Interestingly due to certain genetic features, Japanese people are less prone to sagging skin. Why? Because of the ‘Velcro’ of their skin - the facial retaining ligaments which anchor the skin to deeper tissues - are firmer than ours and keep the skin in place. Our Velcro is less strong and gets looser with age so our skin eventually goes south due to gravity.

velcro in the face

How can we copy them and improve the Velcro in our faces?

Rajiv Grover is a leading plastic surgeon in London who gave a talk about how to prevent needing a surgical facelift. He explained that “Operation should be avoided at all cost” to minimize potential complications.

After having performed hundreds of surgical face lifts, he noticed that the patients with previous filler treatments tended to have firmer tissues to work with. He decided to set up a study to confirm his observations.

He enrolled 51 patients of whom 34 hadn’t had filler treatments before surgical face lift and 17 patients had more than 5 treatments with hyaluronic acid fillers. He also measured the distance between the pupil and the brow (with age the brows descend so that the distance shrinks).

After surgery, he sent some samples from the tissues removed for a histology examination in order to measure the amount of collagen (anchoring fibres) in the samples.

He observed that in the case of patients with previous filler treatments, the amount and density of anchoring collagen was significantly greater compared to those without treatments.

These observations are consistent with previous observations regarding the collagen stimulating capacity of dermal fillers*

He also found a significant reduction in the development of brow ptosis. The mean pupil to brow height was larger in patients who had long term botox treatments.

In conclusion: the 4D approach

In the beginning, we focused on wrinkles and lines with our treatments. Then came the 3D approach where instead of chasing lines, we improved the lost volume and worked on replenishing the original curves of the face. Improving the volume and the curves give a lift to the face which is called the liquid face lift (or 8 point face lift).

liquid face lift

From now on we can use these results to push the Facial PAUSE button and start to think in 4D, where the 4th dimension is the time. By starting in our late 30s and early 40s with hyaluronic acid fillers and botox treatments, we can improve the Velcro in our face which will prevent/postpone the need for surgical interventions.

Remember: Growing older is mandatory, looking old is optional!

To find out more, you can book in for a 15 min free aesthetic consultation where we can discuss the ageing process, its signs and what can be done to improve your look and enhance the Velcro in your face.

Dr Bela


*HA fillers add more than just volume: collagen stimulation

Arch Dermatol. 2007 Feb;143(2):155-63. 

In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. 

Wang F, Garza LA, Kang S, Varani J, Orringer JS, Fisher GJ, Voorhees JJ


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