First and foremost, are aesthetic treatments necessary for those in their 30s, or is it a consequence of aggressive marketing of anti-aging services in our society?
It may be true that marketing of anti-aging services in aesthetic medicine has made people more conscious of their physical appearances and the desire to look at their best. It is not entirely true that aesthetic treatments are not necessary. First signs of aging actually become apparent from around 25 years old and treating them early actually yields better results in the long run.
Prejuvenation is the latest trend in aesthetics – it means to start treating your skin for signs of aging even before they start to develop! Millennials are starting seeking treatments as young as 26 years old. From around the age of 25, fine lines and wrinkles start to develop and a loss of elasticity becomes noticeable over time. Some age better than the others and this largely depends on our genetics and lifestyle. Efforts to ‘prejuvenate’ will require minimal input, avoiding the need of invasive treatment for as along as possible, resulting in better and more natural aesthetic outcome. Treating deep wrinkles and sagging skin after they are prominent as rejuvenating procedures will require more treatments and results may not be as satisfactory as the ability to produce collagen decreases as we age. Starting treatments young definitely has its benefits.
The most effective topical cream that is proven to prevent photoaging is Sunblock! Sunblock does not only prevent pigmentations, it also prevents UV-related degradation of hyaluronic acid and collagen responsible for the development of fine lines and wrinkles. You should keep your skin hydrated by applying suitable moisturisers containing products like hyaluronic acid, ceramides, peptides such as argireline and lipids. Anti-aging ingredients would include active ingredients such as retinoids, antioxidants like Vitamin C and DNA cell regenerating components. Regular exfoliation with gentle peels like AHA, glycolic acid helps to renew the skin regularly and prevent clogged pores.
There is only so much that topical creams can do for you. Many have the misconception that Botox is only reserved for older individuals and causes unnatural ‘frozen’ appearance. This is NOT true. An appropriate dose of Botox will not cause unnatural appearance! Botox is very effective in preventing wrinkles especially the frown lines, crows’ feet and forehead lines. By limiting the dynamic facial movements caused by excessive facial expressions over prolonged periods of time with repeated injections every 4 months, it prevents these lines from developing into permanent static lines. When dynamic lines are not treated early, permanent static lines that form subsequently will be much more difficult to ‘erase’ and Botox alone will not be sufficient.
As many patients are resistant to treatments that involve injection, collagen stimulating treatments with energy devices are commonly performed. The effects of a single treatment are not usually significant but when these treatments are you will be able to tell the difference between someone who started doing these procedures versus someone who didn’t in 5 years down the road. This is what prejuvenation is all about. Collagen stimulating energy devices work by inducing ‘heat’ damage to the deeper layers of the skin, where the body’s healing response is triggered and fibroblast are activated to produce collagen and elastin in the process.
Laser Skin Resurfacing
CO2 laser is the gold standard treatment for skin resurfacing. The heat that goes deep into the 1-2mm is able to stimulate collagen and the laser dehydrates the superficial layer of the skin, causing it to shed. Regeneration of new skin cells help to keep the skin young and remove the ‘old’ skin that is sun-damaged. With improved CO2 technology, the CO2 laser is able to emit fractionated energy, which significantly reduces the downtime and risks.
In individuals with darker skin tone, fractional pico laser is safer as the energy creates areas of ‘Light Induced Optical Breakdown’ deep into the skin, stimulating collagen and elastin production in the deeper layers, without causing damage to the superficial layers, where the risk of post-inflammatory hyperpigmentation arises in CO2 laser.
Radiofrequency skin tightening
You might start to notice early signs of saggy skin in your 30s. Radiofrequency skin tightening provides effective results by delivering heat from the superficial layers of the skin to the tissue below the epidermis, up to 3mm in depth, stimulating collagen production and contracting fibres to tighten the skin. There are many different types of radiofrequency machines available in the market. The prices and grades differ vastly and as always, big brands like thermage are generally more costly but it’s definitely more worth it as they are better researched for safety and efficacy and do not require downtime.
Fractional Radiofrequency, such as Infini, combines the mechanisms of both microneedling and radiofrequency. Conventional transepidermal RF treatments have inherent limitations as the energy is delivered via the skin surface and the optimal temperature for collagen synthesis may not be achieved in the deeper layers of the skin. Fractional RF is able to precisely deliver radiofrequency energy to deeper layers of the skin as the energy is emitted through the tips and length of the needles. As this treatment involves downtime and pain to a greater extent, it is more commonly used to stimulate collagen in the treatment of acne scarring.
Ultrasound Skin Lifting
Ultraformer III and Ulthera are some reputable ultrasound skin lifting systems available in Singapore. Ulthera, also known as non-surgical facelift, delivers focused ultrasound energy deep into the skin, bypassing the superficial layers of the skin. Therefore, the risks of thermal damage, burns to the superficial layers of the skin and potential downtime are lower compared to radiofrequency devices. It is also able to target more precisely into deeper layers of the skin. A good HIFU session would involve using different cartridges where different depths are targeted. This is important as the thickness of the skin is different on different areas of the face! Apart from stimulating collagen growth in the different layers of the skin, the focused ultrasound is able to target the SMAS layer at about 4.5mm deep. Collagen stimulation at the SMAS layer will allow maximal lifting results as it is the muscular structure that provides support to the skin.
If you are all about looking natural and wouldn’t mind some injections, Profhilo is the newest biostimulator approved for use in Singapore. With a specially designed technology to stabilise the high HA content with 100% HA with no added chemicals, it is extremely biocompatitble and safe. Once injected, Profhilo spreads like water to the surrounding tissue without the risk of lumpiness. Not only does it instantly hydrate the skin, the slow release mechanism allows for bio-remodelling of surrounding tissue enabling collagen stimulation and improving skin laxity. Although this is a treatment with results best seen in patients displaying moderate degree of skin laxity typically seen in the 40s-50s, the amount of collagen stimulated with the same procedure shouldn’t be any less in a younger individual.
You may not see such drastic improvements in all these ‘prejuvenating’ treatments but the whole point of prevention is to maintain our best appearance even before we start to age!
If you are looking to modify how you look, and would like to see instant results, you may want to consider fillers. In early 30s, cheek and chin fillers are commonly done to improve the profile of the face. As we age we lose some volume of the face, leading to gradual sagging of the face, typically in the late 30s, resulting in more prominent tear trough and development of marionette lines. Fillers can replace the lost volume and provide an instant improvement in appearance. There are different types of fillers available and it is important that you discuss your desired outcomes with an experienced doctor so that he can give you the best advice.
Other common concerns for patients in their 30s may include pigmentation and acne.
Photodamage & pigmentation treatment
UV damage is the most avoidable cause of ageing. Liberal use of sunblock is the most cost-effective way to prevent photoaging, accelerated breakdown of HA and collagen and pigmentations! Although it might have been a childhood freckle but having pigmentation in the 30s can make you look a lot older than your actual age. Worsening and presentation of pigmentations are common complaints of women in the 30s as this is when we experience surges in hormones with oral contraceptives and pregnancy. Pigmentation can be a long battle. Straightforward freckles and superficial pigmentations generally do respond very well to peels and lasers. However, pigmentation like melasma are a lot more difficult to treat and can potentially worsen with treatment. It is important that you seek medical advice early, with a doctor experienced in treating pigmentations and equipped with the best devices.
Some of us still battle with hormonal acne in our 30s. It always feels as if it is a never-ending one, but don’t lose hope. Hormonal acne tends to settle as we age when our oil glands are less productive. Start with a good skincare routine and seek medical help early for prescription and medical grade products. Your doctor may suggest further treatments such as chemical peels, lasers and even oral medications for moderate to severe acne that is refractory to treatments.
Improving our appearance, commonly helps to boost our self-esteem and body image.
It is important for you and your doctor to discuss and approach aesthetic treatments with a specific and realistic expectation in mind so that you can actually appreciate the benefits of them and achieve satisfactory results.