Genetics and environmental factors determine how our skin ages. Over the years, Ultraviolet (UV) damage results in a loss of collagen and skin elasticity causing sagging and skin folds, fine lines, wrinkles, age spots, and pigmentations.
Skin ageing is one of the significant aesthetic concerns for both men and women. But do you know that ageing of the human face and body is actually more than skin deep? It is a complex process that affects not just the skin but also fat, muscle, and bone.
For example, the underlying fat pad begins to thin as we age, while ligaments of our skin loosen, causing the skin to migrate downwards. This sign is usually most obvious around the eyes and mouth.
Between Ages 0 - 10
Smooth, firm, tight, supple, and well-moisturised skin. Healthy skin cell repair and turnover.
Between Ages 11 - 30
Skin produces sebum, which may be sensitive, easily inflamed, or dry. At this stage, there is a development of acne, uneven skin tone, hyperpigmentation, and enlarged pores. Skin function is altered as skin health begins to deteriorate.
By Age 30
The skin's barrier function and skin cell turnover weaken, leading to depletion of the critical structures (collagen, elastin, hyaluronic acid) within the skin.
Collagen and elastin are proteins that are responsible for skin elasticity and strength. A host of factors, including ageing and environmental problems, can disrupt the production and function of these two essential proteins.
Skin starts to lose its elasticity as we hit our 30s or 40s, and this is when the effect is more visible such as volume loss resulting in a saggy appearance.
Still, premature ageing can and does occur, which causes a dent when it comes to preconceived expectations.
At Amaris B. Clinic, we understand the complexity of ageing and its effect on the face and body. We practise personalised medicine, where treatments are proposed and planned based on your concerns and goals.
To counter the complex effects of skin ageing, such as sagging skin, depletion of collagen and volume loss, we offer UltRA+ Lift, a double-strategy involving a hyper-diluted form of *Calcium Hydroxyapatite (CaHA), a type of dermal filler and Ultherapy® (micro-focused ultrasound with visualisation - MFU-V).
Multiple clinical research and papers[1], [2] have documented the effects of Ultherapy (MFU-V) and CaHA fillers, assessing their clinical and biophysical outcome. This includes a study[3] co-conducted by Dr Ivan Puah on using the combination of Ultherapy® and CaHA fillers to treat brachial laxity, which showed beneficial results and positive outcomes. Dr Ivan Puah also found that a hyper-diluted CaHA filler effectively tightens skin for patients undergoing liposuction post-surgery.
Ultherapy®[4], [5], [6] is an FDA-approved non-invasive skin lifting procedure to lift saggy skin. It uses micro-focused ultrasound with visualisation (MFU-V) to stimulate collagen fibres deep in the foundational level to lift and tighten the skin on the face, neck, and body.
Ultherapy targets areas under the skin and delivers the required amount of ultrasound energy to boost tissue repair. In doing this, Ultherapy also galvanises the body's collagen regenerative process. It effectively addresses the problem without causing damage to the skin's surface while improving the appearance of lines and wrinkles.
Calcium Hydroxyapatite (CaHA)[7,8] filler is a dermal filler that can effectively restore volume loss, enhance facial features, smooth out wrinkles for facial rejuvenation and reverse or slow down signs of ageing.
CaHA filler's complex formula also provides a scaffold that helps our body rebuild collagen. In its hyper-diluted form, CaHA filler acts as a bio stimulatory agent, improving skin quality and firming the skin.
For example, when CaHA filler is injected into the areas of the face where required, it provides immediate volume to the deficient areas. Over time, while the CaHA filler is absorbed and metabolised by the body, it would still leave behind the body's naturally restored collagen.
UltRA+ Lift is born by harnessing the strength of both non-invasive treatments to produce better lifting, rejuvenation, and collagen-strengthening results for our patients. Not only is UltRA+ Lift used for facial concerns, but it is also used for body skin biostimulation.
Dermal filler (classified as a prescription medical device under HSA) and Ultherapy® can only be carried out by trained and registered medical doctors in Singapore.
Dr Ivan Puah, medical director of Amaris B. Clinic, obtained a Graduate Diploma in Family Dermatology from NUS. He has over 17 years of clinical experience treating various skin conditions such as tattoos, hyperpigmentation, acne scars, etc.
He is also the appointed trainer-for-doctors by Allergan Singapore and Merz Singapore on cosmetic injectables.
We can't change things like our genes, although gene editing is being carried out by researchers in the name of health and science. The ageing process is also something, which we can't avoid, but some changes are still within our capabilities.
Protect skin from the sun's harmful rays
If being in the open and under the sun is unavoidable, ensure that adequate skin protection care is adhered to. Applying sunscreen, seeking shade whenever possible, and wearing proper clothing all help reduce the risk of sun damage.
Tone down on tanning sessions
Skin tanning speeds up premature ageing. Whether it is tanning at the beach or at a salon, the effects of the harmful UV rays emitted are the same.
Stop smoking
The detrimental health effects of smoking are common knowledge. Nicotine narrows the blood vessels, which impairs the ability for healthy blood flow to the skin. The skin will then be deprived of oxygen and nutrients resulting in premature ageing.
Consume less alcohol
Alcohol dehydrates the skin and, over time, damages it. A common visible effect is an aged appearance.
Consume a healthy and well-balanced diet
The benefits of a healthy diet should always be considered. It encourages and promotes, among many things, healthy blood flow essential for healthy skin. Cut down on sugar and refined carbs. Include items such as fruits and vegetables as a staple in your diet.
Exercise
Moderate amounts of physical activities and exercise improves our body's circulation and boosts the immune system. You'll feel more energetic and rejuvenated – looking so as well.
Practise good skin cleansing habits
Be gentle when you are washing your skin. Scrubbing too hard only irritates the skin, which is never good in the long run. Remember to apply a suitable moisturiser as well.
Choose the right products
Just because it looks good and seems to do the job for others or even as advertised does not necessarily imply that they will work for your skin. Know and understand your skin type and purchase the appropriate products for better and desired results. These also include the importance of opting for suitable skin treatments.
Wanting to treat skin laxity and counter signs of ageing with UltRA+ LIFT is a personal decision. If you have tried various methods but are not achieving the result you yearn for, we recommend you come for a consultation and assessment with Dr Ivan Puah to understand how UltRA+ Lift can address your concerns.
[1] Casabona, G., & Pereira, G. (2017). Microfocused Ultrasound With Visualization And Calcium Hydroxylapatite For Improving Skin Laxity And Cellulite Appearance. Plastic And Reconstructive Surgery Global Open, 5(7). https://doi.org/10.1097/GOX.0000000000001388
[2] Kerscher, M., Nurrisyanti, A. T., Eiben-Nielson, C., Hartmann, S., & Lambert-Baumann, J. (2019). Clinical And Biophysical Outcomes Of Combining Microfocused Ultrasound With Visualization And Calcium Hydroxylapatite Filler For Facial Treatment. Dermatology And Therapy, 9(1), 135-142. https://doi.org/10.1007/s13555-018-0273-y
[3] Ramirez S, Puah IBK. Effectiveness Of Combined Microfocused Ultrasound With Visualization And Subdermal Calcium Hydroxyapatite Injections For The Management Of Brachial Skin Laxity. J Cosmet Dermatol. 2021;00:1–9. https://doi.org/10.1111/jocd.14573
[4] Shome, D., Vadera, S., Ram, M. S., Khare, S., & Kapoor, R. (2019). Use Of Micro-Focused Ultrasound For Skin Tightening Of Mid And Lower Face. Plastic And Reconstructive Surgery Global Open, 7(12). https://doi.org/10.1097/GOX.0000000000002498
[5] Khan, U., & Khalid, N. (2021). A Systematic Review Of The Clinical Efficacy Of Micro-Focused Ultrasound Treatment For Skin Rejuvenation And Tightening. Cureus, 13(12). https://doi.org/10.7759/cureus.20163
[6] Lifting And Tightening Of The Face And Neck Utilizing The Ulthera® System, https://clinicaltrials.gov/ct2/show/NCT01368874
[7] Pavicic T, Sattler G, Fischer T, Dirschka T, Kerscher M, Gauglitz G, Dersch H, Kravtsov M, Heide I, Prager W. Calcium Hydroxyapatite Filler With Integral Lidocaine Caha (+) For Soft Tissue Augmentation: Results From An Open-Label Multicenter Clinical Study. J Drugs Dermatol. 2022 May 1;21(5):481-487. DOI: 10.36849/JDD.6737. PMID: 35533030.
[8] Corduff, N., Chen, J. F., Chen, Y. H., Choi, H. S., Goldie, K., Lam, Y., Lesthari, N. I., Lim, T. S., Luo, S., Quiambao, A., Siew, T. W., Tseng, F. W., & Chao, Y. Y. (2021). Pan-Asian Consensus On Calcium Hydroxyapatite For Skin Biostimulation, Contouring, And Combination Treatments. The Journal Of Clinical And Aesthetic Dermatology, 14(8), E76. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570653/