[Doctor's Column] Looking Old Is Not Due to 'Wrinkles': The Real Factor Determining Facial Age Is 'Skin Density'

Many people believe that wrinkles are bound to deepen with age. Consequently, most people first seek out procedures to smooth them out. However, if you continue to hear comments like "you look tired" or "you look old" despite managing your wrinkles, the real cause may lie elsewhere than in the wrinkles themselves.

▶ Q. If it's not wrinkles, what determines facial age?

2023 Vision Research According to a study published in [Journal Name], the factor that most significantly influences a person's judgment of another person's age is not the depth of wrinkles. skin tone and texture ...was. Particularly after the age of 40, the uniformity and gloss of the skin surface played a greater role in age perception.

The key element determining this 'tone and texture' is precisely Collagen density of the dermis no see.

・When the dermis is densely filled with collagen, the skin is firm and reflects light evenly, giving a clear and radiant impression.
Conversely, if collagen density decreases, the skin becomes thinner, and uneven light reflection creates a dull and shadowed appearance.

2014 Journal of Anatomy A study published in [Journal Name] confirmed that dermal collagen density decreases significantly starting from the 40s and 50s, and that collagen density in the papillary dermis immediately beneath the epidermis drops from an average of 73.6% in the 40s to an average of 43.3% in the 90s (Marcos-Garcés et al., 2014).

❙ Image: Produced by Maypure Doctor Column

▶ Q. Why does collagen decrease with age?

Collagen is produced by fibroblasts in the dermis. However, in 2006 American Journal of Pathology According to a study published in [Journal Name], in aged skin, fibroblasts lose contact area with surrounding collagen structures, causing a decline in the ability to synthesize collagen itself (Varani et al., 2006).

Ultraviolet rays join the fray here.

・UV rays activate matrix metalloproteinases (MMPs) in the skin to break down existing collagen.
As the amount newly produced decreases and the amount broken down increases, a vicious cycle is created in which the dermis gradually becomes thinner.
This is precisely why, even at the same age, the skin of those who have been exposed to more UV rays appears thinner and less elastic.

▶ Q. Can collagen density be increased again?

While surface care such as moisturizing or masks helps improve the moisture environment of the epidermis, it is difficult to directly increase collagen density deep within the dermis. A procedural approach is required to stimulate fibroblasts to synthesize collagen again by providing stimulation that reaches the dermal layer.

In medicine, this Collagen stimulation or Bioremodeling It is called [this].

・PLLA (Poly-L-Lactic Acid) In the base procedure, microparticles induce a mild foreign body reaction in the dermis, during which fibroblasts are activated to produce new collagen. The effect is characterized by appearing gradually over several months (Christen & Vercesi, 2022).
・PDLLA (Poly-DL-Lactic Acid) The base procedure is reported to simultaneously promote angiogenesis and collagen synthesis.
・Energy devices (HIFU, radio frequency) operate on the principle of contracting and remodeling dermal collagen using thermal energy.

▶ Q. What treatments are available at our Yeonsinnae branch?

At our Yeonsinnae branch, we offer the following procedures to improve collagen density and skin elasticity.

・Olidia (PLLA Collagen Volumizer) This is a procedure that stimulates collagen synthesis in the dermis. A series (multiple sessions) of treatment is performed at intervals of at least 4 weeks.
・Jubelook (PDLLA Skin Booster) You can expect both collagen induction and skin texture improvement.
・Rivicol (Atelocollagen Skin Booster) It is a procedure that directly replenishes collagen while simultaneously stimulating it.
・Coolsonic / Density (Energy Equipment) : Induces dermal collagen remodeling using HIFU or high frequency.

The general protocol is to administer energy devices before heat-sensitive injectables; however, as the specific procedure order and combination may vary depending on skin condition, we will provide guidance during the consultation. Treatment effects and recovery periods may differ from person to person.

▶ Q. Can I maintain collagen density in my daily life?

・UV protection is the most important thing. This is the most effective method to slow down collagen breakdown by inhibiting MMP activation. Please use sunscreen with an SPF of 30 or higher every day.
・Retinoid (Vitamin A derivative) topical preparations It is known to promote collagen synthesis in fibroblasts. However, as it may cause irritation, it is recommended to consult a medical professional before use.
・Please reduce smoking and excessive drinking. Smoking reduces blood flow to the dermis, hindering the supply of nutrients and oxygen and lowering collagen synthesis.
・You must continue to use UV protection even after the procedure to prevent the newly generated collagen from breaking down rapidly.

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Chief Director Sim Dong-gyu of Maypure Clinic Yeonsinnae Branch
· Graduated from Korea University College of Medicine
· Master of Medicine, Korea University School of Medicine
· Full member of the International Society of Aesthetic Plastic Surgery
· Regular member of the Korean Society for the Study of Obesity
· Regular member of the Korean Society of Aesthetic Plastic Surgery and Laser Medicine
· Allegan Juvederm Expert Member

※ This post is intended to provide general information about the procedure, and the effects and recovery period may vary depending on individual skin conditions.
※ Please be sure to consult thoroughly with medical staff before the procedure. Swelling, bruising, and redness may temporarily occur after the procedure.

▶ References
1. Marcos-Garcés V, et al. “Age-related dermal collagen changes during development, maturation and aging.” J Anatomy . 2014;225(1):98-108.
2. “The role of facial skin tone and texture in the perception of age.” Vision Research . 2023;213:108320.
3. Varani J, et al. “Decreased collagen production in chronologically aged skin.” Am J Pathol . 2006;168(6):1861-1868.
4. Christen MO, Vercesi F. “Collagen Stimulators in Body Applications: A Review Focused on Poly-L-Lactic Acid (PLLA).” Clin Cosmet Investigation Dermatol . 2022;15:997-1019.

#Yeonsinnae Dermatology #Yeonsinnae Anti-aging Treatment #Skin Collagen #Yeonsinnae Olidia #Eunpyeong-gu Dermatology

Skin concerns vary from person to person. After a consultation, we will guide you to the most suitable treatment based on your records.
📍 Maypure Clinic Yeonsinnae Branch / 3F, Metro Tower (Directly Connected to Yeonsinnae Station) (856, Tongil-ro, Eunpyeong-gu, Seoul) / ☎ 02-389-9980
Clinic Hours: Weekdays 10:30–20:30 / Saturdays 10:00–17:00 / Closed on Sundays and Public Holidays