Texture, Tone and Volume Correction

Texture, Tone and Volume Correction

Cosmetic treatments for rejuvenation have moved away from a simple solution to synergistic treatments that address all different factors of ageing, from; fine lines and wrinkles, blotchy skin texture, poor skin tone, laxity, through to lack of volume. As we age, there are different treatments which vary and will be ideal for your skin type and concern.


Early skin ageing can be addressed with muscle relaxants, chemical peels, BroadBand Light treatments and good skin care used at home. Patients in the early 30’s and 40’s sometimes require more refreshing and this is when Fraxel® works its best.  It is then usually coupled by muscle relaxants and a tiny bit of dermal filler. Patients in the 50’s and beyond can sometimes benefit from a mini face-lift, full resurfacing  and volume replacement with dermal fillers. Above and beyond, Dermatologists at Westside Dermatology will always give you the natural look.

  • Dermatologists will often combine different lasers; namely Erbium with CO2 to achieve amazing results.
  • Full laser resurfacing will correct skin texture, and also aid in skin tone; making your skin tighter, and removing the majority of wrinkles.  If performed around the eye area it can significantly reduce eye bags, tighten eye lids and remove wrinkles without the need for muscle relaxants.  
  • Laser resurfacing heal times vary from 7 to 10 days, this is dependent on the depth of resurfacing.
  • Volume correction is often underestimated. Replacing mid facial fat loss with dermal fillers can make a significant difference in the perceived age of the patient. Volume correction can also be used to treat eye bags, tear trough hollowness and downward smile lines.
  • Muscle relaxants can reduce and prevent frown and forehead lines; ‘if it doesn’t crinkle, it won’t wrinkle’.
  • Maintaining a simple but effective skin care program after correction of skin texture, tone and volume is very important as it will give you long lasting results.

What did I perform to give her the natural after picture?

  1. Mini-s face lift – to improve skin tone.
  2. Blephroplasty – eye lid surgery to lower lids to remove excess skin.
  3. Laser with erbium and CO2 – to improve skin texture and tone.
  4. Dermal filler (1ml) – to correct volume loss.

This is a natural looking result with out going over the top. My philosophy is to make some an excellent result for their age and to not turn mutton into lamb. Yes, I can add more filler, and yes I could have pulled back more skin with the mini face-lift, but will it look natural for her age? No. So I will not add more. Sorry, if you want to look un-natural, seek help elsewhere.

The second extreme is myself; Dr Davin Lim.  The before photo shows the lack of mid facial fat which we all get when we hit our late 30s and early 40s. 0.5 ml of dermal filler and the difference is noticeable but natural. I did not want any more. I also had 1 unit a muscle relaxant to my lower lids to reduce my prominent bags.

The definition of combination laser resurfacing is when more than one laser is used to gain results.  This procedure is performed by all laser Dermatologists at Westside Dermatology.  By using a combination of lasers it enables the treating Dermatologist to achieve optimal results within the same procedure.  This procedure is often performed by completing full laser resurfacing initially starting with an Erbium laser to remove the upper layers of the skin (removes brown spots, sun-spots, pre-cancerous skin cells and aged skin).  This treatment alone can stimulate collagen to tighten and improve skin texture, tone and laxity. As optimal results are always being achieved by our Dermatologists; a fractionated CO2 laser is then used to further stimulate collagen.  CO2 is known to create far greater stimulation of collagen which then provides better skin tightening and improvement of skin tone than using an Erbium laser alone.

All our combination Erbium and CO2 laser resurfacing procedures are conducted in our on-site laser suites to ensure optimal results.

  1. A pre-planning consultation is essential.  This is conducted prior to any laser procedure. During this consultation a full medical history and pre-procedure photographs are taken. This is also the opportunity for the patient to understand the treatment plan and also ask questions.
  2. Once the pre-planning session has been completed the treating laser Dermatologist then generates a  laser proforma.  This is generated to ensure that specific areas discussed in the consultation are mapped prior to the commencement of the laser treatment.
  3. The patient is then able to make a laser procedure booking with our administration team.
  4. On arrival the patient will be taken to our pre-laser area where application of a topical anaesthetic and any medication will be administered.
  5. The topical anaesthetic requires 60 minutes for efficiency.
  6. The patient is then taken into the laser operating suite where the treating Dermatologist will conduct the procedure.
  7. It is also strongly advised that the patient organizes transportation home with a friend or relative.

The downtime after full laser resurfacing is dependent on several factors:

  1. The depth of laser resurfacing. The deeper the treatment = the greater the downtime = the better the result = the more time you need off.
  2. The location of laser resurfacing. The face, especially eyelids will heal up within a week, whilst neck treatments may take up to 2 weeks to heal.
  3. Your current health. The fitter you are, the quicker you heal. As a rule smokers will take an extra week or so to heal up.
  4. Age does not play a huge role in skin healing.  Many patients over the age of 70 will sometimes heal up just as well or even better than those who are 30 years old.

A patient should consider surgical management of skin laxity over laser resurfacing when there is simply too much skin laxity.  In most cases, surgery is conducted first to remove excess skin, tighten the jowl lines (mini s face-lift) and remove excess eyelid skin (blephroplasty). Laser resurfacing is then conducted 1-3 months after surgery to address skin texture and further tighten the skin by remodelling collagen which is not possible with surgery alone. By performing laser resurfacing after surgery it also allows for rejuvenation to occur on the surgical wounds.

More on eye rejuvenation

Time downtime following either a blepharoplasty or mini s face-lift is on average 5 – 7 days. Following either surgery there maybe residual bruising which may last up to 7-10 days. Scars are generally hidden quite well.  For a blepharoplasty suture lines are hidden in the creases of the upper eye lid and along the hair line for the lower lid and following a mini s face-lift the suture line is well hidden in your scalp, and behind your ear. The pain following surgery is minimal, and well controlled with over the counter pain relievers.

Dermal fillers are an essential part of skin rejuvenation . Why? Because as we age, we loose volume, collagen and fat.  This age related volume loss occurs in the mid to late 30s, and accelerates from there.

  • 20-30 year olds usually have a tiny loss of fat from the mid cheek area, and just adding a small amount of dermal filler (0.3- 0.5 ml) on each side will make a large difference.
  • 40 year olds will benefit from more dermal filler in this region and also along the tear trough areas.
  • 50 and above require more dermal filler however depends on the loss of volume.  On average at least 2-3 ml of dermal filler is required.

If the overall skin texture is good, with even colour and very little wrinkling; the replacement of dermal volume will give you the greatest improvement. If you are young, only the smallest amount is needed. Remember- Westside Dermatology’s aim is to keep the look natural.

More on dermal fillers

Please contact us for pricing.

Cost will depend on the complexity of the procedure. For an accurate quote a consultation with a Dermatologist is advisable.

Full Laser Resurfacing; plus VBeam to reduce redness

Prices vary, but will fall within a range. The price difference is the complexity of resurfacing areas such as the eyelids and upper lip areas.

Dermal Filler

This product should last between 18-24 months. Some patients may benefit from a combination or layering of fillers. Budget for at least 2 mls if you are below 48 years old, and 3-4 mls if you are in the 50-65 age group.

Muscle Relaxants

Our specialist perform this procedure in a different manner compared to normal clinics.  We aim to use less of the product, and scatter it, for a more natural look.

Mini S Face Lifts

Price is dependent if eyelid surgery is performed; in most cases I may have to perform some sort of eyelid procedure as when we lift the skin below, the skin under the eyes may bunch up.

Our aim is to give patients a more youthful, more beautiful natural result. What you have to consider is how much younger you want to look and what is the result you are chasing.

  • Patients in the late 30’s- 40’s will only require light laser resurfacing (like Fraxel®), a small amount of filler, and maybe some ‘scattered’ muscle relaxants to achieve optimal results.
  • Patients in the 50’s will benefit from some heavier laser (possibly laser resurfacing), definitely some filler (2mls at least) and muscle relaxants.
  • Patients in the 60’s may benefit from ‘the lot’ – eyelid skin lift, mini s face-lifts, laser resurfacing, dermal filler, with a tiny bit of muscle relaxants to maintain wrinkle free there after.  Dr Davin Lim states: “This form of total rejuvenation at this age is best, and the most natural, as I address skin laxity surgically and then with laser. This additionally improves skin texture, I then concentrate on volume replacement. This can be the most dramatic change as results are transforming, but remain natural.”

At Westside Dermatology we utilize the most advanced technology to provide outstanding results – safely; however it is our specialist laser and cosmetic dermatologist that make results happen.

Dr Davin Lim and Dr Shobhan Manoharan are experienced dermatologists who have undertaken further training in cosmetic and laser dermatology. Both are members of the Australian Society of Cosmetic Dermatology.

Dr Davin Lim is a national and international trainer for lasers, including the use of CO2 Lasers, radio-frequency, radio-frequecy skin needling and full laser resurfacing. He is a member of the American Academy of Aesthetic Medicine and undertaken advanced aesthetic surgical training in the United States. Dr Lim is also a national and international speaker on cosmetic and facial rejuvenation, and senior advisor for numerous laser and cosmetic boards.

Westside Dermatology have patients frequently asking “what is the best procedure to address skin aging?” This of course will depend on many factors including the patient’s age, their current condition of their skin, their expectations and factors such as downtime. There are 3 factors which must be restored to address skin ageing; skin texture, skin tone and skin volume.

Skin texture

What is the colour contrast and state of your skin? Have you got sun-damage, sun spots, freckles, and age warts? If so, a laser treatment is the way forward. Mild alternations in skin texture can be treated with Fraxel® laser and moderate to severe sun-damage can be treated with combination therapy of Erbium and CO2 lasers. The worse the texture, the stronger the laser, and hence a longer recovery is needed.

Skin tone

How loose is your skin? Are there any wrinkles under your eyes or jowl lines? Are your upper eyelids heavy and sagging? These are all examples of poor skin tone. Depending on the nature of your skin tone, surgical or laser procedures maybe needed. In most cases, surgery followed by laser provides the best results as both tone and texture are addressed.

Skin volume

This can be the most important factor in restoring youth, however is often the most overlooked. Laser resurfacing, to a degree can restore skin tone and stimulate collagen, but it cannot replace loss of volume or fat. Only a dermal filler can achieve this. A small amount of dermal filler, placed in the correct location can make a dramatic but natural difference.

Remember, for optimal skin rejuvenation you must address all 3 factors; texture, tone and volume and achieve it in the correct proportion for one’s age.