Aging of the skin can be divided into two main categories: intrinsic aging, due to genetic factors characterized by laxity and deep rhytides, and aging due to ultraviolet (UV) damage, termed photoaging or photodamage, characterized by dyschromia, elastosis, fine rhytides, redness, spider veins, surface changes, and keratoses. The old face is the consequence of several concurrent factors, including skin laxity, soft tissue ptosis, and volume loss. The First step for successful treatment is to diagnose skin problems; dark spots, red spots, pimples, scars, wrinkles or skin folds with advanced diagnostic tools such wood’s light, polarized light, videodermoscope, dermatoscope, and venoscope according to your skin condition. Improving the condition of the skin is most commonly done with resurfacing procedures, laser and light therapy, daily skin care, and ultraviolet (UV) protection. Correction of soft tissue ptosis is usually surgically treated with a brow lift, mid face lift, and lower face rhytidectomy or non-surgically by energy-based technologies such as radiofrequency or ultrasound. To recapture youth, the lost volume must be restored by means at our disposal. Dermatologists have an increasing number of modalities to improve the appearance of aging skin, including injectable botulinum toxins and dermal fillers, non-ablative and ablative laser treatments, chemical peels, and a diverse array of topical agents, including prescription retinoids and bleaching agents and nonprescription cosmeceuticals. A joint approach is considered ideal for many patients. The goal of type 1 rejuvenation is the optimization of epidermal turnover, and uniform chromo¬phore distribution is achieved with visible lasers, light, fractional radiofrequency, chemical peels, microdermabrasion, and skin care products. Type 2 rejuvenation is more profound, and tar¬gets decreased collagen, disorganized glycosaminoglycans, and elastin, manifested by superficial rhytides and is best treated with non-ablative mid infrared lasers, and intense pulsed light (IPL). Rejuvenation type 3 is most in-depth and targets deep dermal collagen disorders and skin laxity; here comes the role of fractional lasers, radiofrequency, infra-red light, ultrasound are the most effective). For each of these rejuvenation goals, various energy-based technologies are available. Loss and redistribution of sub-¬dermal fat in aging is handled with liposuction and Liquid face lift (Botox, fillers, and fat.

1. The Art Of non-surgical
Facial Skin Rejuvenation
by Prof. Osama B
Moawad. MD