The natural skin aging process can accelerate by up to 6% during menopause. That is why many aesthetic doctors work daily with women over 40 who strive not only to restore the youthful appearance of the skin, but also to do it in such a way that the results of aesthetic correction are not conspicuous to others.
One such case was reported by Dr. Charlotte Woodward and Victoria Manning: it is about menopausal skin rejuvenation with polycaprolactone (PCL) fillers.
Factors contributing to accelerated skin aging during menopause
Aging – multifactorial process involving:
1. Resorption and remodeling of bone tissue, which leads to a loss of volume and changes in the underlying soft tissues and skin.
2. Loss and redistribution of adipose tissue, which contribute to a decrease in volume and a change in the shape of the face. The deep fat held by the ligaments "thinns" and descends, resulting in deep folds and distorted facial contours.
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3. Muscles atrophy and shrink, resulting in displacement and sagging of adipose tissue.
4. Due to a decrease in the amount of collagen, the dermis becomes thinner, the skin becomes less elastic and loses moisture. Aging skin is characterized by thinness, dryness and a tendency to wrinkles, sagging and increased pigmentation.
5. The decrease in estrogen levels associated with menopause leads to loss of elasticity and deterioration of the skin in general.
Ageing skin is characterized by thinness, dryness and a tendency to wrinkles, sagging and increased pigmentation.Case study: skin rejuvenation with polyaprolactone fillers
A 49-year-old patient came to the clinic.
Patient has previously received botulinum toxin injections:
• to the area between the eyebrows, forehead and around the eyes in order to smooth out dynamic wrinkles;
According to the patient, she has always had plump cheeks, but lately she seems to have sagged, especially during menopause (from the age of 45), as a result of which fleas were formed. The patient started hormone replacement therapy as prescribed by the gynecologist, but her skin seems to continue to age rapidly.
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The authors discussed various options for correcting jowls: HA fillers, radiofrequency skin tightening, HIFU skin tightening , thread lifting and biostimulating polycaprolactone (PCL) fillers.
Threads would provide lifting and volumization, however, the recovery period after this procedure is longer than after other proposed correction methods. With the help of radio frequencies, it was possible to tighten the skin, but without the effect of volumization.
Ellansé filler became the drug of choice; based on polycaprolactone, as it improves skin texture, restores volume and elasticity, It also increases skin hydration with minimal downtime and long lasting results.
While HA fillers also provide volumization, a polycaprolactone based product retains volume better over time. Based on the experience of the authors, the effect of HA fillers does not last more than a year, while polycaprolactone fillers provide volumization for more than two years.
Polycaprolactone fillers: features and mechanism of action
Correction with polycaprolactone fillers that stimulate collagen production provides immediate results, as well as volumization due to biostimulation and neocollagenesis. The formation of new collagen provides an increase in skin elasticity and hydration, reduced due to a decrease in estrogen levels.
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Biostimulation provides an increase in subcutaneous fat due to collagen, which increases the thickness and elasticity of the dermis, similarly HA-based skinboosters, but with longer lasting results (> 2 years). The filler contains a gel base – an aqueous solution of carboxymethyl cellulose (70%) and synthetic polycaprolctone (30%). Thus, CMC provides filling, and polycaprolactone – neocollagenesis.
Using a 25 gauge cannula, 2 ml of polycaprolactone filler – 1 ml on each side.
The product was injected subdermally using a retrograde linear fan technique. Work with this zone was carried out in order to volumize the middle and lift the lower third of the face.
The patient was told that immediately after the procedure, the severity of the result would be 85%; after about 2-4 weeks the effect will become less pronounced, and then, as the base gel is resorbed and neocollagenesis is stimulated, the result will become more noticeable again.
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The patient was scheduled for a follow-up appointment 3 months after completion of the neocollagenesis process and achieving maximum correction results.
At a follow-up appointment 3 months later, the patient was very pleased with the result and felt 10 years younger. The volumes in the middle third of the face were restored, and the lower part of the face oval became more uniform due to the cheek lift.
To determine the feasibility of repeat procedures, it is necessary to review patients once a year.
It is important to remember that after this procedure there is a risk of bruising and swelling, and patients should always be warned about this. However, this time there were no side effects after the correction.
In this case, the desired result – cheek lifting and volumization of the middle third of the face – was achieved through correction with polycaprolactone filler. The increase in firmness and improvement in texture both superficially and in the deeper layers of the skin is due to the stimulation of neocollagenesis. The oval of the face has been restored.
Polycaprolactone fillers are safe, effective and provide long lasting results and can also be used for biostimulation and volumization purposes.
Adapted from Aesthetics
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