As usual… great questions! The two main issues patients discuss with us, over the age of 45, are wrinkles and sagging. Our clinic has patients, who at 70, have very little sagging and almost no wrinkles (and no facelift). And some who are 45 with wrinkles and sagging due to sun, tanning beds, no consistent skincare, lack of exercise, poor nutrition, and a history of smoking. Here’s the good news! Wrinkles can be improved some with skincare products. Here’s the bad news… Sagging is NOT affected by skincare products. I don’t care what any marketing says. I would say prove it! To remedy sagging the solution is volume replacement, skin tightening, or surgery. To answer your question above, for nonsurgical skin tightening, Thermage is better than Ultherapy, which is too painful. The results are pretty much the same, but Thermage is much more comfortable. And over 60, without volume replacement, you won’t see much result from any of these.
A good basic program for skin over 45:
- A gentle cleanser AM and PM. If you like creamy, try this one by Eminence (mine :)). If you like foamy, try this one by Skinceuticals.
- A good moisturizer. If normal to dry, try this Pevonia one (midweight). If really dry, try this great new product Triple Lipid Restore.
- A great antioxidant like these.
- A good retinol or prescription strength tretinoin.
- A key sunscreen with 9-18% zinc.
Here’s the order:
AM – cleanse, antioxidant, moisturizer, eye cream, sunscreen.
PM – cleanse, moisturizer, eye cream, wait 5 minutes, a small amount of the retinol all over your face (not near the eyes).
These are the true basics. After you have this solid, you can start adding a few extra steps. Give the above 6-8 weeks to see the difference.
The 4 main reasons why we get wrinkles and sagging:
- Sun damage to the outer layer of skin (epidermis and high dermis).
- Loss of fat pads and other structural support UNDER the skin.
- Repetitive facial movements like frowning, smiling, smoking, drinking through a straw, etc.
- Poor general health habits.
Solve these 4 above, and it makes a world of difference!!!
Hope this helps, Dr. I