03/28/2024
Which treatments do you actually need? There are so many treatment options (neuromodulators, fillers, skin care products and so many energy-based devices). This is how I think when I design any treatment plan. Bespoke plan for all.
Bone layer - as we get more mature, we also go through bone loss (including facial bone). Most commonly noted in temple, cheek and jawline areas. Dense fillers can be used to support/mimic the bone. There are many different fillers on the market, but I prefer to use dissolvable hyaluronic acid fillers for safety.
Muscle layer - Neuromodulators (commonly known as bot*x) can temporarily weaken muscular contraction. In doing so, it can help soften wrinkles allow your skin to recover/regenerate and give you smoother skin texture. Always want to be cautious and avoid over-treating. If you over-treat particular muscles continuously over a long period of time, they go through atrophy (wasting) and you can experience muscle/volume loss.
Superficial muscular aponeurotic system (SMAS) layer - thin organized fibrous network composed of platysma muscle (your neck muscle) and fibromuscular layer covering your cheek. Commonly targeted area for facelift surgery. Multiple energy-based options here. I prefer ultherapy to target this area (as ultherapy allows direct visualization of this layer compared to other devices). Energy deposited in this layer will allow tightening/mild lifting and collagen production.
Hypodermis (our good fat) layer - another area contributing to our mature looks. Commonly noted areas are under-eyes, cheeks, lips. Fillers in this layer. Different options of fillers. If you want an instant volumization, hyaluronic acid fillers. If you want to promote your body’s own collagen production to re-build volume, biostimulatory fillers.
Skin (dermis and epidermis) layer - what we typically consider as our “skin” layer. Our fibroblasts (collagen building cells) live in dermis layer. Microneedling, ultherapy at 1.5mm depth, most laser treatments, radiofrequency treatments, chemical peels, and skin care products are designed to improve this layer. Different treatment options for different need.
