A youthful, healthy face is soft with gentle curves, no shadows, the features well defined, all surrounded by a flawless complexion.

With the passage of time our face changes. It gains the experience of life, our inner self begins to show and hopefully we become more content with who we are and how we look. The natural ageing process is a gentle process that sees alteration in the volume distribution of the face and the skin becomes paler with fine lines.

However life events and experiences can hasten the process and add their own negative influence. This is the process of disease, damage and premature ageing. Disease, weight loss, stress, smoking, sun exposure, severe diet and exercise regimes, chemotherapy and other intensive medical treatments together with the associated psychological traumas are associated with premature ageing. Our current understanding is that these changes are due to a combination of excess free radical formation, incomplete damage repair and free radical neutralisation, programmed cell death (apoptosis) and altered DNA replication and cell renewal. In women this process is accelerated by the menopause when the skin loses its support from the female hormone, oestrogen. Well before the menopause we will experience change in the face and body as the level of oestrogen slowly drops.

Most people complain of looking tired before complaining of looking old. Other people’s remarks about looking tired, sad or miserable are frequently the stimulus to visit the cosmetic doctor.

At the very heart of ageing is a change in all of the support tissues of the face, from the bony skull and facial bones through the muscles, the ligaments to the fat, then the overlying skin.

Lumps, bumps, moles, red veins, scars and various other blemishes spoil the complexion and distract from the harmony of the face.