Dr Stefanie Williams is a leading dermatologist and the Medical Director of Eudelo Dermatology & Skin Wellbeing in Central London, one of the country’s very few ‘fusion’ clinics offering both medical and cosmetic dermatology. Here, she tells us what the top five anti-ageing treatments offered at Eudelo are currently.
What’s the clinic’s philosophy?
People pay lip service to ‘natural results’ but if you look at before and after results on Instagram, it’s often anything but natural. Here at Eudelo, we have a natural result guarantee - no trout pouts, no pillow cheeks! We’re holistic, in the sense of looking at all the factors affecting ageing, but we do use high-tech methods and ingredients.
What’s the most popular anti-ageing treatment?
1. Facial contouring
Lines and wrinkles, facial volume and contours, and finally skin health and skin quality are the three main areas to look at when treating somebody’s face, and although lines are what people are mostly concerned by, they are arguably the least important in terms of how well our face looks.
One of our most popular anti-ageing treatments is facial contouring with fillers. This can be to correct age-related changes such as facial sagging, from your 40s upwards, but also to correct hereditary contour issues such as a recessed chin or a bumpy nose, in younger individuals.
Loss of facial volume, especially in the mid face region, is an important part of the facial ageing process, yet its importance is often completely under-appreciated. From the 30s onwards, we lose volume (which includes fat tissue, but also bone mass) and because then the skin envelope essentially becomes too big, there is sagging, which can show up as jowls and nose-to-mouth furrows, but also generally make someone look exhausted and tired all the time.
My favourite filler type is hyaluronic acid (HA), a substance our skin also contains naturally. There are different kinds of hyaluronic acid fillers – for contouring and replacing volume we use more viscous hyaluronic acid fillers (‘volumisers’), while for softening lines and wrinkles, lighter, more liquid fillers are used. After facial contouring, you might return for another treatment 9-12 months after the first session, but they can last up to 18 months, as intervals tend to get longer over time due to cumulative effects.
What about the procedure itself – is it painful? And what sort of aftercare do you need?
We apply a special numbing cream and leave that on for 45 mins before starting the treatment. With this the treatment is at most a tiny bit uncomfortable, but not painful. After the treatment, we apply special post-procedure make-up and the next day you can just continue with your normal skincare, as it’s not an ablative treatment.
2. Botulinum toxin
How about ‘botulinum toxin’? How popular is that in your clinic?
It’s another one of our most popular treatments. We use this for normalising pathological facial movement patterns such as over-frowning. We don’t want to freeze movement completely, but simply normalise over-movement. After treatment, not only will those pesky frown lines soften, but you will look less angry and more relaxed, so it really changes (in a good way!) how people will perceive you.
It sounds scary, is it?
Actually, we use such fine needles that no numbing cream is required, unless you want it anyway. The injections feel a bit like acupuncture. The treatment lasts between 3– 6 months and then you repeat it again. Once more, no specific aftercare is required.
After injectables such as ‘botulinum toxin’ and fillers, where is there the biggest demand?
3. Micro focused ultrasound with visualisation (MFU-V)
Regenerative treatments are very popular at Eudelo. MFU-V is one of those regenerative treatments that essentially help the skin to help itself via bio-stimulation. MFU-V is a non-invasive energy-based treatment which helps on two layers – the dermis and the SMAS layers. (SMAS stands for Superficial Musculoaponeurotic System – it’s a ‘fibrous mesh’ surrounding facial muscles like an envelope). In the dermis, the ultrasound waves stimulate collagen and elastin production through a process similar to our natural wound healing response, improving the appearance of fine lines and wrinkles, as well as overall skin quality and texture. In the SMAS layer, MFU-V essentially helps lift muscles, thus lifting the eye brows, reducing sagging of the lower face and improving contours on the jawline.
This treatment takes quite a long time, depending on the area treated it can take up to two hours. Afterwards, your skin may feel tender to touch for a few days but usually won’t look any different. The effects will develop over the next three months or so and lasts two years plus. It’s completely non-ablative, so once again, no special aftercare is required. However, a cooling mask such as the SkinCeuticals Phyto Corrective Masque can be soothing.
4. PRP needling
Are so called ‘vampire facials’ popular?
Yes, PRP needling ranks highly in terms of most popular anti-ageing treatments. PRP stands for platelet rich plasma and PRP needling is really a combination of two treatments. We take a sample of the patient’s own blood and isolate the platelets with a specialist method. These are full of growth factors, and we then needle that growth factor rich solution back into the skin with a needle pen which creates thousands of tiny holes. Your skin is essentially tricked into thinking all these minute punctures are wounds and every single one goes through a wound healing process which includes ramping up collagen and elastin production. It’s a strong regenerative treatment which improves elasticity and firmness of the skin, and improves skin texture and fine lines. It also helps with acne scarring and decreases pore size.
PRP needling is usually a course of 3 sessions at 6 weekly intervals and you might want to repeat this a year or so later, depending on how your skin is doing. For a day or two afterwards, your skin looks red like it’s been sunburnt. As aftercare, I would recommend something soothing, for instance SkinCeuticals Redness Neutralizer, which is a light lotion containing cooling ingredients. Also make sure to continue with a non-irritating antioxidant serum such as C E Ferulic. If you are using retinol, you should stop using it 5 days prior and start again 5-7 days after the PRP needling.
5. Dermatology grade facials
Our dermatology grade facials are results driven and different from Spa and high-street facials. They consist of multiple steps including extractions to get all the ‘junk’ out of your pores, advanced wet microdermabrasion, a gentle peel and lymphatic drainage. They may also include LED light treatment and/or cryo-stimulation depending on your skin’s needs. The epidermis layer of our skin has a turnover time of about a month, so you should ideally have these facials in monthly intervals, in order to support a healthy cell turnover. They take about an hour. If you’re using retinol, stop for a few days prior. If your skin feels a little sensitive after (remember, this is a results-driven facial, not a pampering one!), again, Redness Neutralizer is useful to soothe the skin.
You’re well known for advocating the ‘Eudelo Staircase Principle', what’s this?
A lot of people go straight for corrective treatments such as ‘botulinum toxin’ and fillers, while ignoring prevention and skin regeneration support, but this is the wrong way to look at it. You should start at the bottom of what I called a ‘commitment staircase’. It starts with making the right lifestyle choices, like having a healthy diet with plenty of good fats, complete protein and lots of antioxidant vegetables, getting enough sleep, moderating your stress levels, ensuring protection from the sun and not smoking. Next comes the commitment to good skincare. This is extremely important, as daily application of cosmeceutical grade skincare can really slow down the ageing process of the skin. The three most important skincare products everybody should be using is a high-grade antioxidant serum (e.g. C E Ferulic) and SPF 30-50 (e.g. Sheer Mineral UV Defense SPF 50) each morning, and a matrix stimulator (eg Retinol 0.3) in the evening, as often as tolerated, which differs from person to person.
If you want to do even more, add monthly dermatology grade facials, which have gentle regenerative benefits, but without downtime. Then, come minimally invasive regenerative treatments such as PRP needling. You shouldn’t skip any of these steps before coming to the final one which is corrective treatments such as fillers or ‘botulinum toxin’. The latter are great treatments but should not replace prevention with a healthy lifestyle, good skincare and regular regenerative treatments.
For further information on Dr Williams’ approach visit www.eudelo.com or read her book ‘Look Great, Not Done’, available on Amazon: https://www.amazon.co.uk/great-science-ageing-aesthetic-treatments/dp/099263623X
Clinic: Eudelo Dermatology & Skin Wellbeing, 63 Bondway, London, SW8 1SJ
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This article reflects the opinions of dermatologist Dr Stefanie Williams and is intended as general information only.