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The Ageing Face: Unraveling the Tired Look and the 4D Strategy for Rejuvenation

Updated: May 12

About the author: Dr V.P.S Ghotra

Dr Ghotra received his MD degree from Maastricht University and a PhD from Leiden University. Complementing his substantial academic credentials, he acquired a Master's degree in Ageing and Aesthetics from the prestigious University of Manchester. Leading his clinic in the vicinity of Amsterdam, Dr. Ghotra specializes in an array of minimally invasive aesthetic procedures. His expertise encompasses a wide range of treatments, from the precision of Botulinum toxin applications to the innovative techniques involved in thread lifts, fillers, and the latest advancements in laser therapies, providing his patients with cutting-edge solutions in the field of aesthetic medicine.

Why does facial ageing Lead to a Tired Appearance?

Our face undergoes several changes as we age, often leading to a tired appearance. This transformation is not due to a single factor but a combination of various anatomical changes.

Understanding these changes is crucial in developing effective treatment strategies.

Tear Troughs: "The eyes are the windows to the soul, and ageing can draw heavy curtains over them," I often say. Deepening tear troughs create shadows under the eyes, contributing significantly to a tired look.

Low-Lying Eyebrows

With age, eyebrows tend to droop, giving a tired appearance. This is often due to the loss of skin elasticity and changes in underlying fat.

Temporal Fat Loss

The temples lose fat and volume over time, leading to a hollowed appearance that can make one look more tired and aged.

Loss of Cheek Projection

"Cheeks are the pillars of youth," as I describe them. Ageing leads to a reduction in cheekbone projection, contributing to a sagging appearance.

Nasolabial Folds and Marionette Lines

These lines become more pronounced with age, framing the mouth in a way that often conveys fatigue or sadness.

The Need for a Combination Treatment Strategy

A single treatment approach is often insufficient since ageing affects the face in multiple ways. "To restore the vitality of youth, we must approach the face as a harmonious whole, not just a collection of parts," is a principle I advocate in my practice.

The 4D Strategy: A Comprehensive Approach

The 4D strategy is a holistic approach that addresses the four dimensions of facial ageing: skin quality, loss of volume, muscle activity, and gravitational changes.

Skin Quality

Treatments like chemical peels and laser therapy improve skin texture and elasticity.

Volume Restoration

Dermal fillers and fat grafting can replenish lost volume, particularly in the cheeks, temples, and under the eyes.

Muscle Activity Modulation

Botulinum toxin helps reduce the appearance of dynamic wrinkles and lift drooping areas.

Counteracting Gravitational Changes

Techniques like thread lifts can provide a subtle, natural lift to sagging skin.

Dr. Ghotra's Expertise

With my extensive experience in aesthetic medicine, I ensure that each treatment is customized to the individual's needs. "Each face tells a unique story, and our treatments are the pens that rewrite chapters of youth and vitality," is a belief that guides my practice.


Ageing gracefully is not about looking perpetually young but embracing one's age with a refreshed and vibrant appearance. The tired look associated with ageing can be effectively managed with a comprehensive, tailored approach.

If you want to rejuvenate your appearance and address the signs of ageing, I invite you to our clinic. Together, we can explore a treatment plan that aligns with your aesthetic goals and brings back the refreshed, vibrant look you desire. Contact us today to begin your journey towards a rejuvenated self.

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