Cosemtic Medicine and the Mature Woman


Sheena Burnell, M.D.

Like all aspects of ageing, the decision to have “something done” to maintain a youthful appearance is a deeply personal and highly individual one. While for some women this process may start as early as their 30’s or even their 20’s there are other women don’t want or need any intervention until their 50’s or beyond. The fact is that we all age very differently and our desire to look youthful or beautiful is as individual as we are.

For most of us however it’s our late 40’s with our changing hormone levels, thinning of the collagen layer and slowing of cell turnover when we first start to really notice changes in our skin.

For some women this is simply part of the natural ageing process and they’d no more think of trying to change this than deny their maturity and wisdom. For other women however the changes are unwelcome and many describe a mismatch between how they feel on the inside and how they look on the outside. With advances in healthcare and improved fitness levels, clients will commonly say they still feel 35 and don’t know who this slightly grumpy older woman is looking back at them in the mirror! For women who feel this way, cosmetic medicine and cosmetic surgery may offer a very satisfactory solution if performed skillfully and can give a subtly fresher look without altering the appearance or looking ‘done’.

While most people associate ageing with wrinkles and indeed wrinkle-relaxing treatments such as Botox are here to stay, the big news in recent years is the understanding that ageing is not so much due to the actions of gravity on our faces as loss of volume, that is losing the plumpness and cushioning effect of the collagen and fat pads under the skin. We all know about the ageing effects of dramatic weight loss past a certain age and as many women mature they like to have a little meat on their bones – as Sharon Stone famously said, “As I get older I realize I have to choose between my face and my butt”. But whatever weight you are, as you age this volume loss accelerates and is most noticeable in the eye, temple, cheek, lip and jaw area. This results in the eyes and temples looking hollow, the cheeks looking flat and possibly lined, thinning of the lips and laxity of the tissues in the lower face and jawline, giving that slightly sad, jowly, bloodhound look detested by so many women.

With this in mind, many of the products now on the market are designed to replace volume. Whereas in the past a facelift was often the first (and only) option, judicious use of fillers which mimic the skin’s natural physiology such as Restylane, Radiesse and Juvederm is now frontline treatment and may delay or even avoid the need for a surgical procedure altogether.

As well as these tried and tested synthetic products, there is also an exciting new wave of techniques based on kick-starting new collagen growth via stem cell stimulation. These treatments are often spinoffs from more mainstream medical developments and include treatments such as PRP, the “stem cell facelift” and facial fat grafting. Results of these treatments can be very long-lasting and as the bodies’ own cells are used, are extremely safe and risk-free.

Also popular are laser and light therapy treatments again aimed at stimulating collagen production as well as improving skin texture and colour. Very safe and a long way from the destructive older-style laser treatments, these newer laser treatments aim to create plumper fresher skin with far less discomfort and minimal down-time, and are especially popular for the neck and jowl area with women who either don’t need or don’t want a surgical procedure.

What all these treatments noticeably have in common is improving on what you already have rather than trying to alter the underlying features, and they are therefore very suitable for mature faces. Most importantly the treatments can be tailor-made to your aesthetic goals so the results are extremely natural and subtle and bear no resemblance to the ‘wind-tunnel’ or ‘permanently surprised’ looks of previous decades.

As in everything in life good results depend on choosing the best and being prepared to pay for it. Regardless of the materials, techniques and technology available, good results depend upon having realistic expectations, finding the best practitioner you can and being prepared to communicate to them your aesthetic goals, and in turn heeding their advice about what can be achieved. 

Cosmetic medicine and surgery are hot topics in today’s age-conscious society and there are just as many people warning of dire consequences as there are those who consider Botox a normal part of their beauty routine. The most important thing to remember is the choice is a private and personal one and despite pressures from family, friends, the media and society, the decision to have or not to have some type of cosmetic procedure is yours and yours alone and should therefore be made with only one person in mind – and that is you.


 Dr Sheena Burnell is an Australian-trained medical doctor currently living and working in Shanghai. Although her primary qualification is in anaesthesiology, she has also received training in cosmetic medicine and has a particular interest in the use of injectables such as Botox and fillers as well as laser for facial rejuvenation. Dr Burnell also has interests in art, music, wine education and Chinese textiles, and writes regularly for several publications. 



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