic industry. It uses the power of lasers to resurface the skin. 

Radiofrequency energy: These systems deliver concentrated energy to tighten the skin. Advantages are its safety for all skin types and better control of skin surface temperature, thereby lessening the risk of burns.  

Plasma Plexr Pro- Plasma is the fourth form of energy, a high-temperature ionized gas used to sublimate superficial layers of skin. Plxer plasma pro is a device to deliver this energy. It is an outpatient procedure, with no pain, has minimum downtime, is non-invasive, cheap and safe. The primary and common indications for this are: 

• non-surgical blepharoplasty,  
• scar revision,  
• skin rejuvenation,  
• wrinkle correction,  
• acne and cysts removal, and,  
• xanthelasma correction
  

Facial Threads lift: This is a minimally invasive procedure to lift and augment facial structures using medical threads, like APTOS. These are specially designed to lift the facial tissue at the superficial fat layer level. These can correct droopy brow, saggy mid-face, augment jawline, and correct the depressed angles of the mouth. The procedure lasts for 20-30 min, and the results can last up to 18 months to 2 years. 

Surgical Options: There are numerous surgeries available to treat various age-related issues with eyes and face. While they may sound complicated, the overall goal is to restore the looks, function, and emotional quotient. Some of the most popular surgical treatments are as follows: 

Forehead and eyebrow lift is performed to achieve a long-lasting rise of the eyebrows and remove fine lines and minor creases in the forehead.  

Blepharoplasty is used to restore correct functioning to the affected eyelid(s) and eye aesthetics. 

Ptosis surgery is used to treat sleepy/droopy eyelids.  

Midface and small-incision face lifting is used to correct midfacial ptosis.  

Autologous Fat Transfer provides volume to areas of relative atrophy due to facial ageing. It is natural, safe, and long-lasting compared to some fillers.In summary, facial rejuvenation is a complex but exciting art dealing with individual layers of the face yet refining them facial system. The world of minimally invasive facial rejuvenation is vast and constantly changing. Each person needs to create a bespoke plan based on their needs, extent of changes and budget to achieve most optimal results. This should only be done in collaboration with a trained specialist.And as a final note, to make this all real and to share my own personal experience, below are my before and after pictures (taken 10 years apart). I have managed to achieve facial rejuvenation by following a balanced diet, training on a regular basis, using a protocol-based skincare routine (ZO cosmetics) and undertaking some non-surgical options like botox and fillers.  You can reach out to us at www.clinicafai.com or call us at +916281117454 to start your journey today! 

Read More Dr.Dinesh Kumar