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Facial aging, how to prevent and treat it

Dra Nuria Escoda, specialist in Aesthetic Medicine, director of Clínica Escoda

The primary key to effectively addressing facial aging is to thoroughly understand the transformation process that the face undergoes over the years. But have you ever considered how your face ages?

Over the years, we witness how the skin loses its radiance, elasticity, and develops wrinkles, spots, and sagging. Often, we see the emergence of a tired expression in our eyes, or of sadness and bitterness on our face.

These are the most common signs of the facial aging process, but what are they attributed to? Can they be countered? Let’s take a journey through this process to thoroughly understand the facial transformation and explore the most suitable treatments that will help us counterbalance it.

How does the face age?

Not all individuals age in the same manner or pace, as there are multiple factors at play, such as genetic, environmental, lifestyle, and, of course, personal care influences. However, they do share a similar anatomical evolution.

The first thing we must consider is that facial aging is three-dimensional, meaning it involves all the tissues that constitute it. Each of these will contribute in a different way. Starting from the deepest to the most superficial, we have bones, ligaments, muscles, fat, and finally, the skin.

Aging of the facial bone structure

While bones are rigid, bone tissue is dynamic and is in a constant, highly active process of formation and destruction. During childhood and youth, the process of construction exceeds that of destruction. However, as time goes on, the trend reverses, and the process of destruction ends up surpassing the process of construction.

Therefore, in advanced ages, the bone structure begins to recede, affecting the soft structures that are supported by it. As the support diminishes, these structures tend to sag.

The areas where bone resorption becomes evident earlier are the eye sockets, the mandibular ridge, and the cheekbone. The most visible consequences of this resorption are sunken eyes, loss of facial contour definition, and the appearance of the nasolabial fold or nasolabial lines, also known as marionette lines.

Entender el proceso de envejecimiento del rostro y todos sus tejidos. Por la Dra. Nuria Escoda

How do ligaments age?

Ligaments are strong, fibrous structures that connect the skin to bones and muscles. When bones decrease in volume and tissues lose elasticity, ligaments pull the skin inward, causing signs of structural aging. The cheekbone sags, the facial contour loses definition, and under-eye circles appear, giving a tired appearance.

What role does fat play in facial aging?

Fat is distributed throughout the face in separate compartments that help shape our face and provide volume in varying proportions. For example, the fat compartments in the cheeks provide a larger amount of volume compared to those in the forehead, which are almost imperceptible.

During youth, all fat compartments are at full volume, resulting in smooth skin surface without shadows. As the years go by, fat cells start to sag and lose volume unevenly, contributing to the creation of shadow effects on the face associated with aging, giving us a tired appearance.

The first places where we can notice these signs of aging are around the eyes, mouth, and facial contour.

And the facial muscles?

In the face, we have the muscles known as the muscles of expression. These muscles do not connect two bones; instead, they lie flat over the bone and attach to the skin to generate expressions. Thanks to them, we can smile, wink, frown, kiss, or lower the corners of the mouth.

As the years go by, the continuous repetition of these movements leads to the formation of wrinkles, commonly known as expression lines, which become more pronounced over time.

Proteínas anti-envejecimiento SIRT1 y BDNF. Alimentación saludable y ayuno intermitente

Skin aging

The skin, like the rest of the face, ages in a three-dimensional manner, meaning its three layers – hypodermis, dermis, and epidermis – age simultaneously, each causing different signs of aging.

In the specific case of the skin, age isn’t the sole factor determining the state of mature skin. External factors play a crucial role in this tissue.

Areas exposed to the sun, such as the face, hands, or décolletage, experience more pronounced loss of elasticity, firmness, and epidermal regeneration compared to less exposed areas like the abdomen.

So, we can differentiate between different types of factors that affect skin aging: internal or endogenous factors and external or exogenous factors.

Endogenous factors of skin aging

These are genetically determined factors, and they can involve a weakening of cellular regeneration capacity, as well as a reduction in the activity of sebaceous and sweat glands.

Additionally, women approaching menopause experience a significant decrease in estrogen production, which directly influences skin moisture content and the ability to regenerate collagen. During the first 5 years after menopause, women can lose around 30% of their collagen, resulting in structural changes in the skin.

Exogenous factors of skin aging

These are environmental and lifestyle factors that lead to premature skin aging.

One of the external exogenous factors that most significantly contribute to the deterioration of skin quality is exposure to ultraviolet rays. High sun exposure leads to photoaged skin, a type of aging that is not related to internal aging.

These are skins that may exhibit sunspots (you can read an article where we address solar lentigines or sunspots in more detail on our blog), loss of elasticity, and/or couperose or dilated capillaries.

Diet, tobacco, alcohol, and the climate in which we live also have a direct impact on the quality of our skin.

Preventing and treating facial aging

Once we understand the aging process of each of the tissues that make up our face, let’s explore the preventive and rejuvenating treatments that are most effective based on the desired outcome.

Since facial aging impacts all tissues, mitigating its effects will require a multidisciplinary approach to address each of its underlying causes.

Addressing bone resorption, loss of fat, and tissue support

Undoubtedly, hyaluronic acid treatment is the one that will help us the most in combating this loss of facial structure. Injected hyaluronic acid provides support to the tissues, helps ligaments and tissues regain their position, resulting in a facial tightening or lifting effect.

Our Natural Lift treatment, featuring hyaluronic acid, is specifically designed to counteract this loss of facial structure. In this treatment, we inject hyaluronic acid, starting with the lifting area of the face. According to recent studies, this approach is particularly effective because it requires less hyaluronic acid and the results are much more natural-looking.

Furthermore, hyaluronic acid will also help us counterbalance the loss of fat compartments, restoring their volumes.

We refer to the treatment that restores facial volumes as Full Face or facial harmonization, as it addresses the entire face as a whole, including all its structures. In this facial rejuvenation treatment with hyaluronic acid, we follow a specific injection sequence and use a precise and appropriate type of hyaluronic acid based on the points to be addressed.

Natural lift, lifting facial sin cirugía. Centro de Medicina Estética y Regenerativa en Barcelona

Currently, we have many types of hyaluronic acid available that are tailored to different tissues we need to treat. There’s hyaluronic acid with a strong structure that helps us restore the contours of cheeks, chin, and jawline. There are others with medium density, more suitable for injecting within the fat compartments and restoring their plumpness. Lastly, there are very gentle types suitable for injecting just beneath the skin to provide a layer of support and deep hydration to the skin.

Preventing or reducing expression wrinkles

As mentioned earlier, expression wrinkles are those that appear due to the repeated facial movements such as smiling, raising eyebrows, or frowning.

The primary preventive and treatment method for eliminating these wrinkles is the injection of neuromodulators, which work to relax the muscle so that, for a few months, it stops contracting and causing wrinkles in the skin.

Historia de la medicina estética, bótox, ácido hialurónico y peelings. Centro de medicina estética Dra Escoda en Barcelona

Deep facial massages help stimulate bone formation and promote muscle relaxation and stimulation. There have been facial exercise and massage regimes for years aimed at maintaining the facial structure.

Skin rejuvenation treatments

As we’ve seen, one of the factors that significantly influences skin aging is sun exposure, so it’s crucial to always protect the skin from solar radiation. The best prevention tool is a good sunscreen, which will also be essential if undergoing intensive treatments such as laser procedures or peels.

To reverse skin aging, several factors need to be considered. Depending on the specific aspect or imperfection of the skin that you want to improve, you will choose a suitable aesthetic medicine treatment.

IPL treatments for sun spots, redness, capillaries, ruby points or acne scars in Barcelona

For instance, to eliminate sunspots or dilated capillaries, the most recommended treatment is often with laser technology and/or IPL (Intense Pulsed Light).

Tratamiento del contorno de ojos, Eyelid Vital

Facial mesotherapy, on the other hand, allows us to inject active products directly into the dermis, such as antioxidants, non-crosslinked hyaluronic acid, or organic silicon.

Non-invasive facial lifting treatment with HIFU (focused ultrasound). Clinica Escoda, Aesthetic and Regenerative Medicine in Barcelona

If what we want is to tighten the skin to combat sagging, the HIFU treatment will provide us with a non-surgical lifting effect. High-intensity ultrasound activates protein restructuring that leads to the contraction and remodeling of the skin’s connective tissue.

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