First of all, rest assured that many other ladies identify with you, thanks to the multitude of "v-shape" face advertisements.
Your face is like a ‘layered cake’. Simplified from outside to inside, the layers are:
- Skin
- Fat (we doctors call it subcutaneous tissue)
- Fascia or SMAS (tough fibrous tissue layer)
- Muscles and then Bone … i.e your skull
Smoking destroys the elastin part of the skin. The skin tissue matrix has many components, not just collagen.
Collagen may deplete faster than can be replaced by fibroblasts (cells that can make collagen, you can’t eat it to replenish collagen, unlike what 'collagen hot pots' would have you believe it).
The fibrous layer can also sag. When that happens, your mid-face cheek fat compartments which were previously held in place will now start to drop!
So my question to you is, at just 26 years of age, would you like to ‘whip out’ that ‘fallen’ fat ? Remember, fat tissue volume is what stops us from looking like emaciated ‘skull faces’.
If you have seen chronically ill patients, they look very hollow because they have depleted facial fat, and hence volume. So now, I guess you may have thrown the idea of ‘melting’ your fat tissue with mesotherapy out of the window. (By the way, the Ministry of Health in Singapore does not allow the provision of mesotherapy).
You mentioned one of the many High Intensity Focused Ultrasound (HIFU) machines available. Ultherapy is just one of them. In Singapore alone, there is:
- Indigo
- Doblo
- Ultrafomer
- Ultherapy
- SygmaLIFT (Switzerland)
Yes, Ultherapy is just a type of HIFU treatment. This information has surprised many patients. HIFU is a technology, not a brand. So it’s really funny for me to read that one is better than the other.
Now, let’s not be biased with brands and use the generic acronym HIFU. HIFU can indeed be used to tighten the skin. This is like firming up the ‘corset’ of your face.
It can only do so much I’m afraid, but don’t discount its importance.
Can HIFU be adjusted deep enough to contract fat tissue? Yes it can indeed, but is this really what we should do in your situation? Maybe only in certain areas. Your fat, (and this seems counterintuitive), is precious !
Now let’s see if we can firm up deeper fascia layers that also hold your facial compartments up.
Short of a face lift, we can now address this layer at the hair line area. The dermatologists in Korea, (South, not North), have adopted the Enerjet from the USA into an updated version called the AirJet.
This is a needleless (yes, no needles!), drug -delivery device. Instead, it uses a concentrated glucose solution to infiltrate the fibrous tissue layers at the hair line, which have been suggested to have connections with the fibrous tissue layers down the face.
The glucose solution is safe, and can effectively stimulate collagen production and tightening.
This tug of war battle strangely pulls up sagging fibrous layers! With firmer skin, fibrous layers tightened, and judicious redistribution of precious fatty tissue, patients will be able to regain their V shaped proportions.
If the sagging is very severe, a little help from a threadlift with hooks can help stubborn areas.
In short, there are multiple causative factors for sagging skin - balancing your treatment options will put you in a better position to solve the problem.
Finally, to reiterate, fat is precious - if you remove it without much thought about the future, you may find yourself asking for a fat transfer or multiple fillers to get the volume and proportions back in future.
Do find yourself a good doctor to have a discussion with, and I wish you all the best in your quest in restoring your facial proportions. Also, try to quit smoking too!
