Saggy skin is one of the unavoidable downsides of ageing and, to make matters worse, it doesn’t just affect our face, it affects our neck and body too. Where once skin was springy and plump, the ageing process leads to a loss of volume and firmness. Add in the way we lose bone mass from the skull, and the way our facial fat pads shrink - or descend and gather under the jaw, and it is a recipe for sagging skin and jowls.
What can help sagging skin and jowls?
Given that saggy skin and jowls are such a common problem, it’s not surprising that there are many tweakments and devices offering scalpel-free alternatives to a face-lift, a claim I usually take with a pinch of salt, until I have seen the evidence.
What is Endolift and how does it work?
One of the newer additions to this category is the Endolift, a laser-based treatment that remodels deep and superficial layers of the skin to correct mild sagging and fat accumulation on the lower third of the face and neck (that’s your double chin and jaw line) . It can be used to the loose skin that you get on the lower eyelid and on the body for areas such as the knees or excess fat and sagging skin on the tummy, bottom, inner thigh and even the ankles.
It uses a laser beam fixed to the end of an optical fibre, as thin as a hair, which is inserted under the skin to remodel the collagen within – and, if needed, to reduce excess fat – from the inside.
I went to the Cranley Clinic in London to try the procedure with Mr Ali Ghanem, who is a Key Opinion Leader for Endolift and an approved trainer for the procedure.
Find out how I got on and check out our interview in the video above or read the transcript below.
Alice Hart-Davis: I have come to the Cranley Clinic in London’s Harley Street to try a new kind of minimally-invasive laser skin tightening procedure. This is one that uses an optical fibre, with a laser on the end, that is as fine as a human hair, and that’s going to be put inside my skin, to laser it from the inside to tighten up loose areas.
I’m going to see Professor Ali Ghanem who is an expert in this technique, he’s a plastic surgeon, and he works from this clinic, and he’s going to work on the loose skin on my lower face and under my jaw, and maybe the bit under the eyes.
AHD: What is the Endolift and how does it work?
Mr Ali Ghanem: As you know we are all trying to turn the arms of time backwards. It is common knowledge that we start losing our soft tissue from around the age of 30, when our stem cells can’t replace what’s lost and so can't maintain our youth.
Endolift is a form of laser technology. With laser treatment, we have both an immediate tightening and a delayed, progressive collagen production, which improves the thickness of the skin and how healthy looking it is, as well as addressing the laxity [looseness], which is associated with volume loss.
AHD: So you put this laser on this very fine microfibre wire under the skin and work on loose areas from inside?
AG: Exactly. We have a treatment zone determined by the stage of laxity that the patient comes in with. Arguably wherever there is skin you can use this technology, however, the most common areas to be treated are the laxity on the lower lid; the festoon area, which is between the malar and the cheek area; then the cheek itself to soften the smile lines or the nasolabial folds; then moving down to the jowls, to eliminate the sharpness between the marionette lines and jowls; the double chin or the excess of fat and skin under the chin, and also the excess fat and laxity in the side of the neck which will lead to reduction and definition of the jawline.
AHD: So, you can use it either for skin tightening or fat reduction? What would you look at treating on my face?
AG: There is skin laxity on lower jaw area. This is your inferior jowl compartment and this is your superior jowl compartment, so to address both we will design a treatment zone. I usually preserve the fat along the mandibular border because a sharp mandibular border is associated with ageing.
AHD: Would you treat under my eyes too?
AG: There’s a very small degree of laxity here, it’s too mild for surgery. If it’s bothering you, we can put a tiny bit of energy there and it will give you more of a downtime because you have very strong tissue. [On the rest of the face] the swelling associated with the procedure will be hardly noticeable, however, in the lower lid, any little swelling will be very difficult to hide. So, if you’re prepared for a week of lower puffy eyes, we can do that.
Alice Hart-Davis before (above) and after Endolift
THE PROCEDURE: How it feels to have Endolift.
Local anaesthetic is used to numb each area before treatment and intra-occular shields are used to protect the eyes from the laser.
AG: So, I'm just going to make the entry point now and I will start with the eyelids. So, now we're going to numb your cornea. Look away from me please. Well done. Look up now. There you go well done good.
AHD: Wow that's not too bad, it’s absolutely fine. Is that because I've got anaesthetic around the eye?
AG: Okay and then look up. Yes, very good. Close your eyes. Very good. So you are now protected. Now, I want you to within your shield try to think of looking up as if you are looking up on your eye.
AHD: I feel a very slight pressure. So that's the laser energy targeted on the skin. Wow, I can feel like a very thin thread of something. So it seems almost more than damaging the existing collagen, like it's kind of destroying it. Is it?
AG: The aim is like if you have a very nice Wagyu beef, we are making it medium rare we are not charcoaling it, we're just giving it enough energy to make it contract but keep it alive.
AHD: Interesting. I can feel it, just a tiny trickling sensation as you're moving it.
AG: You could see the jawline well defined with the contraction of this area under the mandible and then you could see here the bulging skin representing the skin laxity. So I'm very happy that I cannot see any major bruising, even on the lower lid. Open your eyes. Normally there is hardly any major bruising, which is great and you responded very well.
AHD: Okay, so this is what I look like after a full session of the Endolift. I had 10 areas treated, so this is the full course. Ive got swelling under the eyes, which you warned me about so this will go on swelling for a bit. I've got to wear a pressure garment around my face to contain it, you can probably see the swelling starting in here and there, but it does feel so firm, that's what's really encouraging. I've got to wear that for four or five days. It feels like my eyes are watering from the laser shields, this is probably more uncomfortable than the procedure. This will calm down, the swelling and the tiny bit of bruising, in a week or so and then the results will be coming through from two months but really three to six months?
AG: Yes and it will become better and better up to three months, where we can see almost 60 percent of the results. Beyond three months and up to a year you will continue to tighten.
AHD: And then it will last for about two years?
AG: I would say that whatever we managed to reset the laxity to, if we managed to reset it by three or four years, you will start ageing normally, but then that will carry you for another like three or four years.
Three weeks after treatment...
AHD: Okay, rather than leave you with that particular image on the video, I thought I would show you how my face is looking now three weeks on. You can see it's coming along nicely. All the swelling has gone down. I mean this was quite a heavy duty procedure. It was very intense just because I had so many areas treated and, as you saw I had that bruising coming up around my eyes. That took a week to go. This swelling (around the jowls) you wouldn't have really noticed, because it was just like a thickening, but now it's quietened down.
I think you can see the collagen contraction that I got. It feels much more solid under here already so that's really exciting but, as for the full result, I've got to sit tight for another two to two and a half months, and then I'll really know what it's looking like.
- Endolift at The Cranley Clinic with Mr Ali Ghanem, from £2,200
This video is sponsored by The Cranley Clinic