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Nouveau Antiaging

Timeline for Facial Aging – 3 D’s for Facial Aging

The contributing factors for aging of the skin is multifactorial including genetic aging and environmental aging such as  sun exposure, weight fluctuations, hydration, hormonal changes, medications, acne and more.

There are 3 key components that contribute to the appearance of facial aging that include:

  • D2  Deflation of skin – decrease in facial volume from  LOSS of FAT/COLLAGEN and BONE (osteoporosis) support
  • D3  Descent of skin – increase in skin laxity with facial sagging as a result of BREAKDOWN ELASTIN FIBERS and COLLAGEN SUPPORT


fine lines/creases – first signs motion wrinkles around brows and eyes
facial hairs – lip, brow, perimeter of face
colors – melasma (brown discoloration around cheeks/forehead) from sun exposure, pregnancy, hormones/birth control pills, antibiotics (minocycline, tetracycline)
texture – wide pores, acne scars

Antiaging treatments – sun protection, skin care (retinoids), peels, IPL, laser hair removal, microdermabrasion, Virtue RF, Botox late 20s


skin starts to look “tired” and less radiant
increased fine lines/creases – crows feet around eyes and 11’s between the brows
increased brown spots – from continued unprotected sun exposure
red spots – emergence of dilated blood vessels
first signs of early volume loss and descent of facial skin creating the emergence of nasolabial lines around the mouth. This is a result of loss of “baby fat” from teenage and early 20s years.

Antiaging treatments – same as 20s plus
more Botox/Dysport, lasers such as IPL and the start of dermal fillers
Virtue RF


appearance of lines upper lip– motion lines and fixed collagen breakdown accelerated from continued sun exposure and in some individuals, smoking
continued increased lines of forehead and around eyes/Crows feet
continued effects of D2 (facial volume loss) and D3 (facial skin sagging) – continued cumulative effect of aging and sun damage causing progressive deepening of lines and wrinkles plus with the breakdown of collagen and elastin fibers, start to see loss of volume and gradual descent of facial skin support

Antiaging treatments – continued use of sun protection, skin care, peels, lasers and Botox/Dysport plus
increased use of dermal fillers
Sculptura very effective
consider fat grafts with/without PRP
radiofrequency – no downtime
laser resurfacing – some downtime


continued loss of facial volume (D2) as a result of loss of fat and facial bone resorption plus more sagging/”drooping” of facial skin (D3) continued loss of elastin and collagen support of the skin
skin gets thinner and more translucent with more visible blood vessels below skin surface and skin gets more discolored
untreated brown spots more prominent and new brown spots appear
deeper lines and more prominent wrinkles as result of decrease in estrogen levels causing skin dehydration and accelerates skin aging

Antiaging treatments – continued use of sun protection, more attention to fluid hydration, skincare, peels, lasers, Botox/Dysport and dermal fillers
greater focus on skin tightening treatments such as Virtue RF , Precision Tx laser contouring, deeper chemical peels and fractionated Erbium/CO2 laser resurfacing
Fillers still effective but be careful to over use fillers and cause “filler face”
Sculptura very effective even in later decades of life with natural results

Once all noninvasive and minimally invasive treatment options considered, utilized and maximized, should consider a facelift or our significant Nouveaulift (in office facelift under local anesthesia with oral premedication) as a longterm natural facial rejuvenation procedure. Sometimes people opt for Nouveaulift sooner to avoid excessive use of fillers and find noninvasive skin tightening devices ineffective.

Treatment Options for Following Facial Aging Concerns

Nonsurgical Skin Tightening

  • BTL Exilis Ultra
  • chemical peels
  • Clear Lift
  • Lights and lasers
  • Pelleve

Nonsurgical Fine Lines

  • same as skin tightening
  • BTL Exilis Ultra
  • Chemical peels
  • Clear Lift
  • Lights and lasers
  • Pelleve
  • Botox/Dysport – effective only for motion/expression lines
  • Fillers – effective only for deeper, fixed lines from collagen breakdown

Nonsurgical Texture

  • IPL
  • microdermabrasion
  • Microneedling/PRP
  • chemical peels
  • skin care

Nonsurgical Resurfacing

  • Icon 1540 – non fractionated Erbium laser
  • Icon 2940 – fractionated Erbium laser

Nonsurgical Eyelid Rejuvenation

  • Botox/Dysport
  • Peels
  • Fillers
  • Fat grafts
  • Lights and lasers
  • Microneedling/PRP
  • Skin care

Nonsurgical Neck Rejuvenation

  • Botox/Dysport
  • BTL Exilis Ultra
  • Peels
  • Clear Lift
  • Microneedling/PRP
  • Skin care

Nouveau Medispa – Hockessin

Hockessin Athletic Club*

100 Fitness Way, Hockessin, DE 19707

*Non-members are welcome

(302) 355-1123


Advanced Plastic Surgery Center - Newark

774 Christiana Road, Suite 101, Newark, DE 19713

(302) 355-0005

Philadelphia is 50 min. away from main office: Newark, Delaware

Cherry Hill is 50 min. away from main office: Newark, Delaware

Atlantic City is 1 h 30 min. away from main office: Newark, Delaware

Baltimore is 1 h away from main office: Newark, Delaware

Open 6 days a week
including evening appointments


Advanced Plastic Surgery Center - Elkton

111 West High Street, Suite 207, Elkton, MD 21921

(410) 996-0039


Advanced Plastic Surgery Center - Dover

95 Wolf Creek Blvd. Unit 1, Dover, DE 19901

(302) 355-0005


Rehoboth Plastic & Dermatologic Surgery

18947 John J. Williams Hwy, Suite 305, Rehoboth Beach, DE 19971

(302) 645-7435