Before one starts to think about the appropriate treatments for an individual, it is important for a careful analysis and reflection on the individual person’s aging changes and process. This is not only related to the appearance and degree of volume loss or sagging but also subtle qualitative appreciations of skin quality, skin texture, previous smoking or sun exposure history and their genetic background, amongst others. It goes without saying that some people age better than others and furthermore anti-aging treatments (whether surgical or non surgical) have a better effect on some more than others and will last longer in certain individuals.

Some people have certain characteristics that have a negative impact on their aging and can also, unfortunately, mean that non-surgical treatments will not work as well as in others. Notably these are people with significant sagging and heavy tissues and those who have lost elasticity such as through previous weight fluctuations or purely due to their genetic make-up. In those with lighter features and slimmer faces, whilst the aging changes may take more of an effect by making them look somewhat gaunt as well as affect sagging, anti-aging treatments can have more of an impact and tend to last somewhat longer.

Therefore the aim nowadays is a concept of “positive aging” and looking good for your age rather than trying to turn back the clock a given number of years and trying to work out how long a given procedure will last for. These latter concepts are unscientific and so incredibly variable between individuals that there is no absolute given value that can be placed on any particular treatment.

There is an analogy sometimes used: “you can make the best plans for a summer holiday, but you cannot guarantee the sun will shine when you get there”. This parallel applies with facial rejuvenation treatments, particularly surgery: an operation could be well planned for and well-executed, however there are certain factors that are beyond surgical control. These include the degree of relapse patients’ tissues may undergo, the recurrence rate of sagging and the way in which that individual forms scars and how those scars behave, to name but a few.

It is of vital importance to reflect on these considerations before committing to any form of facial rejuvenation procedure so as not to be disappointed if the results are not what you hoped for,  and to have realistic expectations (that will hopefully be surpassed!). Failure to have realistic expectations can often lead to disappointment which would otherwise have been avoided.

Aging is much like being on an escalator that we can never get off. It is continually going upwards, and all we can hope to do with the variety of anti-aging treatments at our disposal, is try to move down a number of steps. The number of steps we move down will depend on the extent of the treatment we undergo, however we can never get off the escalator and it will keep on moving up.

Maintenance

As the aging escalator continues to move on and we can never step off, if one is looking to maintain the best appearance possible then maintaining the result with continued and on-going periodic treatments is highly advisable. For example, following surgical face lift, having regular skincare, anti-wrinkle injections and periodic filler will maximise the results that can be obtained. In the same way that filler is used to enhance cheek bones or soften nasolabial folds this needs to be repeated periodically to maintain it’s results.

However, at a certain point the non-surgical maintenance is not the correct or best treatment for ongoing facial rejuvenation and consideration periodically has to be given to further surgical procedures. If this is not reflected and reviewed every so often, there is a danger of undergoing continued non-surgical treatments that will end up resulting in a very unnatural or strange appearance. This is perhaps why we see various people in the public eye looking somewhat unnatural as possibly the clinician treating them has not reviewed them and taken a step back to discuss with them the direction that they seem to be heading in. I am always very honest, open and frank with all of my patients and have no hesitation in saying “no” if I think a further treatment is inappropriate or discussing when an alternative approach ought to be considered. I hope this is appreciated by my patients, as I fundamentally feel it is the right approach to take.