With age, our skin starts to break down—thinning, wrinkles, sagging and dark spots are all proof—but it doesn’t happen all at once. Instead, the aging process progresses with time, leaving us all in a constant pursuit of a younger-looking complexion. For this very reason, we spoke with New York dermatologist Marina Peredo, MD about her insights and approach on the aging process through the decades.
When do we start seeing the effects of the aging process?
“Our collagen production decreases as soon as we turn 20. By 40, our collagen drops production drops dramatically. As we age and lose facial volume, the contour of the face changes, causing shadow patterns to develop and youthful highlights to fade. As a result, women can go from having soft and feminine features to looking angular and more masculine. Patients complain about appearing tired, angry or unhappy when they are not.”
What is your approach to helping women pursue beauty at all ages?
“I love making women feel better, look better and giving them confidence. It’s priceless. Over time, I’ve developed my artistic aesthetic skills. Part of that is first looking at the patient before you even decide how and what you are going to treat. I think the art of injectables is really to marry the right procedure to the right person. I take everything into consideration: age of the patient, shape of the face, thickness of the skin and their lifestyle to make each treatment truly unique to them and their desired results. Once you know that, you can create a plan.”
Is there an ideal age to start specialized treatments?
“It’s interesting—our new perspective on aging includes younger patients and a focus on prejuvenation. That’s not to say that at 30 you must get injectable treatments. Through the years, our perspective of beauty and injectables has changed. When injectable fillers and neurotoxins first came on the market, it was over 20 years ago. At that time, we were just focusing on fixing what the patients wanted by filling in lines. When it comes to facial feminization you can’t focus on just lines, wrinkles and hollows—you have to look at the facial shape as a whole and the symmetry and see if you need to reshape the face to make it more symmetric.”
What are the best ways for women in their 20s and 30s to take care of their skin?
“It’s about prevention, enhancement and the proper skin-care products. In the 20s and 30s, fine lines and pigmentation may start to appear, lips may need volume to achieve symmetry and acne may be a concern. Now our most popular procedure among that young age group would be “millennial Neurotoxin.” This consists of neurotoxins in small dosages and in targeted areas. Most of the time this is limited to the upper face, especially if they are more expressive and can have deeper lines, for example, those “11’s” between the brows, uneven eyebrows or deep creases in their forehead.”
At home, what is the best skin care for women in their 20s and 30s?
It is important that they start with good skin care, have a healthy lifestyle and focus on correcting specific issues like acne or hyperpigmentation with laser treatments. Studies have shown if you start a prejuvenation protocol at a younger age, you will age better. For the 20s, skin care should focus on prevention—that includes a cleanser, sunblock and vitamin C. For 30+ skin, it’s about prevention, which would mean adding a retinol to your routine helps to exfoliate and renew skin.
What are the top skin concerns for women in their 40s?
“In your forties, you start seeing some sign of aging. Studies have shown that as we get older, we experience some bone absorption, muscle deflation and loss of subcutaneous fat. Visually you see the cheeks will flatten, the area under the eyes may become hollower and the area around the lips start deflating. Everybody ages differently. Some patients will age more in the upper face where some may age more in their lower face.”
What are the best ways for women in their 40s to care for their skin?
“By the age of 40, the loss of collagen is typically 1-2 percent per year, so for this age group the key is maintenance. Skin care at home should at least include a cleanser, sunblock, retinol/Retin-A and antioxidants daily.
In our office, often patients come in saying they look tired even when they are not. Neurotoxin is one easy way to soften that look. Additionally, we can use fillers strategically to reverse some of the signs of aging. Filler can be used to create a lifting effect. For example, filler added to a cheek to lift the area can also improve the appearance of the under-eye area as a result.”
What are the top concerns for women in their 50s and 60s?
“For women in their fifties, the challenges are more in the lower face. It’s the same issues that occur in the forties, but now gravity is an additional factor. I have a lot of patients in their fifties complaining about jowls and corners of the mouth turning down. In addition to concerns about upper face aging, it’s also the lower face. One of our most popular procedures at Skinfluence is a combination surgical and nonsurgical treatment that includes a facelift using FaceTite and MyEllevate to tighten the lower face and neck.”
What are the best ways for women over 50 to take care of their skin?
“For this age group, the skin care should focus on maintenance and restoration of the face and body. That includes cleanser, sunblock, retinol/Retin-A, antioxidants and DNA recovery serum.
In the office, in addition to fillers and toxins, we often treat with Ultherapy or Sofwave, which are ultrasound skin tighteners. These treatments create microscopic injuries to the skin all the way to the muscle. In terms of depth of penetration, they’re not laser devices. The treatment is almost like surgery because it goes through all the layers of skin, subcutaneous fat to the muscle and it heats up all the areas. This injury stimulates new collagen production and the heat coagulates small areas and creates a tightening effect. It’s a treatment that can be done once a year and the results are cumulative over time.
When you’re older sometimes one modality alone may not work. There is a technique of using three treatments at once: a combination of ultrasound skin tightening, Neurotoxin and fillers all done at once. With the skin tightening, it takes about three months to see results but when you add filler and Neurotoxin right away you see the immediate result. The results from Neurotoxin and fillers are not permanent so by the time the filler and toxin dissipate they are seeing the results from the ultrasound tightening. This way the patient sees immediate and long-term results from one visit, with no downtime, without going under the knife.”
