Don’t for one minute think that someone aged 65-80 does not care about how they look; it is exceedingly important to them.
I never cease to be amazed by the elegant 85-year-olds who walk into my clinic, beautifully coiffured, with immaculate makeup, fit-looking alert and attractive faces, lovely clothes, and good poise.
I am also amazed that the men of the 65-plus group who are wanting to look healthier and younger.
After age 65 men and women no longer have the stresses and strains of young children (although they may have some grandchildren). Often, they have finished working or have less work; they may have retired, or act as a director, sitting on a board or doing charity work.
They may be getting more interested in sport or may even have a new wife or husband. They are acutely aware of how they look and what troubles them is the following.
The 65-80 group are concerned about the loss of volume in their face and the increased lines and hollows. They might have deep nose-to-mouth lines. Often, there are creases halfway across the cheek, and there are under eye deep set tear troughs with bulges. Their hands may need rejuvenation, their skin is ageing and sun damaged, and they have crepey decolletage (not the men). They may want to reshape their face so that it looks fuller and younger. Some of them even notice that their earlobes are beginning to look thin and long.
They are less worried about lip enhancement and less concerned about jowls, and by then they have often accepted that it is part and parcel of being over 65, but the thinness of the face concerns them. They might also be anxious about unhealthy looking skin and deep lines.
Here, I am not talking about small wrinkles or lovely smile lines or crease lines around the eyes, but more about the hollowing that occurs in their temples, under the eyes, across the cheeks, between the nose and the mouth and below the lips and around the chin.
I would say that the primary treatment that I provide for the 65 to 85 group is filler and this is for both men and women. They are much less interested in botox.
For this group age 65 to 85 I recommend a combination of hyaluronic acid gel filler and or Sculptra or Poly-L-lactic acid for volumisation and collagen restimulation. I also recommend our Ultherapy London treatment for lifting and tightening. In this age group, they will require neck and full face Ultherapy with maintenance treatment at six months, one year and two years.
Concerning filler or Sculptra biostimulation, because they lack so much more volume than a younger person, it is inevitable that they are going require more volume replacement. So, the type of volumisers that I use in this age group can be in the range of 7 to 9 vials of filler such as Restylane and Juvederm or a mixture of the two using different types in different places of the face and over two to three sessions.
If I am using Sculptra, I will recommend between 3 and five vials on two occasions, and then yearly maintenance checks for a small top-up. Sculptra gives a gloriously natural appearance.
It is a slow biostimulation of the patient’s collagen and because of the way that we inject it by cannula in a suspension of local anaesthetic and saline it diffuses well through the soft tissue and hence gives a natural appearance.
However, I do not use it directly in the tear trough because of the remote risk that it may cause either a visible or a palpable lump in that very thin area. Therefore, even in a patient who is having Sculptra biostimulation of their collagen, I would recommend that they have TearFill for the tear troughs.
They are interested in skin quality, but they do not like the loss of volume and the sagging overlying skin.
Several years ago we would have offered them surgery, but now we have other options we can provide them as well as the skin care and sun protection they need to look healthier and look younger.
This approach will give them back their self-confidence, make them feel more acceptable to their children and their grandchildren, and help them with their busy lives. These issues are important because – as I have already said – many of them are still heavily involved in their jobs, their hobbies, their pursuits at charities as well as their families and they have to look good. Our brains do not deteriorate, but our body – and particularly our face around the eyes – tends to show the ravages of time. We show these signs, especially if when we were younger, we did a lot of smoking, maybe drugs did not eat well, or had a lot of sun damage. A hard lifestyle in our youth takes its toll later in the life.
In the age group, 65-85 turkey neck becomes an age give away to a sagging thinness discolouration, horizontal-vertical lines and loose skin all called turkey neck, particularly prominent when we clench our teeth.
There is no cure for turkey neck, but the best treatment is Ultherapy, which is non-invasive deep dermis stimulation of collagen, and an FDA approved treatment.
It specifically lifts and tightens the skin on the neck and jowls by targeting the deep layers of the skin and superficial soft tissue. The only alternative is surgery; however, surgery is more serious as it is invasive and carries more significant risks to the patient. Any other options such as laser resurfacing risk downtime with redness and discomfort.
Because Ultherapy bypasses the surface of the skin to deliver its micro focussed high-intensity ultrasound energy to a determined tissue level, there is no overlying redness or visible sign of the treatment afterwards. Ultherapy triggers the body’s collagen synthesis thus stimulating collagen synthesis resulting in lifting and tightening. Treatment of the lower face and neck area can take about sixty minutes.
Before the treatment, we apply local anaesthetic cream and light analgesia (given by mouth). During the treatment, it is normal to feel small packets of energy being delivered to the deep dermis and some patients liken it to an elastic band against the skin. The levels of discomfort do vary depending on the patient’s threshold and the time of the month (if they are female) as they may feel more sensitive immediately before a period.
There is no post Ultherapy treatment down time. The skin can look slightly pink for about twenty minutes after the treatment, and there can be some very minimal swelling and tingling afterwards which are mild and temporary.
Although patients do see an immediate effect that is short lived because the actual results depend on the new collagen forming, which becomes apparent from 6-8 weeks and up to six months. The new collagen acts to lift and tighten the skin on the neck and chin and also helps to smooth the skin.
Ultherapy treatment is not a facelift, but it is a clinically proven non-invasive treatment with no downtime and a gradual, gentle effect. We often use it in combination with fillers (but not on the same day).
There has been some discussion in patient blogs as to whether Ultherapy damages fillers or even fat. The important thing is that the operator – who at Clinica London is the therapy trained nurse – carries out the treatment using the ultrasound to determine the depth and hence which transducer to use, so there is no direct damage to any underlying filler or fat.
After Ultherapy you can return straight to work or straight home as there are not any post-treatment limitations. You don’t require any creams afterwards, and you don’t need a massage. All you need is time to wait for the initial treatment to initiate the collagen synthesis and tightening.
Ultherapy will help to lift and tone sagging skin and soft tissue of the neck and lower face. We recommend annual maintenance top-ups to create and maintain the visible effect. We also suggest that Ultherapy is used in conjunction with proper skin care and fillers if indicated. Ultherapy is an excellent treatment.
In the 65 to 80 age group, both men and women seek less tired and ageing looking eyes by eyelid surgery, called blepharoplasty and ptosis surgery. These approaches are for hooded, drooping and baggy eyelids.