Aesthetic Strategies By Age

Matching Your Aesthetic Strategy To Each Stage of Life

Facial aging reflects changes not only in the skin but also in the underlying fat and bone that support it. Because aging occurs at multiple structural levels, the most natural and durable aesthetic results are achieved by intervening early, maintaining consistency over time, and using a multimodal strategy rather than relying on any single treatment.

In general, different treatments provide the greatest benefit at different ages. Below are my recommendations for the therapies that best produce and maintain optimal results across the decades—recommendations I need to catch up on myself.

Recommendations by age:

Ages 25-35: The prejuvenation stage:

• Daily use of sunscreen with an SPF of 30 or more is the simplest, and yet most beneficial intervention for preventing premature skin aging.

• Start using a topical retinol if you have dry skin or a prescription tretinoin gel for oily or acne-prone skin. They’ll stimulate the continuous production of young, plump skin cells and also help prevent breakouts.

• Wait to start neuromodulator treatments like Botox until you start seeing lines from facial expressions present when your face is relaxed (when you see frown lines but you're not frowning). Starting earlier than that is just a waste of money.

• Treatments including Microneedling, Laser Genesis, or Photofacials done a couple of times a year will stimulate collagen production, shrink pores, and help maintain elasticity without any social downtime.

• Meet with an experienced aesthetician by your early thirties to develop a customized professional skincare product regimen.

Ages 35-50: The rejuvenation stage

All of the above, plus:

• By their mid thirties, most people have started noticing resting expression lines from muscle movement and this is when they can erase and avoid future wrinkles caused by facial muscles by using neuromodulator treatmentslike Botox.

• Using neuromodulators on the facial muscles that pull down your brows, mouth corners, and jawline will lift those areas and prevent them from drooping.

• Blotchy pigmentation can result from hormones or sun damage, but prescription skincare products, chemical peels, and/or Intense Pulsed Light (IPL) treatments will restore even color.

• People with northern European or British Isle ancestry, especially if they have light skin and eyes, tend to have thin skin that’s especially susceptible to sun damage. Thin skin tends to crinkle and can cause crepey skin, initally around the eyes, later on the neck, and eventually all over the body.

  • Fractionated ablative laser treatments will smooth and tighten loose, crepey skin under the eyes.

  • For other areas like the neck, two or three treatments with biostimulants, Nanofat, or the off the shelf fat stimulant, Renuva, will thicken and tighten crepey skin for at least two years.

• Biostimulant or Microneedling treatments with PDRN (salmon sperm DNA)or PRF (a concentrated platelet product made from your blood), stimulate collagen production at a deep level, producing firmer, smoother skin with better elasticity, and smaller pores. An initial series of about three treatments will produce visible improvement that can usually be maintained with one or two maintenance treatments a year.

• Certain areas of facial fat start shrinking in your twenties, and by your thirties, can cause the appearance of shadows under your eyes and deepening nasolabial folds. By your forties, the loss of volume starts causing sagging around your mouth and along your jawline, which is most visible if you catch a reflection of your face when your head is tilted downward. Don’t say I didn’t warn you! You can restore the lost volume and reinflate the frame under your skin with a fat transfer, a biofiller made from your blood plasma, or with injectable filler products.

• Any visible sagging that’s still present after the lost volume is replaced can be subtly lifted with absorbable facial threads.

Age 50-65:The regenerative stage

All of the above, repeated regularly as needed to maintain results.

• Optimizing hormone balance plays an important role in preserving bone density, maintaining skin thickness and elasticity, and supporting overall systemic health. Estrogen deficiency causes about a 30% loss of collagen in the first 5 years after menopause, & low testosterone contributes to sagging, so consider bioidentical hormone optimization when you start experiencing hormone deficiency symptoms. My clients who are in their 60’s and above who are on hormone therapy often look at least ten years younger than others their age.

• People with strong muscles around their lips often develop “smokers lines” in their 50’s, that are vertical lines extending out from the edges of their lips, even though they don’t smoke.

  • When these lines begin to be visible when you’re not pursing your lips, neuromodulators like Botox will prevent them from becoming permanent lines.

    • If up to 10 lines above your upper lip become deep, they’ll probably be most improved by filling them and the underlying surrounding area.

    • If there are lines above your upper lip that are almost too numerous to count, ablative laser skin resurfacing, maintained with neuromodulator treatments, will be the most effective ways to erase the lines and maintain smooth lip areas.

• Those with thicker skin don’t escape their late 40’s and 50’s unscathed because their heavy skin starts to sag. A very rough method used to determine if you can benefit from a facelift is if you can pull the loose skin along your lower face outward so that it partially obscures your ears, you’re probably ready and will benefit most from surgery.

• Skin becomes thinner and drier with age, even in humid climates, and your skin will benefit from professional skinare treatments and medical-grade moisturizers.

Age 65+:The longevity maintenance phase

All of the above, plus:

• Because so much facial volume has been lost in people who are filler and facelift virgins over the age of 65, it can take over 15 syringes of filler, placed over several sessions, to restore youthful facial proportions. Start earlier if possible, and top-offs with smaller amounts will help maintain the results. Fat transfers may be more economical compared to large amounts of filler, and results may last up to 10 years.

• Regular Biostimulant treatments and other collagen stimulating treatments like Microneedling and Photofacials become more important to prevent thinning skin.

• Brown spots on the skin often become thickened but can be removed with spot laser ablation.

Age 90+: The refreshed glow phase

• As much as we’d like, maintaining the previous esthetic treatment regimens don’t produce the same results as when we’re younger, and many clients at this age simply want to look refreshed and have a glow. One of our favorite clients who came in regularly until she passed away at the age of 96, told me when she came in for one of her last treatments, "Tell people that they’ll never stop caring about how they look."

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