Dec
Facial and neck aging isn’t usually characterized by a single issue. Most often, wrinkles are accompanied by lax skin, sagging jowls, neck bands, and more. To address all of these issues with comprehensive skin rejuvenation, Guelph dermatologist Dr. Dusan Sajic has brought 20 years of research and treatment experience to create the 5 Dimension Skin Plan™.
These innovative techniques address the interrelated dimensions of your skin’s health, aging and disease. This integrative approach is designed to correct and delay the signs of aging and to bring out the best version of you.
One of the significant hallmarks of aging is known as the ‘Triangle of Aging’, says Dr. Sajic. “This relates to the areas of the face our eyes are drawn to when looking at someone. When we are young, people notice our eyes, high cheekbones, and smooth, pointy chin. These lines form an inverted triangle. As we age, this triangle is gradually flipped upside down! The most prominent features now are glabellar wrinkles, (vertical lines that develop between the eyebrows due to frowning, scowling, or simply focusing while listening or reading), bags under our eyes, and sagging jowls.”
“Each of the 5 dimensions of the aging process are addressed to help patients age timelessly,” says Dr. Sajic. These 5 dimensions include:
• Bone loss, changes, or hypoplasia leading to a small chin or sunken cheeks
• Fat loss or displacement causing festoons, malar bags, jowls, or double chin
• Structural skin loss from the degradation of elastin, collagen, and hyaluronic acid
• Textural changes to the skin surface causing brown spots, red spots, scarring, or wrinkles
• Muscle and movement imbalances leading to forehead lines, 11s, crows feet, or marionette lines
Loose skin on the face, jowls or a double chin can be corrected, and facial skin tone and texture improved, all with non-surgical or minimally invasive treatments. “Each 5 Dimensions Skin Plan is custom-tailored to each patient’s needs,” says Dr. Sajic.
Dr. Sajic describes the 5 Dimensions Skin Plan:
Hello everybody again. This is Dr. Sage from Dermis Skin Institute, and today we’re going to be talking a little bit about jowls and what to do about them. So what are jowls? Jowls are really the accumulation of skin and fat, really sort of in this area here. And if you can pinch more than a couple of centimeters, they really start becoming an issue for most patients and really something that needs to be done about them. So the question really is what do we do? How do we get them and how do we actually treat them? So before we get into it, we have to just understand why they happen in the first place, what leads to them sort of drooping and accumulating in this such a manner. And one of the key things is understanding that it doesn’t really happen in one process, it’s multiple processes.
Understanding of it really led us to develop our own approach and a treatment that’s only available at the Derma Skin Institute called the Five Dimension Lift. And it’s really based on the five dimensions of aging that we see. So in our skin, there’s what I call five different dimensions where we’re going to all experience three different things, and that’s descent, degradation, and deflation. So first one, degradation. So the collagen, the bone, the muscle, the fat, all of that is going to experience degradation. It’s all going to depreciate, deflation, and also descent because of gravity. So how do we address it? Well, really, I mean we have to look at all of those five dimensions and really find out how we can sort of do that. So the first dimension is bone. So if we’re starting to lose a lot of bone here, guess what? You’re going to lose the support.
So there are ways to enhance the bone, both here and here. And if we’re losing the amount of fluid through the air and bone through there, we really need to strut that up and make it a more firm base and a good support so that we can really drape that skin on top and really help lift it. Now, there are many ways to do that from lasers to fillers to energy devices to surgery. And so the question really becomes is how do I pick the best, the most efficient one that will get me as far as possible to having that really nice defined jawline? Because really that’s what we’re asking about is we want that nice defined chiseled jawline that comes with youth. And as we get on with father time, we start to lose that and most of us subconsciously know that, and we want to naturally and obviously want to get back there as much as we possibly can in the best and most natural way possible.
So the key differentiator for me really is looking at one of two things, and that is either surgical approach or a non-surgical approach. Now, one way to differentiate whether you need one or the other is how much skin you can pull. So if you can grab your skin and you can pull more than two inches, I think it’s definitely time to at least explore surgery. Now the other way to think about it is if you are at a point where you do need surgery, you’re probably going to need some of the other treatments like skin tightening, like volumization, like bridging those struts anyway. So whether you pick surgery first or you want to do a mini non-surgical lift or a maximum five dimension surgical lift, non-surgical lift that we have at our clinic is really up to you. And depending on how much diet and time you have, the budget and also scarring with most facial surgeries, even if they call ’em a mini surgery, you’re going to have a pretty significant scar so that they can actually pull back and remove that tissue.
They try to do their best to hide them. And in many patients, the scars are close to being invisible. But again, for many of our patients that seek us, they really come to us because we’re the experts in non-invasive technologies. And we have a vast array of things that we can use from energies to radiofrequency, to devices, to fillers, to other techniques to really help lift your skin. So the question then really becomes is what type of procedure should we be looking at as the first thing, or should we be combining them with several other procedures to really get the best lift? So for me right now, I think if we look at the literature, we look at what the devices are available, what is the best thing that was given us, the most skin tightening, the most lift, that’s nonsurgical, noninvasive without a scar, I think nothing beats accutight right now.
There are other devices like radiofrequency, microneedling devices like Morpheus, profound, for example, is another good option. But when you compare all the devices across the board and see which one has the most lift on its own, Accu tight, facet tight are generally the best options, I feel both accutight and face tight are more or less the same device. You’re going to get the same type of lift. It’s just really the size of the actual probe that goes underneath and delivers the energy in a way, in a very similar way that’s the same temperature. So we’re going to have the same clinical results just with Accutight. We’re able to target other areas like eyelids, the sub malar, fat nasal lial folds. That makes it all harder to do with face type because it’s a bigger, longer probe than the acuate. So if we’re looking at it, what does it do?
Really, like I said, it’s a probe that goes underneath your skin and is able to check the temperature on a very, very controlled level to a point where we can be very precise to 0.5 of a degree. The machine is checking it many, many, many times, hundreds of times a second to ensure that we’re getting a proper temperature control. And if it exceeds the threshold or it rises too fast, it’s going to control it so that we really, really minimize the risk of burning. So again, for that reason, I think if we’re looking at any one device to really lift, tighten, melt some of the fat that’s under there, Accu is going to be our best number one decision. Now, often we do pair it with a radio frequency microneedling, like for example, the Morpheus eight, the genius phony, sometimes even profound. But it’s knowing and understanding that really the heavy lifting is going to be done by Accutight, and then that finalizing on the cake is really going to be done by something like Morpheus.
Another thing to consider would be fillers. So once we get that, I like to first see my patients do the accu tight, see how much pulling, maybe Morpheus eight with it as well see how much tightening we can get. And then once we get there, I generally assess for fillers. So by doing jawline or chin fillers, we can really get that proper projection and really accentuate and give you that chiseled jawline associated with youth that many of our patients desire. But really, like I said, I like to start with Accu type first, see how far we get. And then that way, even if we need fillers, we generally need less fillers, less volumization, and our critical goal is really to avoid that unnatural overfilled look that results when providers and other doctors and other physicians really only address the one issue and the one dimension in aging.
And it leads to this overfilled or pillow face look that we really generally try to avoid. The best, I think, is really to come in for a consultation. There are many strategies and many other treatments that can be quite complimentary. For example, if you have a lot of sun damage, your skin is very loose, or you have a lot of pigmentation on your face, sometimes we do combine it with carbon dioxide or CO2 laser. That can also give a lot of lift, a lot of volumization that can help restore that structure to the face that we miss with aging. Anyways, stay tuned. Stay tuned for our next conversations. Hopefully that was informative and we hope to see you soon. Stay tuned for next one.
Recommended treatments may include a combination of radiofrequency-based procedures, lasers, or other treatments. Fillers (Restylane®, Belotero®, and JUVÉDERM®) and neuromodulators like BOTOX® or Dysport® are used as required.
Preventive maintenance is the main concern for those aged 25 to 35. Starting or keeping to a skin care routine is absolutely essential. Take steps to protect yourself from the sun and pollution. You may be surprised to learn that blue light emitted from electronic devices can age the skin and make you look older.
The most common treatments you’ll need in your age range are usually:
BOTOX / Dysport / XEOMIN® – as preventative treatments
Facials / professional exfoliation / dermabrasion
Microneedling
Rejuvenating and glowing lasers
Sunscreen, vitamin C, retinol
For patients who are 35 to 45, these additional treatments are most common:
BOTOX / Dysport / XEOMIN – treatment and reversal
Dermal Fillers – Structural and Hydrating
Radiofrequency Microneedling – (Morpheus8) for skin tightening, collagen building, elastin building
ClearLift Laser – (4-6 sessions initially) texture, pigmentation, fine lines,
DyeVL or IPL – (3-6 sessions) – redness, rosacea, light pigmentation
For our patients 45 to 55, treatment often involves a combination of the following:
Botox / Dysport / Xeomin – treatment and reversal
Dermal Fillers – Structural and Hydrating
Radiofrequency Microneedling (Morpheus8) for skin tightening, collagen building, elastin building – recommend a package of 3
Erbium or CO2 laser – more advanced texture, pigmentation, deeper lines and wrinkles and sun damage
Those older than 56 may have a treatment plan similar to above age group in terms of noninvasive treatments. Some may consider surgical revision/surgical facelift, however many of our patients wish to avoid or delay surgery. Combination treatments to lift, fill and tighten are critical to provide the most natural results.
AccuTite and Morpheus8 combination – lift jowls, eyebrows, marionette lines while building elastin
CO2 laser resurfacing to erase deep lines and wrinkles, build collagen, erase pigmentation and wake up sleeping cells, increase DNA repair mechanisms
Dermal fillers to lift, volumize and hydrate.
Consider different types of hyaluronic acid fillers as well as biostimulatory fillers like Radiesse® and Sculptra®
BOTOX / Dysport / XEOMIN to relax the muscles that contribute to engraining the deep wrinkles
For each age group, we recommend maintaining your look with a regular schedule of home skin care and in-office treatments. You can see some of the results our patients have enjoyed by looking at our 5 Dimension Skin Plan before and after pictures.
Ready to explore your options for a younger, more vibrant-looking face and neck? You can request a consultation at our Guelph dermatology clinic using our online form or calling us at (888) 803-3762.
Dusan Sajic, MD, PhD
Richard Backstein, MD
Sonja Sajic, CCPA
Daniel Wong, MD, FRCPC
Tiffany Chen, MD, FRCPC, DABD
Toni Alberto, CCPA
With more than 20 years of experience, deRMA Skin Institute strive to offer patients the most advanced treatments available to keep their skin healthy and looking its best. Board Certified Dermatologist, Dusan Sajic, MD, PhD, board-certified Plastic and Reconstructive Surgeon, Richard Backstein, MD, FRCSC, Sonja Sajic, CCPA, Toni Alberto CCPA, Tiffany Chen MD PRCPC and Daniel Wong MD FRCPC are committed to providing state-of-the-art medical, surgical and cosmetic treatments to all patients in Guelph, Burlington, Cambridge, Kitchener, Hamilton, Milton, and surrounding areas.
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If you are an existing patient inquiring about appointments and services, please contact
Guelph Cosmetic Department: (888) 803-3762 cosmetic@dermaskininstitute.com
Guelph Medical Department: (519) 836-8558 patientcare@dermaskininstitute.com
Burlington Cosmetic Department: (888) 803-3762 burcosmo@dermaskininstitute.com
Burlington Medical Department: (905) 849-5057 burmedical@dermaskininstitute.com