Eternal Youth

Looking at a future of wrinkles and sagging skin? You don’t need to, says ELSA KRÜGER, who has learnt a lot about looking young from Dr Nerina Wilkinson.

HAVE YOU EVER noticed the woman in the chair next to you at the hairdresser pulling her cheeks up or back with her hands? You can bet she is wondering if a cosmetic procedure would make her look younger.

And why not? With the many hi-tech aesthetic and surgical procedures available these days, it’s easy to maintain your youthful looks.

“Think of your face and complexion as a garden,” says Dr Nerina Wilkinson, a well-known cosmetic surgeon in Cape Town. “If you want a beautiful garden, you have to work on it constantly. To keep a pretty garden in bloom, you need to ensure it has water, well-balanced soil, fertiliser and regular care. And from time to time it will need rejuvenation. You have to adopt a holistic approach of nurturing. If you stop watering the garden, it shrivels and dies. A garden evolves with the seasons. So do the skin and facial structure, so you can’t simply keep doing the same thing. Maintaining a youthful appearance needs to evolve as your face changes.”

“And knowledge and prevention are key,” she adds, “no matter which decade of your life you are in.”

In Your 30s and 40s


First, know your genes. Genetic DNA tests are vital for your plan to keep your youthful looks. They analyse the skin’s tendency to become inflamed, and there is a strong connection between inflammation and ageing. The tests also indicate your predisposition for vitamin and mineral deficiencies, pigmentation, psoriasis, and acne – all factors that we are not normally conscious of – are likely to affect how your skin ages. Technology can now give you and your skin doctor the knowledge to design a tailor-made treatment for your needs. It enables you to choose the correct procedure to target a specific issue and spend your money on an efficient treatment that delivers optimum results.

“It is equally important to determine gut health,” says Dr Wilkinson. “Good bacteria in the gut and harmonious micro-biomes living on the skin are paramount to healthy, radiant skin.”

‘Healthy skin barrier’ is today’s buzz phrase according to Dr Wilkinson. “Protecting this barrier against damage is the first and most important preventative step you can take,” she advises, and warns that harsh treatments can do tremendous harm to it. A Visia scanner analysis determines the current health of the skin barrier and also exposes what lies beneath, which tells you what you can expect later in life. With this knowledge, you can make the correct choices for skin treatments and procedures.


Hydration is the number one treatment for ensuring a healthy skin barrier, says Dr Wilkinson. “Skin ages better if it has an adequate supply of hyaluronic acid.” Her favourite procedure to ensure the correct supply of hyaluronic acid is skin booster injections. “They provide an internal and external harmonious skin barrier environment; if this harmony is disrupted, the skin is unhappy,” she says. It’s a treatment that is beneficial for both women and men. Botulinum toxin (Botox) micro boosting is the future of rejuvenation and the prevention of early ageing. Micro-doses of Botox combined with hyaluronic acid are injected all over the face to reduce enlarged pores, rejuvenate the skin and promote a radiant glow.

Dermal hyaluronic fillers no longer need to result in overfilled cheeks and trout pout lips. The latest trend is foundation fillers, clarifies Dr Wilkinson. “Sagging skin is like a deflating balloon. It means that skin becomes loose because of bone shrinkage. The skull is the foundation of the face and once the bone shrinks, the face sags. Now we inject filler on the bone as support for all the facial soft tissues. The difference is that we inject foundation fillers under the muscle to maintain structure instead of injecting it into wrinkles and deep lines to simply fill them up or ‘iron’ them out. This procedure creates a more defined look, makes muscles stronger and fills out skin in a natural way.”

Surgery in this age group is usually eye surgery or blepharoplasty, especially for people with sagging eyelids. “Generally I don’t encourage other facial surgery at this age – there are so many different options before one needs to do a full facelift.”

In Your 50s and Older


You have, hopefully, built a good foundation for maintaining your youthful appearance in the previous two decades and now it’s time to switch to a higher gear and intensify treatments and procedures. It is at this age that earlier damage starts showing and also, for women, the ravages of menopause tend to appear. They can be rapid; in five years of menopause a woman can lose 30% of collagen, which speeds up loss of elasticity and the formation of wrinkles and sagging.

However, don’t be in a hurry to opt for the procedure your best friend had, warns Dr Wilkinson. “Everyone has needs of their own. We have to work on a tailor-made treatment plan for you. Your genetic make-up is unique, and there are so many choices. Your plan must be individual to you, not a one-size-fits-all treatment that produces a cookie-cutter look.”


Collagen stimulation comes into its own now, as this is the time to encourage the body to create healthy collagen. Radio frequency is a non-invasive procedure that regenerates collagen, tightening the skin and improving its elasticity.


Others such as Morpheus, Ulthera and various laser treatments stimulate fibroblast cells to form a robust and firm collagen that tightens the skin. To create collagen that plumps the skin, stimulation with hyaluronic acid skin boosters like Sculpta is the treatment to opt for. Multiple micro-injections of hyaluronic acid will give your skin a healthy glow. It is best to have a plan that combines procedures that both tighten and plump out the skin, says Dr Wilkinson. “This is how you regain healthy, plump skin and a radiant complexion.”

Dr Nerina Wilkinson consults with a patient to determine the correct procedure or combination of treatments for her individual youth maintenance needs.

Growth factors reverse signs of ageing and stimulate the turnover of skin cells. They are derived from a patient’s own blood plasma. Stem cells – harvested from fat cells in love handles or thighs – are the future of treatments that will keep you looking younger for longer, says Dr Wilkinson. She based the Stemcell4DLift Scarless Facelift on micro fat cells and nano fat cells in the cutting-edge procedure she pioneered. The result is so natural that she now always combines the procedure with skin resurfacing lasers and, if indicated, with face-lifting procedures.

Facelifts should result in the face looking refreshed and youthful but not tight, asserts Dr Wilkinson, with the emphasis on a natural, whole-face rejuvenation.

Asked about the future of looking young, Dr Wilkinson foresees more skin rejuvenation with the help of nano cells and stem cells. Invasive cosmetic surgery will increasingly become the last option. Instead of the term anti-ageing, she prefers to talk about ‘resisting ageing’, or keeping one’s youthful appearance and vitality irrespective of age.

“I believe in ageing gracefully, but I also want to empower people to feel good about themselves, which improves their mental well-being. When you look in a mirror and your skin looks tired, this could affect how you feel. I believe in being kind to oneself. Nurture your garden, don’t neglect it.”

In a nutshell, her formula for the best face you can have is hydration, sunblock, and sorting out any problems with the help of an expert skin doctor who will create a unique plan for you to keep looking young for as long as possible. And don’t wait for the first signs of ageing before you take action. With the right knowledge, prevention is easy. V

For more information, visit drnerinawilkinson.co.za.