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When should I start treatments?


Ask Dr Imaan: I don’t need anti wrinkle or filler treatment! Do I?

Before I began training in this field, I used to think similarly.

When we are in our 20s and even early 30s, we are blessed with beautiful plump skin and provided we look after our skin with some basics, a skincare regime, a decent diet with enough fresh fruits and veggies and sun care, we radiate the glow of youth effortlessly even if we stay up late, drink too much every now and again.

So I used to think that most people wouldn’t need anything till they began showing signs of ageing, whether premature, due to lack of care, or age appropriate.

Training and working in Cosmetic  Medicine has led me to change my viewpoint slightly.


When I see patients in their late 30s and 40s and 50s, with static wrinkles, thinning skin, deep wrinkles and a gaunt hollow look or a jowled appearance around the jaw, I realise that to halt these changes takes a fair bit more time and a lot more money, than if they’d begun preventative care 5-10 years earlier.



Age related skin changes aren’t just skin deep. As mentioned elsewhere, fat pads around the face are lost; skin thins and loses its elasticity; gravity begins to drag skin down, towards the jaw; bones change shape underneath the skin, leading to shadows and hollows and a general look of fatigue, anger or sadness. Wrinkles are more set in and harder to erase with some anti wrinkle treatment and many of the changes related to thinning requires large amounts of filler to replace.

My approach now tends to be that of maintenance and prevention-

– in your twenties, when skin is still smooth, plump and beautiful, small amounts of anti wrinkle treatments help relax muscles without freezing and delay wrinkle formation. Filler may not be needed at all, or only used to plump naturally thin areas such as lips or cheeks for definition.

– in your thirties, preventative maintenance continues, with some anti wrinkle treatments aimed at reducing wrinkle formation and depth. Fillers may again only be needed as enhancement.

– in your forties, anti wrinkle treatments may be used in the lower face together with fillers, which may now have a bigger role in replacing lost collagen in the face- temples, forehead, cheeks and around the mouth.

– in your fifties and beyond post menopause ongoing maintenance would require a combination of anti wrinkle and fillers with great subtle results that will have you looking great for your age and even a few years younger and refreshed.

So my advice would be: if you can afford to do so, consider incorporating some basic treatment when able so as to age gracefully and naturally in your 40s and beyond.

Any further questions? Email me at drimaanjoshi@skin-deep.com.au

Till next week!

  • Dr Imaan Joshi has been working as a doctor since graduation from the University of Sydney in 2001. She spent years between 2004-2011 as a surgical trainee before switching to a different speciality program for work-life balance. She is passionate about her work in Medicine and especially about procedural Medicine, and loves her work as a Cosmetic Physician. When she isn't working, she is busy focusing on an active life with her family, which includes 4 active children! Dr S Imaan Joshi BSc, MBBS, FRACGP


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