FFA: A structural rejuvenation approach for the transitions all women face

“Why treating just one area doesn’t work after 35”

Structural rejuvenation during semipermanent biological transition

There are stages in a woman’s life where her face can change rapidly. If you are a woman reading this, you know what I am talking about. You may have had a glimpse of this if you’ve been pregnant, had babies and dealt with the sleep deprivation that caring for young children brings. 

These transitions were a peek into what’s ahead in 10+ years, when you are done with childbearing and begin to transition into the next stages: 

Perimenopause.
Menopause.
Significant or rapid weight loss.
High stress 

The changes often feel disproportionate to time. They seem like they occurred overnight. In fact it is literally what women as early as their 30s say to me in clinic “I feel like it happened overnight!” “I woke up one day and hated the way I look in the mirror!” 

What is behind all of this? 

Did it really happen overnight? All of a sudden? 

We rarely age overnight. More commonly, we age so slowly it’s barely noticeable, until it begins to add up rapidly, when it “suddenly” becomes noticeable. When we say “It happened overnight!” 

So what has happened? 

• The volume  of our fat pads changes.
  
• Our skin thins.
  
• Our fat pads reposition such that our jawline feels heavier.
  
• Our midface/ eyes and cheeks, appear hollow.
  
• Our smiles and expressions look different “ I look like I am angry when I’m not!” “I look like I’m sad but I’m not!” “I look like I’m grimacing when I try to smile.” 

These changes are not superficial. They are structural and affect every layer of the face (& body). 

We notice it more on the face because it is what we use to greet the world. Our faces and expressions are what we get judged on.
 

It is the face that we get unsolicited comments on from well meaning but ultimately careless people who have not learnt to mind their own business.
 

During hormonal and metabolic transitions here are some of the changes that occur:

• Collagen production declines
• Skin thickness reduces
• Fat pads deflate or sag
• Ligament support becomes more visible
• Facial tension shifts due to overactive muscles that pull harder than they used to

Collagen loss begins as early as our 20s at 1% per year. In the first 5 years of menopause, this increases to an additional 30% of collagen. In our post-menopausal years loss continues at an increased rate of 2% per year. 

You can lose upto 80% of collagen production ability by age 70 if you do nothing. 

With rapid weight loss, structural deflation can occur faster than the skin can adapt. The skin cannot keep up. 

Elastin, the sister of collagen responsible for the stretch of healthy, young tissue, is not produced past puberty. What does this mean? Your skin loses the ability to “snap back” effectively. 

Think of the stretch marks on your arms, breasts, hips and belly with changes due to rapid weight gain and pregnancy. Think of the sagging tisue weight gain and then loss leaves. Does your skin go back to normal? If it did, we’d not have as the only solution to excess skin. 

The result is not simply “wrinkles.”

It is architectural change in the skin and its quality. 

The psychological toll that many women are shamed for: 

Most of my patients in their mid 30s and older describe a quiet but profound realisation:

“I don’t recognise myself.”

“I look tired even when I’m not.”

“I feel vibrant inside but I don’t look it.”

“It happened overnight.”

This is not vanity.

Our face is tied to identity, vitality, competence and presence.

When structural change occurs quickly – particularly during already vulnerable life stages –  it can impact confidence, professional presence, career advancement and self esteem. 

Our signature FFA – Full Face Aesthetics- approach is designed to bring back the face you love, not to create a different one.

A Final Word

Ageing is not the enemy… at the same time, abrupt structural change can feel destabilising and even distressing.  Whether we like it or not, we live in a patriarchal world where we are still judged by our appearance and how vibrant we look. 

Our FFA was designed to address the biology behind those changes, with precision, restraint and respect for your identity.

Ready to begin? (Request a consultation link here) 

FAQs 

We told you what an FFA is. Here is what it is not.

Our Full Face Aesthetics is a medically guided doctor-led plan designed for your concerns. 

It is not:

• Spot treating lines & wrinkles
• Chasing facial symmetry
• Overfilling to erase all lines and folds 
• Chasing fads and trends
• Seeking unachievable perfection 

It is a whole-face assessment and restoration strategy designed to:

• Replace lost volume
• Support thinning and lax tissues
• Improve skin density and quality
• Restore full facial proportions
• Maintain expressions unique to you
• Preserve your identity and ethnicity

The goal is subtle structural recalibration so you look like yourself, not a carbon copy of the influencer of the day. 

A Thoughtful Screening Process- am I guaranteed a place? 

Our FFA is best for women 30-55 experiencing genuine structural change due to time and life including hormonal changes.

It is not appropriate for someone with flaws that are not clinically visible, or only in certain lighting, or for those struggling with unrealistic standards. If you are someone prone to worry during healing, this process may not be right for you. 

If there is any indication that aesthetic treatment may not be psychologically beneficial, this will be discussed openly and respectfully.

If Dr Joshi does not feel on balance, that she can confidently help you, or that you may be a surgical candidate first, she will also discuss this with you. The consultation is just that; a first step to help both of us determine if we are on the same page as to your concerns, goals and willingness to commit to the suggested plan and have the budget for it. 

If we do not tick all boxes, then it remains a duty of care for us to advise you to wait until that changes. 

“First do no harm” is part of good care and not just a slogan. 

The FFA Process- what can I expect? 

At your initial consultation, a comprehensive structural facial assessment and also a thorough discussion of your work, lifestyle and other factors that may impact your willingness and ability to commit to your own FFA if suitable. 

If appropriate, it may also involve a discussion of hormonal and metabolic influences or a recommendation for followup with your own GP if suitable in parallel with our work. 

Photography and a discussion of your concerns and which ones can be improved and what that looks like. We will also show you examples of other FFA patients over the years to show you an example of Dr Joshi’s aesthetic so you can decide if it aligns with your idea of what you are wanting from your own FFA. 

We will discuss a staged treatment plan if we both agree to work together. This is a timebound plan and it is imperative that we both agree and commit to doing the work for the duration of the 3-4 month process for best results. At the end of this time period, we will reassess next steps, including whether we continue working together on your FFA maintenance or we part on good terms. 

If we agree to work together, you will be expected to pay 50% of the full quote to secure your place and the rest over the next 2 appointments. It is important that you understand this and commit fully. 

This is not a one-appointment fix.

It is a structured approach to looking and feeling your best for years to come, until surgery becomes unavoidable. 

Who is Dr Joshi’s FFA designed for? 

On principle, Dr Joshi does not take on patients for FFA who are in the prime of their youth and who need very little to correct to look their best. At Skin Essentials we do not feed on patriarchal interpretations of beauty, pander to the male gaze nor aim to look forever 25. 

Who do we work with then? 

• Younger women at any age who are genetically challenged in key areas of the face eg around the eyes or the mouth, that leads to them looking aged or tired and sad. 
  
  
• Women 30-55 who have noticed accelerated facial ageing during pregnancy, and then perimenopause or menopause
  
  
• Women of any age who have experienced significant weight loss and feel structurally deflated
  
  
• Our patients value subtlele over conscpicuous; “you look great, what did you do?” 
  
  
• Our women prefer medical reasoning and expertise over trends, crowdsourcing and influencers.
  
• Our women want to look like a better and less tired version of themselves
  
  
• Our women are realistic and understand these are medical procedures with no guarantees 
  
  
• Our patients value the longterm therapeutic relationship and do not move around between multiple doctors or clinics; exclusivity and trust is gained one appointment at a time.