The 50s are often the decade where it may feel like it all goes downhill, especially if you are female. 

Perimenopause may have begun to make its mark known from your mid 40s, but it is often not until menopause that many women begin to struggle - the plummeting in oestrogen levels can cause an impact on most of our systems, from mood, to brain fog to dry skin, hair loss and more. 

This is the time, if it is appropriate to do so, to talk to your primary care provider about your options including and especially for MHT or HRT, aka hormone replacement therapy. Menopause is nature's way of allowing us a reprieve from the draining and exahusting role of childbearing and caring for young children but with improved quality of life and function, many of us will live to our 80s and it makes no sense to be chronically miserable in our skin (literally!) and body and deprived due to outdated ideas of what we ought to accept as being normal; additionally a holistic approach will ensure that any in-clinic procedures we formulate with and for you will strengthen each other to help you live life to the best of your ability. 

That said, your 50s are the time when if you've maintained some degree of care of your skin in the preceding decades, you will begin to see them pay off dividends now, as you continue to build on it. 

Many women tell me they look in the mirror and no longer recognise themselves. Others regularly get unsolicited comments from colleagues and friends and family about how tired/ cranky they look as well as questions asking if they are ok. If these women are still working outside the home, this can be challenging and sometimes demoralising since we place such an emphasis on the way we present to the world and how we are seen based on it. 

Even if you've thus far done the bare minimum or even neglected your skin, it's never too late to begin, as long as you have realistic expectations of what is and is not possible. 

For many women who have done nothing to date and who find themselves disliking what they see in the mirror now which is usually a myriad of things- age spots (brown discolourations), deepening wrinkles even at rest and sagging skin due to volume loss. Sagging is by far, the biggest issue for this age group. 

Many non invasive techniques may be insufficient and this may be the perfect time to consider minimally invasive surgical options or,  if budget and downtime allows, we can refer to plastic surgeons who can address this concern with you if needed via a face and neck lift. 

If surgical options are not feasible for you, read on to see what else you may wish to consider to help improve your skin quality over the years and decade to come. 

1. Eyelid Correction Surgery

Often recommended for people in their 40s, this continues to be a staple for many people in their 50s also, not just for vanity but also because in many people the drooping eyelids which began in their 40s begin to affect functional ability, especially at the end of the day or when tired, when they might droop a bit more, or with the use of anti wrinkle when even a judicious dose of treatment to the forehead lines causes discomfort. Some patients also report chronic headaches that resolve post eyelid correction surgery. 

This surgery is undertaken in clinic under local anaesthetic and most patients tolerate this very well. There is some downtime as with most procedures involving the eye area, and we would suggest a week or two of time off work, not due to any disability but due to expected swelling and bruising as the wound heals. Results are permanent and last years until further skin sags over the eyes again. 

2. Dermal Fillers 

If you first explore medical aesthetics in your 50s, it may be sagging and volume loss that brings you in for an opinion. Hollowing under the eyes, eyebags (which may only be amenable to surgery), excess skin around the eyes as well as jowling around the lower face and deep smile lines may be causes for concern as well as the seemingly overnight appearance of a double chin due to volume loss and sagging of skin from above. 

Used judiciously dermal fillers may be used to replace some of the volume loss while we work on the deeper underlying issues, which will take longer and require planning, time and budgeting. The risk of too much dermal filler of course, is that they risk overfilling and leading to a caricature so it is best to stick to a practitioner who understands medical aesthetics and whose work you like. 

3. Skin Therapies 

By far and away, the mainstay of skincare in your 40s and up is effective skincare that is personalised to you and your concerns. In our 20s and sometimes even our 30s, we may get away with dabbling and trying every new trend that erupts on the scene, but by our 30s, we begin to see signs of a childhood with too much sun, or active facial muscles or chronic sun damage that never quite turned into an actual sunburn. 

Fine lines and wrinles on animation as well as the appearance of dark discolouration on the skin begin to accelerate with age and over time if we do nothing in addition to progressive collagen loss that leads to a loss of plumpness and glow in our skin. 

For most patients who are adequately volume replaced, my go-to in clinic is a combination of collagen induction therapies using biostimulator fillers 6-12 monthly as well as a series of skin therapies personalised to your skin concerns, with our skin therapist. 

Most skin therapies take time, and a series of regular treatments to begin to see effects - usually 3-6 months minimum, in conjunction with a personalised skincare regimen to use at home and as always, rigorous sun protection. 

4.  Fat Dissolving Injections 

With the ageing process comes redistribution of fat pads in our faces to where gravity reshuffles them - in our lower faces, usually as jowls and double chins. Equally, with the ageing process and hormonal changes comes pockets of fat we would not normally expect anywhere else - back fat, bra fat, love handles and pockets of abdominal fat - larger pockets are obviously more amenable to liposuction but smaller pockets can be harder to remove and for this, permanent fat dissolving injections may be suitable and appropriate to melt these via a series of injections (usually a minimum of 2 sessions). 

5. Minimally Invasive Fat Dissolving Treatments 

For larger pockets of fat such as jowls, fat under the chin and on the neck as well as under the armpits, on arms and elsewhere, minimally invasive treatments such as FaceTite and AccuTite may be suitable options. Done in clinic under local anaesthetic, these treatments are relatively comfortable with minimal downtime and bruising. They work by both dissolving fat during treatment and tightening skin using radiofrequency over the following 12 months to provide subtle lift and improvement in skin quality. Results are permanent. 

While certainly not exhaustive, the best advice I always give patients is, begin to plan ageing in your 20s when you can, with a personalised holistic plan, such you maximise your results in your 50s. In saying that it is never too late to begin right where you are, but you must begin if you wish to effect change in what you see in the mirror. Time waits for noone, certainly not the ageing process. 

Ready to begin a discussion? Begin with a consultation here.