#AskID : Prof Ryan about addressing problem areas

We asked Prof Caitriona Ryan:
It has been a year of much self-observation and for many, self-criticism. I have never seen such low levels of confidence as I have in my patients of late. I think this is a combination of many things; of course we have missed out on the best part of a year of cosmetic treatments, but we have also had so much more time to inspect ourselves, increased stress, less dressing up and wearing make up, weight gain or weight loss, and the negativity surrounding us which has permeated so many aspects of our lives. All of this has contributed to a very negative impact on our self image.

Whether it is for work or to interact with friends and relatives, our use of videocalls has increased exponentially. Observing ourselves as we talk, or even as we listen, on a videoconference call can be very discomfiting. We tend to be highly critical of ourselves, and the unforgiving nature of Zoom, Teams or facetime videocalls shows up every wrinkle and flaw. So many patients tell me that they feel like they have aged dramatically in the past year and are often unhappy and distressed by their appearance.

Videoconference calls have seemed to focus everyone on their sagging jawlines and jowls. It is definitely the most frequent complaint I have had from those who spend time watching themselves online on camera. Mandatory mask-wearing also immediately focuses us to our eyes, and unfortunately to our “crows feet” wrinkles, crepey lax skin, dark circles, undereye hollows and sagging brows. These are the most common current cosmetic complaints, for which there are multiple solutions. There is no one magic treatment that can address all of these problems in isolation. It is the combination of the best skin care regimen with skin rejuvenation and tightening techniques, anti-wrinkle injections and subtle but volume-restoring dermal fillers.
My absolute favourite solution to crepey undereye skin is the combination of PRP (Platelet-Rich Plasma) therapy and Exilis radiofrequency. It has completely transformed the skin around my eyes. When injected into the skin, PRP kick-starts the skin’s regenerative capabilities. Growth factors in the plasma increase collagen and elastin production, stem cell proliferation and vascular formation. This products a plumping and tightening effect on the treated area. The skin is rejuvenated and rehydrated and wrinkles are reduced. Typically 2 treatments are needed 4-6 weeks apart. Exilis is a non-surgical, non-invasive radiofrequency treatment which heats the skin to stimulate the production of new collagen and elastin deep within the dermis. Typically 2-4 treatments are needed 7-10 days apart. The procedure is pain-free, with no down-time post procedure and one can resume normal activities immediately.
For sagging jowls, the combination of anti-wrinkle injections, dermal fillers and skin tightening techniques alongside a scientifically driven anti-ageing skincare regimen is highly effectively. Subtle anti-wrinkle injections of the lower face and platysmal bands of the neck can counteract the downwards pull of the musculature of the neck which can often contribute to the development of early jowling. I use a high density hyaluronic filler such as Juvaderm Voluma in the mid to lateral cheeks of my patients to lift sagging jowls. The biostimulating pan-facial dermal filler Sculptra can be even more effective in suitable candidates as it enhances collagen production throughout the face while restoring volume to produce a more natural and subtle look. Exilis Ultra 360 is a also highly effective in tightening the skin of the lower face and neck. It is pain-free with no downtime. Ultherapy is an FDA-approved, non-invasive, focused ultrasound treatment that stimulates the production of new collagen and elastin deep within the skin without disrupting the skin’s surface to lift and tighten skin of the lower face, jawline and neck.