joel-muniz-fLhghqC2Jp4-unsplash

If ever there was a beauty, skincare, and wellness buzzword that stands the test of time, ‘[collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine)’ would be it. You’ll be hard pressed to research anything related to skin health or aging without coming across the term. When it comes to plump, youthful skin, we know collagen is good and a lack of collagen is not. What’s often left out of conversations about collagen, however, is a deeper exploration of exactly what it is, how it’s produced, and the effect it has on skin quality.

Simply put, collagen gives the skin its structure and natural collagen levels start dropping pretty early in life (think: [mid-twenties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s)). But all is not lost. There are steps that can be taken to slow the declines and even stimulate new collagen production. Intrigued? Here, top dermatologists and nutritionists break down everything we need to know about the beautifying protein.

## **What Is Collagen?**
Collagen is a protein that is naturally found in the human body. “It is a protein produced by the body that makes up something we call connective tissues,” says [Angela Lamb, MD](https://aedit.com/provider/angela-lamb-md-34643), a board certified dermatologist in New York City. “You can also consume collagen through external sources.” Aside from water and fat, the body is mainly made up of proteins – and collagen is the most ubiquitous of them. 

There are different types of collagen, but type I makes up roughly 90 percent of the collagen in the human body. It is a vital component in bones, muscles, cartilage, and, yes, skin. “Collagen is a structural protein that provides rigidity and firmness to the skin,” says [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), a NYC-based board certified dermatologist. 

Basically, collagen is an essential building block of healthy skin. “Collagen is the main component of the skin – in fact, 80 percent of our skin is formed from collagen,” explains [Jennifer Hanway](https://jenniferhanway.com/), a board certified holistic nutritionist. “It is found in the extracellular matrix of the skin, so it plays a pivotal role in the skin's structure and rigidity.” Said another way: “It really is the framework that keeps our skin supple, firm, and lifted,” she adds.

## **What’s the Relationship Between Collagen & Skin?**
“The main role of collagen in the skin is to give it elasticity, bounce, and stretch,” Dr. Lamb says. That’s a lot of responsibility, which is why we’re sorry to say that, once you reach your mid- to late-twenties, natural collagen levels start declining at the rate of about one percent a year. “From the age of around 25, both the types of collagen and the amount of collagen in the skin begins to decrease, leading to dryer, thinning skin,” Hanways shares. Hormonal changes (think: [menopause](https://aedit.com/aedition/cosmetic-procedures-skincare-for-women-in-menopause)) and external forces (i.e. sun exposure, [smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health), poor diet, etc.) can speed up the degredation process. “Poor diet, environmental factors, and [stress](https://aedit.com/aedition/impact-of-stress-on-skin-acne-wrinkles-dryness) can all negatively affect the quality and integrity of collagen in the skin,” she says. 

Changes in the quality and quantity of collagen correlate to changes in the skin. “With the loss of collagen, the skin sags and develops the [fine lines and wrinkles](https://aedit.com/concern/fine-lineswrinkles) we associate with age,” Dr. Camp notes. The reason? “Collagen constitutes a large portion of the dermis, one of the layers of skin,” he explains. “Think of it like scaffolding off which other skin structures are supported.” The webbing of collagen, elastin, and [hyaluronic acid](https://aedit.com/aedition/guide-to-hyaluronic-acid-in-skincare-dermal-filler) found in the dermis that makes the skin supple, sculpted, and supported in our younger years, breaks down as we get older and aging fibroblasts (the makers of collagen and elastin) can’t produce enough to offset the loss.

![Aging Skin vs Younger Skin Cross Section Illustration](//images.ctfassets.net/zw35sfestf1t/73J5weI4xxCbfEVQnowdc5/7eb132f953c98475752ebb2dcd4b0bae/aging-skin-vs-younger-skin-cross-section-illustration.jpg)

It’s not uncommon to first notice these changes on naturally fuller areas of the face, like the [cheeks](https://aedit.com/concern/cheek-volume). Then, you may find that the area around your eyes starts to look a little less plump. As for the rest of your body, the texture of your hair could start to change, your nails might become more brittle, and you may find you begin to experience joint pain or a loss of muscle mass.

To put a finer point on the timing, collagen production peaks in the [twenties](https://aedit.com/aedition/best-mens-skincare-routine-products-ingredients-for-20s) and starts decreasing at that annual one percent rate by the mid to latter part of the decade. For females, that continues until [menopause](https://aedit.com/aedition/menopause-specific-beauty-skincare-hair-products), at which point collagen levels have a significant falloff. There is an estimated 30 percent drop in collagen during that phase, before stabilizing to a two percent yearly decline thereafter. 

## **Where Does Collagen Come From?**
As we've been talking about, the body makes its own collagen proteins. Fibroblasts are the cells in the connective tissues that produce collagen and elastin. Your body is constantly replenishing its natural supply to counteract the breakdown that occurs. When we are young and healthy, more collagen is created than lost – hence your firm, elastic, and resilient skin that bounces back quickly and efficiently heals itself. But, with age, that scale tips in the other direction as fibroblast activity slows. 

In order for the body to function optimally and produce collagen in the first place, it requires [proper nutrition](https://aedit.com/aedition/how-food-impacts-skin-aging). “All of the foods that we eat are broken down and absorbed through the process of digestion, then used for cellular growth and repair throughout the body,” Hanway explains. “Collagen is formed via multiple processes that need specific amino acids – the building blocks of protein – combined with vitamin and mineral cofactors.”

While Hanways says the nutrients from a diet high in amino acids, vitamins, and minerals promote collagen repair and growth, the opposite is also true. “If a person’s diet is lacking in these foods, then collagen repair and growth will be compromised,” she notes. But it’s not just what you aren’t eating that will negatively impact collagen production. “A diet high in [sugar](https://aedit.com/aedition/the-impact-of-candy-sugar-sweets-on-teeth-and-skin) and refined carbohydrates can actually damage collagen and elastin fibers in the skin via a process called glycation that can cause premature aging, fine lines, and wrinkles,” she cautions.

And then there is collagen supplementation. You’ve no doubt seen plenty of collagen powders and capsules promising to rejuvenate the skin. Research [shows](https://www.mdpi.com/2072-6643/11/10/2494) that collagen supplements can improve skin hydration, elasticity, texture, and density, but not all products are created equal (more on that below). 

## **How Can You Boost Collagen Levels?**
Just because your body's natural collagen levels decline over time doesn't mean there aren't ways to kickstart production. Eating a well-balanced diet, taking collagen supplements, adopting healthy lifestyle habits, and even trying certain skincare and aesthetic treatments can stimulate collagen production. 

### **1. Diet**
You are what you eat. To build collagen, the body makes procollagen from amino acids (i.e. glycine and proline), vitamin C, and minerals. Consuming a [diet](https://aedit.com/aedition/best-diet-for-healthy-beautiful-skin) that is rich in these nutrients will give the body the fuel it needs to create natural collagen.

### **Eat This**
- **For Amino Acids**: Animal & fish protein
- **For Vitamin C**: Guava, kiwi, citrus, berries, leafy greens
- **For Minerals**: Oysters, cashews, sesame seeds, almonds

“Diets that contain animal and fish proteins can help collagen production, as they contain the specific amino acids that the body uses to form new collagen,” Hanway explains. “Adding protein-rich foods into our diets provides us with the raw materials necessary for collagen production.” She recommends “high quality animal proteins,” such as organic chicken, grass-fed beef, and wild-caught salmon. Bone broth is also “a great source of dietary collagen” that can be used for sipping or added to sauces, she notes. 

As Hanway explains, [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) is an essential cofactor in the formation and stabilization of new collagen, so foods rich in the antioxidant vitamin are essential. “Guava and kiwi are the two fruits that are highest in vitamin C, but other citrus fruits, berries, and leafy greens are also great sources,” she says. Additionally, “copper, manganese, and zinc are the three minerals that play a key factor in collagen production,” she shares. They are, however, “often lacking in our modern-day diets,” she cautions. To up your intake, she suggests adding oysters, cashews, sesame seeds, and almonds to the menu.

While feeding your body what it needs to build collagen is paramount, there are also foods you can add to your diet to fortify your collagen reserves. “Fermented foods such as tempeh, yogurt, sauerkraut, and kombucha contain lactobacillus, a strain of probiotic bacteria that produces superoxide dismutase,” Hanway says. “Superoxide dismutase is a powerful antioxidant that may prevent collagen breakdown by reducing the production of free radicals.” Her advice: “Aim for one serving of fermented foods a day and consider supplementing with a good quality probiotic.” 

### **2. Supplements**
When we talk about [supplements for skin](https://aedit.com/aedition/how-dietary-supplements-can-benefit-the-skin), collagen is almost always part of the conversation. “I’ve supplemented with collagen powder for years and I recommend it to all my clients who want to look after their skin from the inside out,” Hanway shares. Clinical [research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070905/) and [trials](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073484/) have shown that collagen supplements can support skin elasticity, minimize the appearance of fine lines, and boost moisture levels in the skin. “While even I was skeptical at first, there is strong research to support this,” Dr. Lamb says. “It is exciting.”

With that said, the type of supplement matters. “Hydrolyzed collagen is composed of low molecular weight small peptides, which means it is both highly digestible and easily absorbed and distributed in the human body,” Hanway explains. “When taken orally, it is absorbed into the bloodstream in the form of both collagen peptides and free amino acids that are then distributed around the body – especially to the skin – where they can stay for up to 14 days.”

When they reach the skin, Hanways says the collagen peptides and free amino acids have a two-fold benefit:

1. They provide building blocks for the formation of collagen fibers.
2. They stimulate the production of new collagen, elastin, and hyaluronic acid. 

In order to enjoy the benefits of supplementation, it needs to come from the correct source. “I recommend choosing marine collagen from wild caught fish or bovine collagen from grass fed cows,” Hanway says. Collagen only exists in the animal kingdom, which means the concept of ‘vegan collagen’ is a little misleading. “There is no such thing as vegan collagen,” she notes. “Collagen powder is made from the skin or connective tissue of fish and animals.” If a supplement is marketed as vegan, it's probably better classified as a collagen booster and will likely contain ingredients like amino acids, vitamin C, [vitamin E](https://aedit.com/aedition/guide-to-topical-vitamin-e-in-skincare), and other botanicals that protect against collagen degradation. “There are some supplements available that contain the cofactors for collagen formation that may be helpful,” Hanway says.

When it comes to format, Hanway recommends a collagen powder over a collagen capsule because of the clinically significant serving size. “It takes around 10 grams a day to notice changes in the skin, and that amount is hard to get via a capsule,” she says.

As with any type of supplement, not all are created equal. “The conclusions behind research looking at collagen supplements are a mixed bag,” Dr. Camp cautions. “Some data supports the use of supplements, some does not, and some is biased as the makers of supplements produce it.” This is why research into the brand you are purchasing from is key. 

### **3. Lifestyle**
We don’t need to tell you that your lifestyle plays a role in the overall quality of your skin, and collagen is no exception. Unprotected exposure to [damaging ultraviolet (UV) rays](https://aedit.com/aedition/best-skincare-to-treat-sun-damage), poor sleep hygiene, smoking, not eating well, and stress can all cause the premature breakdown of collagen. When you are in your peak collagen-making years, you might not notice the effects of an all-nighter or sweet tooth, but, as natural production slows, the effects will become visible and compound. As such, there are some healthy habits you can adopt to kickstart your body's natural collagen production *and* protect what you already have:

- Get enough sleep
- Limit sun exposure 
- Manage stress
- Quit smoking
- Eat a well-balanced diet
- Avoid sugar & alcohol 
- Use collagen-stimulating skincare 

### **4. Skincare**
You can’t have a conversation about inducing collagen production without talking about aesthetics and skincare. Let’s start with what you can do in-office. On the most non-invasive end of the spectrum, [red light therapy](https://aedit.com/procedure/led-light-therapy) has been [clinically shown](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926176/) to improve intradermal collagen density. [Sculptra®](https://aedit.com/procedure/sculptra) is a poly-L-lactic acid (PLLA) bio-stimulatory injectable that encourages the body to create new collagen, and Dr. Lamb says [hyaluronic acid-based fillers](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables) can jumpstart production as well. 

### **Aesthetic Treatments**
- Biostimulatory injectables
- Thread lifts
- Microneedling
- Red light therapy
- Resurfacing lasers
- Radiofrequency

[Thread lifts](https://aedit.com/procedure/thread-lift) are also touted for their collagen-boosting abilities, as is [microneedling](https://aedit.com/procedure/microneedling) (a.k.a. collagen induction therapy). Studies [show](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556180/) the tiny needles penetrate the stratum corneum with minimal damage to the epidermis, though it leads to the generation of growth factors that then stimulate the production of collagen and elastin in the papillary layer of the dermis. And then there are energy-based modalities. “Most [resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) and [radiofrequency devices](https://aedit.com/aedition/radiofrequency-skin-tighening-fat-reduction) stimulate collagen,” Dr. Lamb says. Consulting with a board certified dermatologist or plastic surgeon can help determine the best treatment plan for your anatomy.

Topical skincare can also play a role in collagen production. As Dr. Lamb shares, [retinol and retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) are perhaps best known active ingredients for collagen concerns. [Bakuchiol](https://aedit.com/aedition/guide-to-bakuchiol-in-skincare) is often touted as a gentler, plant-based alternative to the vitamin A derivatives, and [research](https://pubmed.ncbi.nlm.nih.gov/24471735/) shows it doesn’t skimp on the collagen upregulating benefits. 

### **Skincare Ingredients**
- Retinol & retinoids 
- Bakuchiol
- Glycolic acid
- Peptides
- Vitamin C
- Sunscreen

A member of the alpha hydroxy acid (AHA) family, [glycolic acid](https://aedit.com/aedition/benefits-of-glycolic-acid-for-body) is [believed](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891644/) to increase collagen production by triggering the body’s natural healing response. [Vitamin C](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare) is instrumental to collagen making and preserving in all forms, but, as a topical, the antioxidant [plays a part](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547010/) in collagen synthesis and stabilization. Additionally, certain types of [peptides](https://aedit.com/aedition/guide-to-topical-peptides-in-skincare) can either slow the breakdown or increase the supply of collagen and elastin.

Finally, a word on [sunscreen](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body). In case you need another reason to double down on your sun care routine, unprotected exposure to UV rays speeds up the degradation of collagen. Wear a broad spectrum sunscreen with a sun protection factor (SPF) of at least 30 every day as a first line of defense.

## **The Takeaway**
Collagen is a protein that plays a crucial role in the body's makeup, including the structure of the skin. With age, natural collagen production slows and levels begin to decline, which leads to fine lines and wrinkles, thinning, dryness, and volume loss. From diet to supplements to at-home and in-office skincare, however, there are steps you can take to stimulate collagen for smoother, stronger, and more supple skin.

Wellness

A deep dive into the structural protein that keeps skin supple, sculpted, and supported.

The Role Of Collagen In The Skin

Everything You Need To Know About Collagen And The Skin

shutterstock 1760754215

Hyaluronic acid-based fillers work somewhat like magic. Injecting them into the appropriate facial planes allows for deflated areas – such as the [cheeks](https://aedit.com/procedure/cheek-augmentation-with-fillers), mid-face, temples, and [lips](https://aedit.com/procedure/temporary-lip-fillers) – to experience an immediate improvement in volume and contour. Often, dermatologists and plastic surgeons veer on the conservative side and take a less is more approach when filling. After all, adding too much volume in any one area, at any one time can lead to an unnatural appearance. However, some patients require more volume than others, which may call for multiple syringes to achieve the desired effect.

Lately, we’ve talked a lot about [overfilled facial features](https://aedit.com/aedition/hyaluronidase-to-dissolve-dermal-filler), [filler migration](https://aedit.com/aedition/why-lip-filler-migrates), and [filler fatigue](https://aedit.com/aedition/dermal-filler-fatigue), which are just a few of the reasons why the concept of injecting large amounts of filler may sound scary. The truth is, in inexperienced hands, it can be. But, if you are working with a highly skilled injector who understands your aesthetic goals, it’s possible for the specialized technique to be both safe and effective. Here, top physicians break down everything you need to know about large-volume filler. 

## **Large Volume vs. Overfilling: What’s the Difference?**
The term ‘large-volume filler’ is relative. It depends on the treatment area and the anatomy of the patient. Generally, it refers to injecting more than the ‘typical’ amount of filler required for a noticeable change in the average patient, says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a double board certified facial plastic and reconstructive surgeon in Arlington, VA. “I consider ‘large volume’ anything more than a single syringe (one cc) of filler,” he explains. For context, about five syringes of filler are needed to achieve one teaspoon's worth of volume, says [Joshua Zeichner, MD](https://www.instagram.com/joshzeichnermd/?hl=en), a board certified dermatologist in New York City. He adds that a typical ketchup packet contains about seven syringes worth of filler — just a little food for thought.

While large-volume filler equates to a larger, albeit appropriately used, dose, there is some confusion between it and [overfilling](https://aedit.com/aedition/how-to-correct-overfilled-facial-features). A clear distinction exists between the two:

- Overfilling refers to excessive and inappropriate filler placement
- Large-volume filler precisely injects more-than-average doses into the appropriate facial planes

Dr. Zeichner explains that, when placing more volume, the outcome is 100 percent determined by the skill and aesthetic of your injector. “It is no different than going to the museum and seeing a Monet versus a van Gogh,” he shares. “It's the same oil paint just used differently on the canvas.” If the injections are appropriate, the results should be natural and complement, not hinder the patient's appearance. “When the filler is not placed where it should be, patients often look odd or overfilled,” Dr. Zeichner adds.

We all know what an overfilled face looks like, and, unless that's the aesthetic you're going for, most people try to avoid it at all costs. For that reason, it's understandable why some patients get nervous that they will end up looking overfilled when their provider lays out four or five syringes of filler. Seeing a medical [tray of needles](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) does more than send off sirens that a substantial bill waits for you at the front desk. Dr. Zeichner says patients are more so afraid of looking overfilled and fake, than the price tag.

## **The Ideal Candidate**
Whether you need half a syringe or five ccs, a full assessment is vital before your provider injects a single drop of filler into your face. This includes studying the anatomy of the treatment area and its relationship to the rest of the face, in addition to learning more about your aesthetic goals. Not every patient needs the major volume technique, and the degree of evident aging determines who benefits from it and who doesn't. 

Typically, those with a significant [volume deficit](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) and/or [asymmetries](https://aedit.com/aedition/cosmetic-procedures-for-body-asymmetries) are candidates for multiple syringes of filler. As such, age is not a factor when it comes to who can reap the benefits. More mature patients who require significant volume restoration and younger patients who mandate facial balance are often contenders, says [Michael Schwartz, MD](https://www.drschwartz.com/), a board certified plastic and reconstructive surgeon in Los Angeles. “Full facial balance restoration improves proportions and [creates harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) within the features instead of augmenting one area,” he explains. “It requires more product because we treat the face entirely to achieve natural results.” However, patients seeking intentional exaggeration of specific features that are not harmonious with the face's natural contours may not be well-suited for large volume injections, adds [Shirley Madhère, MD](https://elementsandgraces.com/about), a holistic plastic surgeon in NYC and founder of [Jet Set Beauty Rx](https://jetsetbeautyrx.com/).

Sometimes, it can be challenging for doctors to educate their patients on how much volume loss they have – and for patients to accept it – “but it is an important conversation to avoid potential disappointment, especially if a patient does not get the result they are looking for when using fewer syringes,” Dr. Zeichner explains. The last thing any provider wants is for a patient to invest in their face and not be happy with the results simply because there is a need for more product.

## **The Right Way to Do It**
What constitutes large-volume filler depends on each patient's face and how much filler they can safely benefit from, says [Kenneth Mark, MD](https://kennethmarkmd.com/), a board certified dermatologist with offices in New York, Aspen, and the Hamptons. Despite the volumizing benefits, he finds patients can be skeptical of substantial amounts of filler because of the suboptimal outcomes they’ve seen on social media from either too much of the wrong filler or poor injections in the wrong places. This rightfully creates legitimate concern amongst patients when they hear the words ‘large-volume filler.’

Using filler as an alternative to traditional cosmetic surgery procedures (like a [rhinoplasty](https://aedit.com/aedition/facts-about-liquid-rhinoplasty) or [chin implant](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures)) and in areas that require more noticeable correction (think: jawline, temples) call for larger volume – often two syringes of filler or more – says Dr. Cabin. “The nose and chin are unique in that fillers create changes in two-dimensional shape in the profile view, as opposed to three-dimensional facial volume change goals with other areas,” he explains. The chin typically requires one to four ccs of filler to create the necessary balance. When injecting insufficient amounts of filler, the results will not be noticeable and can even call unwanted attention to a specific feature.

In the hands of an expert injector who understands the nuances of filler and anatomy, using more than moderate amounts of product can create an aesthetically pleasing result, especially when the placement is deep. “It makes a big difference," says Dr. Zeichner, who regularly uses five or more syringes (often in a single session). “Most of my injections tend to be deep, down to the level of the bone,” he notes. This technique helps provide structure, support, and mattresses to lift and reposition the overlying soft tissue and skin. “If all of the injections are superficial, it weighs down the face and makes the patient look overfilled,” he cautions. Deep placement creates the opposite effect.

Deep injections also create a smoother appearance – sans bumps, lumps, and irregularities. Not injecting more robust fillers deep enough can cause superficial lumps, nodules, and a blue tinge to the skin, known as the Tyndall effect. “When injecting thicker fillers into the skin, it is important to employ a technique that places the filler in the layer of skin that is appropriate to accept the dynamic properties of that filler,” Dr. Madhère explains.

In the case of large-volume fillers, Dr. Mark likes to use a layering technique. Layering is just what it sounds like and consists of placing fillers in various depths of the skin and locations as needed over time. He says layering filler and staging it out over multiple sessions avoids overcorrection and provides natural-looking results. “Utilizing this method and pinpointing precise placement has allowed me to avoid complications and obtain optimal cosmetic results,” he adds.

Technique aside, injecting the right fillers in the right place is essential. Dr. Madhère says thicker hyaluronic acid-based fillers, like [Juvéderm® Voluma](https://aedit.com/procedure/juvederm) and [Restylane® Contour](https://aedit.com/procedure/restylane), occupy more space. But it's not just hyaluronic acid filler that fits the bill. Injectables that fill more robustly, including [Sculptra®](https://aedit.com/procedure/sculptra), which provides a scaffold for a volumizing effect, may be used. “Additionally, thick and long-lasting calcium-based [Radiesse®](https://aedit.com/procedure/radiesse) can also be used,” she explains. “So can [fat injections](https://aedit.com/procedure/facial-fat-grafting), but they involve a surgical procedure and additional costs.” No matter what filler you and your provider ultimately decide on, it's always important to find an injector that understands the differences between the products and where to place each one.

Just like every patient isn’t a candidate for large-volume fillers, not every facial feature should be treated with the technique either. The parts of the face that tend to respond well include the temples, cheeks, midface, and jawline. Dr. Madhère advises against using a lot of volume in the [forehead](https://aedit.com/aedition/cosmetic-forehead-procedures) and [eye area](https://aedit.com/aedition/under-eye-filler-pros-cons), as they can swell and cause undesirable puffiness.

## **One Session or Multiple: Which Is Best?**
There are plenty of patients that only need a bit of filler and respond well to an average dose. Yet, the ‘a little filler goes a long way’ rule doesn't apply to everyone. Dr. Zeichner says that “more filler goes a long way” for many of his patients. And, when there is a need for significant volume and it is within a patient's budget, he prefers injecting it all at once. “This means less anxiety over the visits and a single period of downtime versus multiple visits with potential bruising after each one,” he shares.

Some providers, meanwhile, choose to space out the injections. For example, Dr. Cabin rarely does large volume filler in a single appointment. Instead, he performs spreading out large-volume injections over a few visits because, as he says, there’s a greater chance of unnecessarily high levels of short-term swelling. “The filler tends to settle better when I inject it over several sessions,” he notes. “It settles and creates a more natural correction.”

[Swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) may be one reason to break the injections up, but there's also the potential for volumetric changes that patients don't know to account for. A filler may be a specific volume when it is going in and, most of the time, that volume increases since the product naturally pulls in water from the surrounding tissue (hence, post-treatment swelling). Some of this extra water can remain, causing what Dr. Cabin describes as a more considerable volume change than you would anticipate from the syringe volume alone. Volume fluctuations are another reason why some providers avoid injecting large amounts of filler at once.

## **How Long It Lasts**
The more product your provider injects, the longer it can take to break down and for the area to return to baseline. So, injecting more filler may equate to longer-lasting results, but there is a lot that goes into how long filler results last. “Longevity depends on several factors, including, but not limited to, the main ingredient, chemical composition, amount injected, and patient's metabolism,” Dr. Madhère explains. 

While injectable brands provide an average of how long each product lasts given its intended use (i.e. up to one year), those timeframes vary from one person to the next. “Everyone metabolizes fillers differently, so I like to start with full correction treatment and then follow-up with a [maintenance plan](https://aedit.com/aedition/how-frequently-to-get-non-surgical-cosmetic-procedures-like-dermal-filler-botox-chemical-peel) to keep the results up,” Dr. Schwartz says.

## **The Takeaway**
If your doctor says you'll benefit from multiple syringes of filler, it doesn't mean you will end up with an overfilled face that looks doughy or unnatural. In fact, some patients sport numerous syringes of filler, and no one but them and their injector knows. More often than not, it’s poor injection technique and improper placement that will land you in the ‘done and don't’ category. Ultimately, the decision is yours, but, with the help of an expert injector who understands how to use more robust amounts of filler to replace lost volume or correct asymmetry, you may be happier with the outcome. In the right hands, more can be more.

Expert Opinion

Dermatologists and plastic surgeons break down the benefits of injecting large volumes of filler for certain patients.

The Pros And Cons Of Large-Volume Filler Injections For Volume, Symmetry, Contour

Why Injectors Say Not To Be Afraid Of Large-Volume Filler

sigmund-MQ2xYBHImKM-unsplash

Injectables are constantly evolving, and what was considered the gold standard yesterday may be passé by tomorrow’s standards. One class of injectables that has largely proven to be trend-proof: [Neuromodulators](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) and their ability to limit muscle contraction and soften the look of fine lines, wrinkles, and other age-related concerns. In fact, [Botox® Cosmetic](https://aedit.com/procedure/botox) is celebrating the twentieth anniversary of its approval by the United States Food and Drug Administration (FDA) for the temporary improvement of the appearance of moderate to severe frown lines in adults. It was the first of its kind when it entered the market, and it’s since been joined by [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin). 

Since no two faces are the same, no two dosages of these products are necessarily the same to achieve a desired result. That’s where so-called ‘Botox sprinkles’ – also known as ‘baby Botox’ – come into play. Not to be confused with [microbotox](https://aedit.com/aedition/aquagold-botox-microdosing-facial), the sprinkle technique is essentially just a smaller dose of a neuromodulator. A modest amount of Botox® and the like may produce a more natural result for younger patients or newbies who are just dipping their toe into the wrinkle-relaxing pool and concerned about appearing frozen.

So, what are the pros and cons of Botox sprinkles, and how can you tell if you are a candidate? We tapped top dermatologists and plastic surgeons for the scoop.

## **What Are Botox Sprinkles?**
A tongue-in-cheek reference for a smaller dose of a neuromodulator, the term ‘Botox sprinkles’ are injections of Botox®, Dysport®, Jeuveau®, or Xeomin® into a specific part of the face to soften the look of fine lines and wrinkles without eliminating all movement. “Botox sprinkles are great for smoothing fine lines and wrinkles on the face without completely removing muscle movement,” says [Michele Green, MD](https://aedit.com/provider/michele-green-md-34642), a NYC-based board certified dermatologist.

The trend of less-is-more shows no signs of slowing down, and some injectors and patients are preferring to use minimal amounts of neuromodulator to preserve expression. At his Arlington, VA, practice, double board certified facial plastic and reconstructive surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), says a large percentage of his patients opt for these treatments to soften facial wrinkles and prevent traditional aging-related wrinkles while preserving natural movement. “It is the ideal option for [first-time Botox patients](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) who are a bit nervous, younger patients interested in prevention, and patients who depend on powerful emotive facial expressions for their work,” he explains.

Like traditional injections of neuromodulators, the ultra-light dose version still requires a medical professional to inject botulinum toxin type A under the skin to temporarily relax the underlying muscle. A sprinkling of a neuromodulator within a particular area may provide a reduction of wrinkles and lines and their formation but not to the same degree as a standard treatment, says [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), a board certified dermatologist in New York City. Striking this balance is dependent on the [skill of the provider](https://aedit.com/aedition/botox-neuromodulator-safety). “An experienced injector will be able to determine the right amount of Botox to inject based on how strong your facial muscles are and how deep the wrinkles are,” Dr. Green says. 

The just-right amount of product will soften the visible appearance of wrinkles while limiting – but not paralyzing – the movement that causes them in the first place. Botox sprinkles aren't the best route if you want very little to no movement in the treatment areas. Using less Botox is less likely to completely paralyze the muscle and, therefore, results in more expression, says [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a board certified dermatologist in NYC. “Ultimately, with Botox sprinkles, you retain some movement and some wrinkles but soften the overall appearance,” she notes. Most injectable patients eschew the fully frozen look (though some want it) and the overarched eyebrows and difficulty moving that accompany it. If you specifically request baby Botox, you are less likely to have that frozen appearance since your doctor injects smaller amounts of the product.

Even though the name ‘sprinkle’ implies injecting a dusting or smidgen of neuromodulator into any one area, it's a little more precise than that. While there is no set requirement for what a sprinkle treatment consists of since each patient requires a different dose, expect about half the unit use compared to complete treatment. “For Botox sprinkles, I use as little as five units of Botox in the forehead and glabella, whereas the official dosing is 20 units for each,” Dr. Cabin says. “For the crow's feet, I use about 2.5 units per side, whereas the official dosing is 12 units per side.” Again, a consultation with your injector will dictate the best approach for you.

It should be noted that a full dosage doesn’t necessarily mean an unnatural or immobile result. If your doctor recommends using the standard dose of a neuromodulator, it still can provide a refreshed look that allows for facial movement. “However, if a patient is interested in maintaining a lot of movement, a lighter treatment with neurotoxin can be a great option,” Dr. Camp says.

## **Where to ‘Sprinkle’**
It's safe to ‘sprinkle’ the same areas of the face that providers commonly treat with larger amounts of neuromodulators – like the glabellar lines (a.k.a. the elevens), [crow's feet](https://aedit.com/procedure/periorbital-botox), and even the horizontal lines on the forehead. For the most part, smaller areas don't require as much product to begin with to erase wrinkles and lines seamlessly. Dr. Green prefers to use the sprinkle technique on areas of the face with lighter lines or where the skin is just starting to develop them. “It also works wonders in reducing mild to moderate wrinkles while still looking natural, but it often fails to yield the desired results for deeper lines etched in the skin,” she says.

## **Who’s the Best Candidate for Botox Sprinkles?**
Botox sprinkles are suitable for anyone who doesn't have many lines yet or has lines that aren't very deep but wants to prevent further wrinkles, Dr. Garshick says. “It's also good for someone who prefers a very natural look with minimal correction but still wants a refreshed appearance,” she explains. “And it can be helpful for older patients with a low-set brow or those who rely on the muscle movement to keep the eyelids and brows open to soften the movement without causing the brow to drop.”

Not everyone will benefit from a smaller dose of neuromodulator injections. While Dr. Camp says it may be a “good option” for those with minimal wrinkling who don’t require a full dose, others may find that a smaller amount of neuromodulator does not produce their desired result. Dr. Green says some patients come in expecting to get baby Botox, but, upon consultation, find out they have strong facial muscles and need more product to achieve optimal cosmetic effects. “The key to getting the best results from a neuromodulator is to go to an experienced injector, like a board certified dermatologist, who can give you natural-looking results,” she notes.

Generally speaking, the deeper the line, the stronger the muscle, and the more product needed to create smoother skin. Dr. Green explains that, with baby Botox, such small quantities of Botox are added to the muscle that it is not entirely relaxed. For deep wrinkles that are the result of overly active or strong facial muscles that repeatedly crease in the same spot for years, too little of an amount won't effectively smooth the area. “It's difficult to undo years of wrinkles with small quantities of Botox, so a regular amount is better for deep lines,” Dr Green shares. “But always ask your doctor what is best for you.”

That’s not all. As Dr. Garshick explains, Botox improves dynamic wrinkles or wrinkles that form with expression as opposed to lines at rest. Regardless of the amount of neuromodulator used, if a line is deeply etched in while at rest, it may not go away with Botox alone. “For these types of deeply etched lines, it can be helpful to also use [laser resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) or [microneedling](https://aedit.com/procedure/microneedling) treatments, which can be helpful to improve the appearance of lines at rest,” she adds.

Skin health may also play a role in who Botox sprinkles do and do not work well for. As Dr. Cabin shares, patients with mild-to-moderately etched-in wrinkles but otherwise elastic skin with healthy levels of collagen can eliminate and prevent deepening with consistent sprinkles. “But, in people with poorer skin or those that have significantly deep etched-in lines, this treatment may improve their lines a bit but will not be powerful enough for significant improvement or reversal,” he notes.

## **Does Less Botox Mean Less of a Result?**
In a single word: no. Just because you choose to go lighter on the amount of neuromodulator that is injected doesn’t mean the results are suboptimal. “Botox sprinkles can help the forehead look smoother, the wrinkles around the eyes less pronounced, and the lines between the eyebrows less deep,” Dr. Camp says. “However, the results are more subtle than standard treatments.”

Generally speaking, Dr. Green says baby Botox will yield a similar result to regular Botox, just on a smaller scale. “It is great for younger patients in their [twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s) and [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s) who are looking to prevent fine lines and wrinkles from developing and subtly reducing the appearance of mild to moderate frown lines,” she shares.

Patient response to neuromodulators varies, and what may equate to a ‘lesser dosage’ for one person may be the standard treatment for someone else. “A ‘sprinkle’ for one could significantly decrease muscular movement for another patient,” Dr. Cabin notes. This is why first-timers are usually encouraged to come back for a follow up. “This is why I recommend two appointments with every new Botox patient,” he explains. “The first appointment is a conservative treatment, and the second appointment – two weeks later – is to see the response and if touch-ups are needed for undertreated areas.”

Certain features, like the forehead, actually respond better to smaller amounts of product versus larger quantities. For example, too much neuromodulator in the forehead can weaken the muscle in the area and force the brows to drop. “Injecting too many units can give the impression of a heavy brow,” Dr. Camp cautions.
 
As far as longevity goes, the lesser dose holds just as much weight in terms of results. It shouldn't wear away any faster or slower, so you can expect, on average, to stay wrinkle-free for about three to four months. In some patients, however, fewer units may equate to a shorter duration of results. This is especially true if the muscles are strong. But, “if the muscles are weaker, you will still notice some benefits for the same duration as expected with a full course of treatment,” Dr. Garshick says.

## **The Takeaway**
Whether it’s a preventative treatment, gateway procedure, or aesthetic preference, Botox sprinkles can serve many purposes. By using less neurotoxin, the muscle will retain more movement than a standard dosage, which can lead to a more natural-looking result. Depending on the depth of your lines, the quality of your skin, and/or your goals for treatment, baby Botox may be all you need to enjoy a more refreshed appearance. Consulting with a board certified dermatologist or plastic surgeon is the best way to determine how much neurotoxin you’ll need to achieve your desired outcome.

Aesthetics

Dermatologists and plastic surgeons weigh in on whether using a smaller dose of neurotoxin can still be effective.

The Pros And Cons Of Baby Botox (a.k.a. Botox Spinkles) For Fine Lines And Wrinkles

Are Botox Sprinkles The Way To Go?

javier-sierra-6jopFhZkGGk-unsplash

A drop in collagen and elastin production; a loss of bone mass; a decrease in facial volume. These changes are part of getting older, and you often notice them as laxity and crepiness around the eyes, a flattening of the midface and cheeks, or jowling of the jawline. One facial feature you may not have realized is also impacted? [The nose](https://aedit.com/concern/nose-shape).

With age, the nose begins to droop as collagen is lost and the supporting structure diminishes. And, unfortunately, even a nose job from your teens or early twenties isn’t immune to effects of Father Time and Mother Nature. So, while secondary (or even primary) rhinoplasty surgery may be the answer for some, other [nose shaping solutions](https://aedit.com/procedure/nose-shaping-solutions) can help lift the sniffer back to where it belongs. Here’s what you need to know.

## **The Causes of a Droopy Nose**
Sometimes called a floppy nose or downward-pointing nose, there are a handful of reasons why we start to see the front of the nose – more specifically, the tip – fall forward with age. Not everyone experiences drooping to the same degree. But, for those who find it noticable, it can be reason enough to want to understand why it’s happening and what to do about it. 

Both guys and gals are equally susceptible to developing a droopy nose over time. Men generally begin with a more acute angle than women and the muscles acting on the tip are a bit stronger, says [Andrew Frankel, MD](https://aedit.com/provider/andrew-frankel-md-275), a double board certified facial plastic and reconstructive surgeon in Beverly Hills. Furthermore, hormones are partially to blame. Females lose estrogen with age, making the skin and tissue thinner and less supportive. Men, meanwhile, often see sagging as a result of nasal injuries that were never corrected. 

Unless it’s impacting your [ability to breathe](https://aedit.com/concern/breathing-issues), a droopy nose isn’t a cause for medical concern. But that doesn’t mean it doesn’t pose an aesthetic one. Across the board, these are the main reasons why your once perky nose may be looking a little longer and less angular these days:

### **1. A Weak Internal Structure**
As we age, it’s typical for the cartilage and ligaments inside the nose to weaken, which creates a droopy tip, says [Farhad Ardesh, MD](https://aedit.com/provider/farhad-ardesh-md-19202), a double board certified facial plastic and reconstructive surgeon in Beverly Hills. “The nasal septum is a wall consisting of cartilage and bone that divides the inside of the nose into the right and left sides,” he explains. “It is the foundation and support beam that holds up the tip of the nose.” If the front part of the septum is crooked, then the tip lacks proper support. “As the unsupported nasal tip droops down, it pulls the skin over the bridge of the nose down over the bones,” he shares. This downward pull of skin creates the appearance of a hump or makes pre-existing humps seem more pronounced.

Cartilage changes can also cause the midportion of the nose to begin to look pinched or asymmetric. In addition, as the ribbons of cartilage that make up the tip of the nose relax outward and downward, the nose may look rounder, wider, and ‘droopier’ than it used to, says [Dara Liotta, MD](https://www.facialplasticsnyc.com/), a double board certified facial plastic and reconstructive surgeon in New York City. Changes to the blueprint of the cartilage can also give way to difficulties in breathing. 

With lost tissue support, the stiffness imparted by these tissues also diminishes, causing the nose to ‘stretch’ to a degree, says Dr. Frankel. “Given that the forces acting on the nasal tip when one speaks and smiles are often directed downwards, the tip will tend to fall over time,” he explains.

### **2. Genetics**
If your parents or grandparents sport a flaccid nose, there’s a pretty good chance you will, too. Dr. Ardesh says that those genetically inclined to experience drooping should consider surgery – particular if they have cosmetic or breathing concerns. [Ethnicity](https://aedit.com/aedition/guide-to-ethnic-rhinoplasty) can also influence where and how the nasal tip sits. Some nationalities generally have a weak or small amount of cartilage that affects overall support. Trauma and previous rhinoplasty or other nasal surgery also affect how the nose ages (more on that below).

### **3. A Previous Rhinoplasty with Poor Tip Support**
Droopy tips can occur if past nasal surgeries did not provide adequate cartilage grafting to support the end of the nose. “Rhinoplasties can contribute to either more or less drooping depending on the technique utilized by the surgeon,” says [Jay Calvert, MD](https://www.instagram.com/DRJAYCALVERT/), a board certified plastic and reconstructive surgeon in Beverly Hills. For example, [open rhinoplasty](https://aedit.com/procedure/open-rhinoplasty) techniques use cartilage grafts to add support, whereas a [closed rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty) approach does not employ these grafts. This can lead to more pronounced tip sagging down the line. 

### **4. The Natural Aging Process** 
The nose is not impervious to age-related shifts and alterations in the body. Changes in the bones, cartilage, fat, ligaments, and skin all contribute to the way our nose ages, says [Mary Lynn Moran, MD](https://www.marylynnmoranmd.com/), a double board certified facial plastic and reconstructive surgeon in Franklin, TN, and past president of the American Academy of Facial Plastic and Reconstructive Surgery ([AAFPRS](https://www.aafprs.org/)). “The facial bones begin to resorb, thus providing less of a foundation for the nose and the ligaments loosen, which can cause the tip to become less defined and droop,” she shares. 

There are also changes to the skin (it thins) and fat (it often resorbs), giving way to a skeletonized appearance. The ligaments that support the nose weaken and collagen fibers shorten, which causes less robust soft tissue support, Dr. Calvert explains. “All of these factors result in the descent of the tip of the nose,” he says.
 
## **The Effect on Facial Balance**
[Facial harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) is all about proportion, which means changes to one feature (i.e. the nose) can impact the structure and aesthetic of the entire face. Here’s a few of the ways it can manifest:
 
- **The Lower Face**: As the nose becomes longer or the tip more bulbous, the distance between the lips and the base of the nose can appear shorter. A droopy tip makes the upper lip look longer (not necessarily fuller), which ages the lower face since the distance between the nose and mouth shortens.
- **The Eyes**: The nose and eyes are close to one another, and that relationship changes markedly with age. “As the shape of the eye sockets deepens, the nasal bridge can look more prominent and the eyes appear closer together,” Dr. Frankel explains. “Often, lowering the height of the nasal dorsum will have an overall rejuvenating effect on the face.”
- **The Whole Face**: As the tip begins to fall forward, it’s common for the nostrils to start to widen, which can throw the entire balance of the face off-kilter. Furthermore, when the tip droops, it can lead to the appearance of a more prominent nasal dorsum (the bone and cartilage ‘hump’ of the nose), says [Adam Kolker, MD](https://drkolker.com/), a board certified plastic and reconstructive surgeon in NYC. This might draw new attention to your sniffer. 

At this point, you might be wondering if there is anything you can do to slow down or stop the hands of time. While there is seemingly an endless stream of preventive treatments on the market today, the nose is a little more complicated. 

[Laser treatments](https://aedit.com/aedition/laser-prejuvenation-for-younger-patients) may be able to treat the skin on and around the nose, Dr. Calvert notes. And, for some, he says injecting fillers in the columella may also help support the tip. Those with a naturally acute angle between their lip and nasal tip can prevent it from progressing by having rhinoplasty to change the relationship between the septum and tip cartilages. “Rhinoplasty surgery is only indicated when an individual desires improvement of changes that can already be seen, not as a proactive measure,” Dr. Kolker clarifies.
 
It should be noted that, even if you had rhinoplasty as a teenager or young adult, there’s no guarantee that the previous surgery will make the nose resistant to drooping, especially the tip. “It depends upon the technique used and whether the surgeon cut cartilage away to achieve the desired cosmetic result (‘reductive rhinoplasty’) or if the surgeon added structure to build the new shape of the nose in an architectural way (‘structural rhinoplasty’),” Dr. Liotta says. “Cutting away the cartilage in a primary rhinoplasty can make these changes worse and can cause asymmetry and more drooping with time, while building a new structure can help keep the underlying structure of the nose strong and prevent, or limit, drooping.”

Other than that, there isn’t much to do preemptively. Sure, healthy lifestyle choices are always the way to go since they can help minimize a breakdown of collagen and elastin, but, unfortunately, chromosomes and gravity always prevail. 

## **How to Correct a Drooping Nose**
If a droopy nose is what you focus on every time you look in the mirror, there are ways to fix it — and they’re not all surgical. But, of course, surgery is usually the most transformative option since it provides the longest lasting improvement and the most structural support. “All noses are dynamic and will change over time,” Dr. Kolker says. “While many rhinoplasty techniques include maneuvers to support and stabilize the nasal tip – including a variety of cartilage graft techniques – these noses are nevertheless subject to the same laws of genetics and physics that affect all noses.” With that in mind, below are the surgical and non-surgical treatment options for addressing a drooping nose:

### **1. With Surgery**
Rhinoplasty is the most traditional way of correcting major nasal issues. If a crooked septum is causing your droopy nose, Dr. Ardesh says a [septoplasty](https://aedit.com/aedition/difference-between-septoplasty-rhinoplasty) can be performed in tandem. But, as we’ve mentioned, technique matters. “Rhinoplasty and septoplasty surgeries can create a droopy nose tip years after surgery,” he cautions. During a [septorhinoplasty](https://aedit.com/procedure/septorhinoplasty), your plastic surgeon will remove portions of the septal cartilage, but not all of it. “Then, we carve the cartilage into support beams called grafts that we place to enhance the structural integrity of the nose,” he shares.

At her practice, Dr. Liotta is seeing many patients in their [forties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-40s) and [fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s) coming in for what she calls ‘nasal rejuvenation’ surgery. “These patients don’t want to change their look,” she says. “They just want to get back to the more refined and airbrushed look that they had when they were younger.” Where is this renaissance of [rejuvenation rhinoplasty](https://aedit.com/procedure/rejuvenation-rhinoplasty) coming from? “I think this stems from the Zoom culture — people staring at themselves in ways they hadn’t previously,” she shares. “These aren’t the patients obsessed with their selfies and striving for perfection.” As such, Dr. Liotta says her nasal rejuvenation surgery also optimizes breathing by restoring structure and support, a big plus for those that suffer from poor breathing that may result with age.
 
### **2. With Fillers**
There are also non-surgical options to consider as long as you know they will not provide the same result as a surgical fix. “[Liquid rhinoplasties](https://aedit.com/procedure/liquid-rhinoplasty) use hyaluronic acid fillers, such as [Restylane®](https://aedit.com/procedure/restylane) or [Juvéderm®](https://aedit.com/procedure/juvederm), under the skin of the nose, which may help enhance the side views of the tip and nasal bridge,” Dr. Ardesh says. They can also help push the tip of the nose up, so it appears as if it’s not falling. 

Yet, the results of liquid rhinoplasty are temporary (think: six to 12 months), and, if there’s too much blunt definition at the tip, it can further weigh down the nose. “Liquid rhinoplasties performed in patients who do not have adequate support to the lower half of the nose can result in poor appearance and even compromised breathing,” he warns. In addition, using fillers to improve a descending tip can create more of an obtuse angle between the top of the nose and lip to help soften the degree of flaccidity.

### **3. With Neuromodulators**
Injecting neuromodulators (read: [Botox®](https://aedit.com/procedure/botox), [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin)) can, however briefly, help to lift the tip. Placing any one of these products into the small muscle under the nose (i.e. depressor septi nasi) can help lessen the extent of drooping when smiling. It’s not a permanent fix (it lasts the standard three to four months you can expect from all neurotoxin injections), but, for those bothered by their tip and not willing to undergo surgery, the subtle and short-lived change can be just what the doctor ordered. Strategically placed [neuromodulator injections](https://aedit.com/procedure/muscle-paralysis-rhinoplasty) can also be used to smooth bunny lines around the nose.

### **4. With Threads**
There is no denying that [thread lifts](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) are having a moment, and the nose can also benefit from their minimally invasive lifting powers. In some patients, threads can ever-so-slightly pick up the nasal tip. But, unlike other more predictable and lasting measures, Dr. Ardesh cautions that thread lift results are not very effective and only last a few months before the tip of the nose falls back down. At best, it’s a short-lived solution.

## **The Takeaway**
If you feel like you woke up one morning with a different nose, you are not alone. The facial feature is not immune from the effects of gravity and aging, which, for many, manifest as a drooping tip and the elongation of a once perky and proportional sniffer. If you are unhappy with the way these changes are impacting you aesthetically or functionally, there are both surgical and non-surgical treatment options. 

Age-Related Drooping Nose: Causes, Symptoms, Surgical And Non-Surgical Treatment Options

The Truth About Why Your Nose Is Drooping

kinga-cichewicz-5qNTJcCckmc-unsplash

In the world of aesthetic medicine, we talk a lot about ‘rejuvenation,’ but the breadth of non-surgical treatment options available today has made the idea of ‘[prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend)’ not only possible but popular. When it comes to taking preventative measures to keep your skin looking youthful, a solid skincare and sun care routine tops the list. From there, [neurotoxins](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time), [fillers](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time), [facials](https://aedit.com/aedition/what-its-like-to-get-a-hydrafacial-for-clear-glowing-skin), [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels), and the like can proactively address concerns before they become, well, concerning. 

A treatment option that is growing in popularity? [Laser rejuvenation](https://aedit.com/procedure/laser-skin-resurfacing) or, in the case of patients under 35, laser prejuvenation. To better understand the concept of preventative procedures and how laser therapy fits in, we’ve spoken to a top dermatologist and a prejuventation patient.

## **What Is Prejuvenation?**
Sure, ‘prejuvenation’ might sound like nothing more than a trendy buzzword, but there is actually some substance to the concept. The term refers to the steps taken to prevent or correct early signs of aging. Compare that to ‘rejuvenation’ — which describes treatments that are designed to address visible signs of aging — and you’ll get the gist of why many plastic surgeons and dermatologists are increasingly working with patients in their late twenties and thirties.

So, what is this demographic looking for? “Younger patients tend to be concerned about skin tone, pore size, texture, and fine lines,” says [Jessica Weiser, MD](https://aedit.com/provider/jessica-weiser-md-34640), a board certified dermatologist in New York City and assistant clinical professor of dermatology at Columbia University. Treatment protocols are as unique as the patients themselves, but she encourages everyone “to commit to a [comprehensive skincare routine](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s) with [liberal sun protection](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body).” 

From there, she explores in-office remedies on a case-by-case basis. “I may recommend small amounts of [neuromodulator injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) for patients who have static wrinkles,” she says. For the uninitiated, ‘static’ wrinkles are the lines that stay put at rest, while ‘dynamic’ wrinkles are those that only occur with movement. For patients who start to experience [volume loss](https://aedit.com/concern/facial-volume) in their thirties, “small quantities of [dermal filler or biostimulatory injections](https://aedit.com/aedition/hyaluronic-acid-filler-vs-biostimulatory-injectables)” may be helpful, she adds.

And then there are lasers. “There are a variety of lasers that can address redness, pigmentation, and [general skin tone](https://aedit.com/concern/uneven-skin-tone),” she explains. Additionally, she says there are “a variety of other lasers and energy-based devices that are more specific to [overall skin texture](https://aedit.com/concern/uneven-skin-texture), including [acne scars](https://aedit.com/concern/acne-scars), [fine lines](https://aedit.com/concern/fine-lineswrinkles), and more.”

## **Laser Prejuvenation 101**
First, a quick primer on laser therapy. There are a few different types of lasers to keep in mind (learn more in our [complete guide to laser skin resurfacing](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing)):

- **Ablative Lasers**: Also known as ‘wounding’ lasers, these devices remove some or all of the epidermis.
- **Non-Ablative Lasers**: ‘Non-wounding’ lasers preserve the epidermis, while heating the dermis layer.
- **Fractional Lasers**: A pixelated energy beam dissipates some of the heat.
- **Non-Fractional Lasers**: The laser beam remains focused and concentrated.

Different combinations of the above (think: [ablative fractional](https://aedit.com/procedure/ablative-fractional-lasers), [ablative non-fractional](https://aedit.com/procedure/ablative-nonfractional-lasers), [non-ablative fractional](https://aedit.com/procedure/nonablative-fractional-lasers), [non-ablative non-fractional](https://aedit.com/procedure/nonablative-nonfractional-lasers)) make a device better suited for different concerns. Non-ablative [pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser), for example, are used to treat vascular lesions (think: broken capillaries and other redness), while a non-ablative fractional laser like [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) is commonly called a ‘lunchtime laser’ because less inflammation means less downtime (but also less dramatic results).

It should come as no surprise then that the type of laser Dr. Weiser recommends for a patient depends on what they are looking to address. “For those with red scars, [rosacea](https://aedit.com/concern/rosacea), and broken capillaries, I use vascular-specific lasers to reduce or remove these concerns,” she shares. For mild texture concerns, she notes “there are lower energy and less invasive devices” that can do the trick. When it comes to [acne scars](https://aedit.com/procedure/acne-scar-treatment-laser-resurfacing), Dr. Weiser often reaches for what she describes as “more intense fractional resurfacing devices” — including non-ablative resurfacing with [Fraxel®](https://aedit.com/aedition/guide-to-fraxel-laser-skin-resurfacing-treatments) or [microneedling with radiofrequency](https://aedit.com/procedure/microneedling-with-radiofrequency) or ablative resurfacing with [CO2 laser treatments](https://aedit.com/procedure/ablative-co2-laser).

An additional prejuvenation benefit? [Collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine) production. “Some treatments do yield collagen regeneration — those that work on textural irregularities of the skin, primarily — and may provide some anti-aging benefits,” Dr. Weiser shares. As she explains, devices that target redness and pigmentation tend to provide less collagen production. But, with that said, “all heat can help stimulate healing,” she notes. Stimulating healing, stimulates collagen.

None of this matters, however, if you aren’t taking care of your complexion at home. “What usually proves to be most beneficial is early implementation of skin health awareness and sun protection,” Dr. Weiser emphasizes.

### **What to Expect From Laser Treatments**
Because there are so many different types and intensities of lasers, there is no one single treatment or recovery protocol. Generally speaking, “most energy-based devices require a series of treatments,” Dr. Weiser notes. You can usually expect at least three sessions to see results, she says, though more may be needed. “For more severe textural issues, additional treatments may be required to reach an ideal endpoint,” she adds.

While more invasive ablative lasers may call for general anesthesia (and a couple weeks of downtime), a [topical anesthetic](https://aedit.com/aedition/numbing-cream-breakouts) suffices for many laser treatments. You may feel a bit of discomfort during the treatment, and, depending on the device, swelling, [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), and redness are common side effects. Your provider will share any additional post-op instructions prior to the procedure, but you may be encouraged to switch to a [gentle skincare routine](https://aedit.com/aedition/post-procedure-skincare-makeup-product-guide) for a period of time and be extra vigilant with your sun protection. 

It is also important to note that many lasers are not suitable for all skin tones. When performed incorrectly on melanated skin, it can lead to burns, scars, and [unwanted pigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma). This is why it is imperative to consult with a board certified laser expert who has a range of tools in their kit and experience treating a [range of skin types](https://aedit.com/aedition/best-laser-skin-hair-removal-treatments-for-darker-skin-tones). 

## **Patient Perspective**
Now that you have a better sense of what laser prejevenation is, it’s time to hear what it's really like. Below, a patient shares her experience undergoing laser therapy to treat early signs of aging. 

### **Lea, 28, Los Angeles**
*Lea opted for laser treatments to address the fine lines around her eyes. After consulting with a dermatologist, she decided that Fraxel® treatments would be more suitable for her than fillers or Botox®.*

<Dialogue>
  <Question party={The AEDITION}>
    What led you to book a consultation with your cosmetic dermatologist?
  </Question>
  <Response party={Lea}>
    I work in an image-oriented profession, so I spend a lot of time looking at pictures of myself. Many of my peers were getting Botox® or fillers, so I decided to start looking into options that were open to me. I was open to having injectables, but I also knew that I wanted to go easy to begin with so I have options when I get older. During the consultation, my dermatologist suggested Fraxel® as an alternative. After talking about the benefits and risks, I settled on that option.
  </Response>
  <Question party={The AEDITION}>
    What was the procedure like for you?
  </Question>
  <Response party={Lea}>
    I had five sessions in total, and each of them lasted around half an hour. The most surprising thing about the treatments was the smell. I suppose it makes sense that, if your skin is being burnt, there would be a smell to it! It wasn't off-putting enough to make me tell people not to try it — it's just something worth keeping in mind. I would say the pain level during the procedure was less than having a bikini wax. It was a little unpleasant, but, again, not enough to put you off going back for your next session.
  </Response>
  <Question party={The AEDITION}>
    How was the recovery process?
  </Question>
  <Response party={Lea}>
    I was told to expect some soreness, but it wasn't too bad. I used a mix of milk and iced water on a flannel to soothe my skin, as recommended by my dermatologist. I had my sessions on Thursdays and worked from home on Fridays. By Monday, it was absolutely fine. I made sure to reapply sunscreen every few hours when I was out for a couple of weeks after each session, and I still keep up with sunscreen to keep my results looking as good as possible for as long as I can.
  </Response>
  <Question party={The AEDITION}>
    Are you happy with the results?
  </Question>
  <Response party={Lea}>
    My goal was to even out the skin around my eyes. I felt the area was starting to show signs of aging, especially when I laughed. After the first couple of sessions, I didn't see too much difference, although a couple of friends said they noticed a difference after the second session. By the fifth session, I was pleased with the results we achieved. My skin looks smoother and regenerated, almost fuller.
  </Response>
</Dialogue>

## **The Takeaway**
While laser therapy can be a great way to address skin tone and texture concerns at any age, it is not a silver bullet. For patients starting treatment in their [twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s) or [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s), it is important to remember that the skin will continue to age. “It is not accurate to say that many laser or other energy-based treatments at a young age would offset more invasive procedures later on,” Dr. Weiser says. But, when coupled with other [healthy habits](https://aedit.com/aedition/skin-aging-habits), it can go a long way toward long-term benefits. “Often patients who begin laser therapy at a younger age are adopting other skin-healthy behaviors, including photoprotection, [antioxidant use](https://aedit.com/aedition/facts-about-vitamin-c-in-skincare), good cleansing practices, and proper hydration,” she explains. “The  incorporation of laser treatment usually inspires better skincare and preventative habits!”

*Patient name has been changed 

The concept of 'prejuvenation' for patients under the age of 35 is gaining steam, and laser treatments can be used to prevent and address early signs of aging.

The Benefits Of Laser Skin Resurfacing For Younger Patients

What Is Laser Prejuvenation?

shutterstock 1828508141

Beauty

More brands are catering to the delicate and transitional type of skin with menopause-specific products that run the gamut of hair, skin, and pretty much everything else imaginable.

A Guide To Menopause-Specific Skincare, Beauty, Hair Care Products

Do You Need To Add Menopause-Specific Products To Your Beauty Routine?

josue-escoto-jn4dzVGeweQ-unsplash

As a beauty editor, there’s not much I wouldn’t try when it comes to smoothing [fine lines and wrinkles](https://aedit.com/concern/fine-lineswrinkles). I’ve been obsessed with my anti-aging skincare regimen since my [late twenties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s), and I started getting Botox® in my forehead and [around my eyes](https://aedit.com/procedure/periorbital-botox) as another preventative measure by the time I was 30. Every 12 weeks, I would sit in my dermatologist’s chair in New York City and smile as I faced one of my biggest fears – needles. As the years went on, I noticed my Botox® wasn’t lasting as long, and, as someone who is Type A, I began going in every eight to 10 weeks. That’s when the switch from Botox® to [Dysport®](https://aedit.com/procedure/dysportr) was recommended. 

## **What’s the Difference Between Botox & Dysport?**
The truth is, at a chemical level, there isn’t much of a difference between Botox® and Dysport®. The active ingredient in both [neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) is botulinum toxin type A, which means they work in the same way. “All type A botulinum toxins have the same mechanism of action: blocking the release of acetylcholine and preventing the muscles from contracting to maintain the aesthetic effect,” explains [Dennis Gross, MD](https://www.dennisgrossmd.com/), a board certified dermatologist and founder of his [eponymous skincare line](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fdrdennisgross.com%2F). 

[Botox®](https://aedit.com/procedure/botox), or onabotulinumtoxinA, was first approved by the United States Food and Drug Administration (FDA) to temporarily improve the appearance of frown lines between the eyebrows in April 2002. It has since received more aesthetic approvals, in addition to its therapeutic uses. [Dysport®](https://www.dysportusa.com/what-is-dysport) (a.k.a. abobotulinumtoxinA), meanwhile, was first approved to treat glabellar lines in April 2009. Other cosmetic neurotoxins on the market include [Xeomin®](https://aedit.com/procedure/xeomin) and, the newest to the scene, [Jeuveau®](https://aedit.com/procedure/jeuveau).

While the active ingredient in each product is BoNT-A, they also feature unique protein blends that can affect the diffusion and wear of the injection. “The amount of core active neurotoxin in each on-label dose is different,” Dr. Gross says. “Dysport® has shown to include more core active neurotoxin compared to other neurotoxins.” 

Another point of difference? The appearance they each give is very different to my editorial eye. When treating my forehead lines, I find Botox® to give a more localized freezing, whereas Dysport® spreads evenly throughout for a more air-brushed effect. “I love the results that Dysport® gives since the results are natural-looking — fresh but not frozen,” Dr. Gross notes.  

## **How Long Does Dysport Last?**
For me, Dysport® lasts about 12 weeks just like [Botox® used to](https://aedit.com/aedition/botox-immunity-neurotoxin-resistance). For some, it can last up to five months (yes, I’m extremely jealous of those people). For others, it may be less. “The time length varies from patient to patient depending on genetics – some people break down neurotoxins at quicker rates than others,” Dr. Gross shares. 

But that’s not all. How you take care of your skin [in between appointments](https://aedit.com/aedition/maintaining-skin-with-devices-skincare-products-between-cosmetic-procedures) matters, too. He recommends using a consistent skincare regimen that includes active ingredients like [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), hydroxy acids ([alpha](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) and [beta](https://aedit.com/aedition/guide-to-beta-hydroxy-acids-salicylic-acid-in-skincare)), and [niacinamide](https://aedit.com/aedition/guide-to-topical-niacinamide-vitamin-b3-in-skincare) to stimulate collagen production and prolong the life of your treatment. 

## **The best part…**
If ever there was a ‘[lunchtime procedure](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time),’ neurotoxin injections are it. Dysport® is a quick 10- to 20-minute non-surgical treatment with little to no downtime (you may experience localized swelling, redness, or tenderness at the injection site for about 24 hours). And, unlike some of its competitors that take five to seven days to kick in, Dysport® results start to show in just 48 to 72 hours. Living in a world of instant gratification, I love the quick turnaround. 

Patient Perspective

Consider this my love letter to an air-brushed forehead.

Why I Switched From Botox To Dysport To Treat Forehead Lines

Why I Switched From Botox To Dysport To Treat My Fine Lines

shutterstock 579142042

When it comes to cosmetic enhancements, figuring out when to opt for non-surgical procedures and when to consider surgical nips and tucks can be ticky. If you are experiencing the [volume loss](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) and [skin sagging](https://aedit.com/procedure/facial-skin-firming-and-lifting-solutions) that naturally arrives with age, injectable filler alone may not be enough and it may not yet be [time for a facelift](https://aedit.com/aedition/can-you-be-too-young-for-a-facelift). For those who fall somewhere in between, wanting a natural-looking lift and an increase in [collagen](https://aedit.com/aedition/guide-to-collagen-in-skincare-supplements-aesthetic-medicine) (the youth-preserving protein), a [PDO thread lift](https://aedit.com/procedure/pdo-thread-lift) may be the Goldilocks option.

[Thread lifts](https://aedit.com/procedure/thread-lift) have humble beginnings. They fell out of favor in the early 2000s due to their fragility, visibility under the skin, and lackluster results. Recently, however, the minimally invasive procedure has enjoyed a glow up. After a few enhancements of their own, threads are being utilized from head to toe to behind (specifically: [the buttocks](https://aedit.com/aedition/butt-thread-lift-vs-bbl-implants-filler)). 

So, with their ability to address not just skin laxity concerns but also the internal production of collagen, could thread lifts lessen the need for facelifts, if not make them obsolete? The answer is not a simple yes or no, and we’ve gone to the experts to understand the pros and cons of the PDO thread lift.  

## **What Is a PDO Thread Lift?** 
“A PDO, polydioxanone, thread lift is a procedure that uses dissolvable sutures to rejuvenate and lift sagging skin,” explains [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon and founder of the Few Institute. It is one of three types of sutures commonly used in thread lift procedures — the other two types are made from [poly-L-lactic acid (PLLA)](https://aedit.com/procedure/silhouette-instalift) and polycaprolactone (PCA). 

When it comes to choosing PDO, PLLA, or PCA threads, Dr. Few says it really depends on the needs of the patient and their aesthetic goals. “PDO threads are better at repositioning and revitalizing tissue, while PLLA and PCA threads are better at lifting sagging parts of your skin,” he notes. These threads vary in length, diameter, size, and strength, says [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), a board certified dermatologist in New York City, which all impact the lifting process. 

As she explains, “very fine threads would be used in smaller facial areas,” such as around the eyes or the lips. “Medium strength and length threads can lift the jawline, the marionette area, or the lines around the mouth and chin,” she says. Other use cases? Lifting the nasolabial folds and decreasing the wrinkles in the neck, she continues. Last but not least, “wider and stronger threads have been used to address laxity in areas such as breasts, [sagging knees](https://aedit.com/aedition/best-cosmetic-procedures-for-knees), and other body parts that may need a mild lift,” Dr. Karcher adds. 

## **How PDO Threads Work**
If you’ve seen videos of thread lifts on social media, the process of threading might look a little graphic. In reality, it is a relatively painless and quick procedure. “A small amount of [local anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) is inserted into the area where the threads will be placed to lift,” Dr. Karcher says. “The threads are then inserted, gently tightened so that the tissue is gathered, and gently pulled with the excess thread cut.” The threads have little ridges that allow for the thread to act as an anchor and grasp the skin as it is pulled. 

Externally, the use of these threads gives the skin the appearance of an immediate, albeit subtle, lift. Internally, the threads stimulate the body’s natural collagen production. They break down over the course of a few months (think: three to six), but the collagen remains. Depending on what the patient is hoping to accomplish, the thread lift may be paired with other facial rejuvenation treatments. 

Dr. Few, for example, has developed his own approach for delivering more comprehensive and longer-lasting results. “The Inverso Suspension technique is a non-surgical treatment that I developed to incorporate non-surgical thread lifting with the restoration of lost volume in the jawline with [micro Botox®](https://aedit.com/aedition/aquagold-botox-microdosing-facial) or [Xeomin®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) to the frown muscles of the mouth to create a graceful appearance that is not ‘done’ or unnatural in nature,” he explains. “The results of this approach may last two years or more.”

## **The Right Candidate for PDO Threads**
While the benefits of thread lifts are promising, there are limits to what they can achieve. “The ideal thread lift candidate is usually in their [late thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s) to [early fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s),” Dr. Few says. “Most patients over the age of about 55 will benefit more significantly from facelift surgery.” With that said, if you are of facelift age but not able to go under the knife, a thread lift can be an option. “Thread lifts can provide a facelift alternative for older patients who are unable to have surgery for medical reasons,” Dr. Few shares. Because they can be performed under local anesthesia, “many people who have age-related conditions that make them ineligible for surgery — like high blood pressure, type two diabetes, and cardiovascular disease — can safely have this treatment,” he adds.

## **PDO Thread Lift Recovery & Results** 
From procedure time through recovery, thread lifts are among the most expedited facial rejuvenation options. “One of the best things about this treatment is it only takes about 30 minutes,” Dr. Few says. “After that, you’re free to go back to work or whatever else you had scheduled for the rest of your day.” Post-procedure, patients may be advised to limit [rigorous exercise](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) and activity for about a week, but it’s usually possible to return to work immediately after. [Swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) may also occur depending on the patient. 

Now for the most important part: the results. As we mentioned, thread lifts have both short- and long-term effects that allow the visible results to keep on giving. “Another advantage is the results are seen immediately,” Dr. Karcher says. While the benefits of the collagen production take several months to show up, the lift from the threading is instant. The results can last up to two years, though you may seek a touch up before then...

## **Yes, You Can Get a PDO Thread Lift More Than Once** 
As we mentioned, the results of a PDO thread lift can last up to two years. Due to their nature, [maintenance](https://aedit.com/aedition/how-frequently-to-get-non-surgical-cosmetic-procedures-like-dermal-filler-botox-chemical-peel) isn’t as routine as say, neurotoxin or filler, but Dr. Few notes that, at his practice, many patients come back for additional thread lifts after the initial sutures are absorbed by the body. 

If you don't find the results satisfactory, surgical intervention may be the better solution — and it’s important to find a provider who will give it to you straight. “For patients who are clear surgical candidates, PDO is not the ideal tool, surgery is,” Dr. Few cautions. “If a patient feels, after three months, they want more lift than the PDO can deliver, I would advance them to either PLLA or surgery as an enhanced lifting, rejuvenating tool.”

## **Why PDO Threads Are Not the ‘New’ Faceliift** 
Now that we understand the powers and limitations of the procedure, it’s safe to say that, while they may offer a plumping lift, thread lifts are not a ‘forever’ option for all. “It’s a cheaper and faster alternative to facelift surgery, but the results don’t last as long and aren’t as dramatic,” Dr. Few says. Even so, the right cocktail of genetics and maintenance might make thread lifts enough for some. “Because the thread lift procedure is so low-risk, patients who like the results of their thread lift can usually opt to have a fresh set of temporary sutures placed once their old sutures are absorbed by the body,” he adds. 

For those who can afford the upkeep, “this maintenance may help forestall or eliminate the need for a facelift down the road,” Dr. Few shares. Dr. Karcher echoes this sentiment. “The PDO thread lift will give the benefit of a more uplifted, tighter area without all the downsides of surgery,” she says. “This can greatly extend the time before someone gets surgery or it can eliminate the need for surgery.”

## **The Takeaway**
Few procedures work from the inside out to enhance and lift the way PDO threads do, which is what makes this modern version of the thread lift so popular. By addressing multiple causes *and* symptoms of skin again on a plethora of areas, it’s a great option for those who aren’t yet candidates for a facelift or are looking to avoid one altogether. There are, however, limits to what a PDO thread lift (or any thread lift) can accomplish, so it is important to consult with a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) dermatologist or plastic surgeon to determine the best treatment protocol for your anatomy and aesthetic goals.

Too young for a facelift? Not interested in filler? Looking for a youth-preserving alternative? PDO threads build collagen while lifting the skin. Here’s what you need to know.

Benefits Of PDO Thread Lifts For Facial Rejuvenation, Sagging Skin, Volume Loss

Could The PDO Thread Lift Replace The Facelift?

shutterstock 1743648053

Here at The AEDITION, we spend a lot of time discussing the professional measures you can proactively take to preserve your skin: [Botox®](https://aedit.com/procedure/botox), [microneedling](https://aedit.com/procedure/microneedling), [chemical peels](https://aedit.com/procedure/chemical-peels), [laser skin resurfacing](https://aedit.com/procedure/laser-skin-resurfacing), you name it! But, what about the everyday things you should (or shouldn’t) be doing at-home to keep the fountain of youth flowing longer? 

From [unexpected wrinkle inducers](https://aedit.com/aedition/unexpected-causes-of-wrinkles-fine-lines-face-neck-chest) and [dehydrators](https://aedit.com/aedition/how-to-treat-prevent-dry-skin-face-body-hands) to habits that cause [volume loss](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) and [pigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments), there are likely a lot of small and seemingly insignificant actions in your day-to-day life that are leading to premature signs of aging. If you’ve ever wondered if your routine is speeding up the hands of time, we’ve tapped three top dermatologists to find out what everyday habits you might want to kick or reconsider. 

## **1. Sleeping On Your Side**
- **Causes**: Fine Lines & Wrinkles

This just in: If you truly want some [beauty rest](https://aedit.com/aedition/impact-of-beauty-sleep-on-skin-health-nighttime-skincare-products), don’t be a side sleeper. “The friction and tugging that occurs through the night when we sleep on our side can contribute to the formation of [fine lines and wrinkles](https://aedit.com/concern/fine-lineswrinkles) on the face,” says [Michele Green, MD](https://aedit.com/provider/michele-green-md-34642), a board certified dermatologist in New York City. It may take some getting used to, but you might want to train yourself to sleep on your back — or, at the very least, alternate sides and switch to a silk pillowcase (we’re fans of the super smooth options from [Slip](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fsilk-pillowcase-standard-queen-P402944)). Your skin and strands will thank you.

## **2. Skipping Sunscreen Indoors**
- **Causes**: Pigmentation, Fine Lines & Wrinkles, Volume Loss, Laxity

We regularly extoll the virtues of a [daily sunscreen routine](https://aedit.com/aedition/difference-between-chemical-sunscreen-physical-mineral-sunscreen), but, a little louder for the people in back: You need to be wearing sunscreen everyday, rain or shine, whether you step foot outdoors or not. “It is a good idea to wear a daily SPF moisturizer, even when you don’t plan on going outside, as UVA rays can penetrate glass windows,” says [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), a board certified dermatologist in NYC. While UVB rays burn the skin, Dr. Camp explains that UVA rays “contribute to the breakdown of collagen and elastin fibers, which lead to the formation of wrinkles and sagging skin.” 

His tip? Choose a daily moisturizer that provides broad-spectrum UVA *and* UVB protection with an SPF of 30 or higher. In case you’re in the market for a new formula, we’ve rounded up our [favorite sunscreens to wear indoors](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors).

## **3. Not Washing Your Face Before Bed**
- **Causes**: Uneven Skin Tone & Texture

Remember when your mom told you never to go to bed without taking your makeup off? Well, mama knows best. Skipping your daily cleanse step can “contribute to clogged pores as well as dullness of the skin,” cautions [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a board certified dermatologist in NYC. Clogged pores lead to a host of skin texture and tone concerns. “Without washing your face at night, there is often a buildup of oil, bacteria, and dead skin cells, which, in the short term, can lead to [breakouts](https://aedit.com/concern/acne), but, in the long term, can cause dullness of the skin,” she explains. Check out our [guide to the best cleansers and makeup removers](https://aedit.com/aedition/best-makeup-removers-for-every-skin-type) that will make you look forward to washing the day away.

## **4. Too Much Screen Time**
- **Causes**: Pigmentation, Fine Lines & Wrinkles, Volume Loss, Laxity

You probably already know that excess screen time can negatively impact your mental health and eyesight, but are you aware that it can also damage the skin? “The [blue light](https://aedit.com/aedition/how-to-treat-blue-light-damage) the screens emit causes premature signs of skin aging to develop,” Dr. Green explains. To help combat the effects of oxidative stress (think: pigmentation, fine lines, and uneven texture to name a few) caused by blue light, she recommends antioxidant-rich skin and sun care products, like the [Cocokind Daily SPF 32](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.cocokind.com%2Fproducts%2Fphysical-sunscreen), to limit damage when limiting screen time isn’t an option.

## **5. Being Too Rigid With Your Skincare Routine**
- **Causes**: Fine Lines & Wrinkles, Pigmentation, Dryness

A consistent and [well-curated skincare regimen](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-20s) is an essential building block of healthy skin, but mindfulness matters. “It is important to pay attention to skin changes that may signal your skin is irritated,” Dr. Camp says. A prime example? Failing to press pause on active ingredients that increase [photosensitivity](https://aedit.com/aedition/difference-between-sensitive-vs-sensitized-skin) (think: vitamin A derivatives and hydroxy acids) while spending a week at the shore. “It may not be necessary to apply a retinoid every night if you are on a beach vacation,” he explains. “Retinoids make your skin more photosensitive, which can put you at an increased risk of a [sunburn](https://aedit.com/aedition/how-to-relieve-and-treat-sunburn).” But that’s not all. “The salt water can dry your skin making it more prone to the side effects of a retinoid,” he adds.

Seasonally switching up your skincare routine or temporarily swapping out one or two products that may cause irritating side effects due to a change in climate or circumstances can help to ensure you don’t undo all of your efforts. To get a better sense of what ingredients work best at certain times of the year, check out our guides to [winter](https://aedit.com/aedition/best-hydrating-soothing-skincare-ingredients-products-for-winter-2020), [spring](https://aedit.com/aedition/aestheticians-share-best-spring-2020-skincare-ingredients-products), [summer](https://aedit.com/aedition/best-brightening-sunscreen-skincare-ingredients-for-summer-2020), and [fall](https://aedit.com/aedition/celebrity-aestheticians-share-fall-2019-skincare-ingredients-products) skincare.

## **6. Failing to Reapply Sunscreen**
- **Causes**: Fine Lines & Wrinkles, Pigmentation, Laxity, Volume Loss

It’s not enough to [apply sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot) as part of your morning routine. “If you don’t reapply sunscreen throughout the day and you are exposed to UV radiation, there is a risk of [sun damage](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage),” Dr. Garshick warns. For the uninitiated, sun exposure breaks down collagen, which leads to volume loss, line and wrinkles, and skin laxity. Additionally, brown spots crop up and [skin cancer](https://aedit.com/aedition/dermatologist-skin-cancer-screenings-mole-checks) is a serious concern. “As a result it is important to remember to reapply sunscreen every two hours and sooner if swimming or sweating,” she says.

## **7. Not Drinking Enough Water**
- **Causes**: Dryness, Fine Lines & Wrinkles, Dullness

The body needs an adequate amount of water everyday to function at its best — and so does the skin. “The top layer of the skin, the stratum corneum, is the protective barrier that shields skin from harmful elements of the environment,” Dr. Green explains. “The [skin’s protective barrier](https://aedit.com/aedition/skin-microbiome-skincare-products-ingredients) requires adequate hydration to remain strong, which can be supplied by drinking a sufficient amount of water.” What happens when we’re dehydrated? “Without enough water, the skin barrier weakens, making skin more prone to irritation, dryness, and the appearance of [fine lines and wrinkles](https://aedit.com/concern/fine-lineswrinkles),” she says. 

While it may seem counterintuitive, a lack of moisture can lead to a surplus of sebum (read: oil). “When your skin cells aren’t well-moisturized, they tend to retain excess oil to make up for lack of hydration,” Dr. Green shares. “Excess oil in the skin can lead to pores becoming clogged and the formation of acne.” The takeaway? Drink up.

## **8. Over-Using Retinol & Retinoids**
- **Causes**: Dryness, Pigmentation, Fine Lines & Wrinkles, Volume Loss, Laxity

You’ve probably heard us wax poetic about the unparalleled skincare benefits of topical vitamin A derivatives like [retinol and retinoids](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare). But, as with anything, it is possible to have too much of a good thing. “Some patients tell me that they do not think their prescription retinoid or over-the-counter retinol is working unless it is making their skin peel,” Dr. Camp laments. “Some of the side effects of retinoids include redness, dryness, and scaling, but these are signs that the product is irritating the skin, not that it is turning back the clock on your skin’s age.” 

If your complexion is struggling to make it through the retinization process, Dr. Camp says it’s important “to either use less of the product, apply it less often, combine it with a moisturizer, or use a lower concentration so that your skin better tolerates it.” And, if OTC retinol or prescription retinoids are just not for you, there are some [gentler alternatives](https://aedit.com/aedition/skincare-ingredient-alternatives-for-retinol-retinoids) to try.

## **9. Aggressively Washing Your Face**
- **Causes**: Dryness, Fine Lines & Wrinkles

Yes, rule number three was to never skip washing your face, but, with that said, there is such a thing as ‘too clean.’ “While it may be tempting to have skin that is so clean it feels tight, this actually can strip the skin of its natural moisture leading to dryness of the skin,” Dr. Garshick explains. “When the skin loses moisture, it can make fine lines and wrinkles more noticeable.” She suggests steering clear of harsh soaps and abrasive scrubs that lead to that squeaky clean feeling. Instead, she says to opt for a gentle cleanser that will [effectively cleanse](https://aedit.com/aedition/dermatologist-tips-for-applying-removing-makeup) “without stripping the skin of its natural oils” and may even “help to replenish moisture.”

## **10. Forgetting to Apply Sunscreen on the Backs of Your Hands**
- **Causes**: Pigmentation, Fine Lines & Wrinkles, Volume Loss, Laxity

One of the first areas of the body to show signs of aging? The [oft-neglected hands](https://aedit.com/concern/aging-hands). “We all are very good about paying attention to the skin on our face, but the skin on the back of our hands is an area that is also under chronic sun exposure and susceptible to the changes associated with aging skin,” Dr. Camp says. He recommends “applying SPF to the back of the hands” and, if you spend a lot of time in the car, “wearing driving gloves when commuting.” These are simple ways “to help your [face and hands age in harmony](https://aedit.com/aedition/aesthetic-treatments-for-aging-hands),” he shares. If applying your go-to face or body sunscreen is too greasy for your manis, consider a [SPF-infused hand cream](https://aedit.com/aedition/best-anti-aging-hand-creams) instead (and be sure to reapply throughout the day!).

## **11. Smoking**
- **Causes**: Fine Lines & Wrinkles, Pigmentation, Volume Loss, Laxity, Dryness

We don’t need to remind you of the health implications of [smoking and vaping](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health), but did you know puffing away also wreaks havoc on your skin? In case you need another reason to quit, Dr. Garshick says “smoking has been shown to lead to premature aging.” Both combustible and electronic cigarettes expose your body to free radicals, while depleting levels of vitamins A and C — antioxidants that play important roles in collagen and elastin production. The nutrient deprivation leads to dryness, enlarged pores, sagging, wrinkling, hyperpigmentation, and uneven texture (to name a few). “For many reasons, including to keep your skin looking young, it is important to stop smoking,” she emphasizes.

## **12. Not Protecting Your Skin From Visible Light**
- **Causes**: Pigmentation

There is, rightfully so, a tremendous amount of attention paid to the dangers of ultraviolet light, but the visible light spectrum also deserves attention. “Visible light can contribute to conditions with increased skin pigmentation, such as [melasma](https://aedit.com/concern/melasma) and [post-inflammatory hyperpigmentation (PIH)](https://aedit.com/aedition/how-to-treat-acne-induced-post-inflammatory-hyperpigmentation),” Dr. Camp explains. One way to ensure your skin and sun care are providing adequate protection is to opt for a tinted sunscreen or moisturizer with iron oxide, which, he says, “filters out visible light” in a way non-tinted formulas do not. His favorites include [EltaMD UV Clear Tinted Broad-Spectrum SPF 46](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Feltamd-uv-clear-tinted-broad-spectrum-spf46%2F11370312.html) and [bareMinerals Complexion Rescue](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.bareminerals.com%2Fmakeup%2Fface%2Ffoundation%2Fcomplexion-rescue-tinted-moisturizer---hydrating-gel-cream-broad-spectrum-spf-30%2FUS91792.html%3Frrec%3Dtrue). 

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

From sleeping on your side to not drinking enough water, you are likely guilty of a lot of small and seemingly insignificant actions that are leading to premature signs of aging.

Coming of Age