The Facts About Facial Ageing

The Facts About Facial Ageing

By Dr. Philip Bushell-Guthrie, Specialist Plastic Surgeon and Oral and Maxillofacial Surgeon at Brisbane and Mackay


A quick glance at a person’s face and neck gives you a good idea of their age but this can be wrong if the person has premature skin ageing.

What Causes Skin Ageing?

There are intrinsic and extrinsic factors.  The main intrinsic factor is the epigenome because it controls how our genes work.  It appears to have a pre-determined program that controls ageing, however its function can be altered by lifestyle.

The most important of the extrinsic factors is sun exposure causing premature skin damage.  Ultra violet B radiation damages the skin matrix, cells, and even the cell genes.

What Happens When the Skin is Damaged?

The skin can only do two things to protect itself.  The epidermis can thicken and it can become pigmented.  This is called “the cry for help” from the skin.

In Summary

  • The thickened epidermis makes the skin look course and rough.
  • The dermis thins because there are less fibroblast cells and matrix. This results in:
    • Less collagen which provides structure
    • Less hyaluronic acid which holds cells together and provides hydration
    • Less elastin which provides firmness
  • The basal cell layer slows production of cells so the epidermis thickens and appears less healthy.
  • The melanocytes produce more melanin so the skin pigments
  • Many of the immune cells in the skin are damaged which increases the risk of skin cancer
  • The blood supply to the dermis decreases. This decreases the vitality of the skin making it look sallow.
  • The proteins of the skin denature and become cross-linked
  • The layer of fat under the skin thins so that the skin loses support and the face loses volume
  • The facial bones can lose volume slowly also
  • The overall effect is one of sagging and wrinkling

How can we Decrease Skin Damage

Prevention is always better than cure and cheaper too.

Use a sunscreen daily

Do not smoke

Diet and exercise are important

Do not drink alcohol to excess

How can we Treat Facial Ageing?

The aim of treatment is to reduce each of the ten listed factors of skin damage.  Treatment can be grouped into non surgical and surgical.

Non Surgical

Use quality skin care products based on Vitamin C and A preparations.  Peptide products appear to be useful also.  You must use these products regularly and on a long term basis to get the full effect.

Non surgical procedures can be divided into two groups.

  • Those that make the skin look better on a temporary basis. These include:
    • Muscle relaxants
    • Skin fillers
    • Facials
  • The procedures that improve the quality of the skin as well as the appearance include:
    • Peels
    • Radiofrequency
    • Ultrasound
    • Laser
    • Near infrared light
    • Microdermabrasion

Surgical Procedures

If significant skin tightening is required then only surgery can achieve this.

Surgical procedures include:

Face and Neck Lift:

A full face and neck lift is performed under general anaesthesia in hospital.  It removes excess skin and tightens the muscles getting rid of wrinkles.  A mini facelift can be carried out under local anaesthesia in a plastic surgeon’s rooms.  It can only excise excess skin so the results are less pronounced


This procedure excises excess skin from the eyelids and braces back or excises bulging fat to treat the eyebags.  It can be done under general anaesthesia or local anaesthesia.

Brow Lift:

The eyebrows can be selectively lifted or the whole forehead can be lifted.


This is done by transferring a person’s own fat from their tummy or thighs to fill out the fat under the skin that has shrunk away.  This makes a person look fresher and more youthful.

Bone Loss:

If there has been significant bone loss this can be corrected using synthetic bone granules to augment bony features.

In Conclusion

By utilising these treatments you can make yourself look fresher and younger and make your skin healthier at the same time.

You will need a plan tailored to your needs so talk to your Specialist Plastic and Reconstructive Surgeon.

If you have any questions about the facts about facial ageing or anything discussed in this blog, don’t hesitate to contact the rooms at Brisbane Street Clinic


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