Age is a product of time—the older we get, the more changes we see in our appearance. Each decade presents new challenges in the quest to maintain the youth and vibrancy that make you the best version of yourself. Sabrina Fabi, MD, of Cosmetic Laser Dermatology in San Diego talks about these changes and the best treatments to address them in her webinar, Beauty by the Decade

How do we age?

It’s never too early to begin an anti-aging regimen, according to Dr. Fabi, since aging begins as soon as we are born. Each year, we lose 1% of collagen – an essential protein that supports the dermal structure and gives the skin its smooth, supple appearance. Elastin fibers also fragment over time, which leads to skin laxity. Dr. Fabi explained that the aging process involves four key components: 

  1. Bone loss 
  2. Fat depletion and repositioning
  3. Muscle contraction
  4. Skin laxity 

To effectively treat aging symptoms, Dr. Fabi stresses the importance of knowing the underlying reason behind the symptom. When she pinpoints the cause, whether it is bone, fat, muscle, or skin, she can tailor the procedure to the specific need for a natural, beautiful result. While there are general changes that happen throughout each decade, everyone ages at their own unique rate. Dr. Fabi recommends a consultation and in-person examination to ensure you receive the right treatment at the right time for you. 

In Your Teens 

Dr. Fabi sees patients of all ages. Her teen patients often come in for acne treatments, as 80% of people in this age group suffer from the condition. Dr. Fabi has found the most effective way to address acne is with the topical medication Levulan and a combination of devices. By using blue and red light, as well as a pulse dye laser and intense pulsed light (IPL) therapy, she can achieve a superior result. 

Once active acne is under control, Dr. Fabi also treats acne scarring that is often left behind after the breakouts stop. She also uses a combination of lasers for scarring to get the best result and encourages patients to seek treatment as early as possible to ensure an optimal outcome. However, she often treats patients in their 40s and 50s to improve their acne scars as well. 

In the 20s 

It may not be noticeable just yet, but changes are beginning that will lead to more obvious signs of aging later on.


The orbital bone around the eye begins to widen, leading to hollowing under the eye. The maxilla also starts to resorb, which can flatten the cheekbone. Patients might also be concerned about a weak chin and poor jaw definition at this time. 


Some patients begin to see lines on the forehead and around the eyes and eyebrows when they make certain facial expressions. If you clench or grind your teeth, you may also experience some widening of the jawline as the masseter (chewing) muscle enlarges. 


Some patients are concerned with what they perceive as excess buccal fat below the cheekbone. Dr. Fabi cautions patients to avoid surgical procedures to remove this fat since it can affect the aging process later on. Submental fullness, which gives the appearance of a double chin, can also be an issue for younger patients. 


Changes to the skin at this age are due to your first 18 years of sun exposure. You might see increased discoloration, brown spots (freckles or melasma), redness, and rough texture. Acne and acne scars may also continue to be a concern during this decade. 

While signs of aging are typically minimal during this decade, patients in this age group are often interested in preserving and restoring ideal facial proportions, a process known as beautification. Fillers can be used for facial contouring and lip augmentation, which is a popular treatment choice for this age group. 

Other common treatment options for patients in their 20s include: 

  • IPL and Fraxel Dual treatments to address early sun damage
  • Fat reduction, including Kybella, CoolSculpting, and liposculpture
  • Neuromodulators to relax an overactive masseter and treat dynamic lines in the upper face
  • Sclerotherapy to eliminate visible leg veins
  • Cellulite treatments such as Cellfina 

Voluma and Botox to reverse signs of aging in San Diego, CAIn Your 30s

By this decade, age-related changes often become more noticeable.


The orbital bone is widening and the maxilla continues to resorb, leading to hollowing under the eyes, flat cheeks, and nasolabial folds. The mandible also begins to resorb, creating marionette lines and early jowl formation. 


In addition to the dynamic wrinkles that form on the forehead and around the eyes, you might begin to notice bunny lines at the top of the nasal bridge, more gum showing when you smile, and an orange peel texture on the chin. 


Additional damage to the skin might include a dull tone as skin cell regeneration begins to slow down. The fine lines you saw when you made expressions in your 20s might be evident even when the face is at rest now. 

Treatments at this point are designed to restore youth and not make dramatic changes to your appearance. In addition to the treatments popular in the previous decade, you might consider: 

  • Ultherapy to tighten skin around the jawline
  • Fraxel Dual treatments for skin rejuvenation
  • Neuromodulators to treat dynamic wrinkles
  • Biostimulators to add fullness to the midface and jawline

Dr. Fabi recommends starting early and undergoing some of the quick, easy procedures every three months or so. By maintaining a treatment schedule now, you will be able to age more gracefully without the need for a flurry of combination treatments when the aging symptoms become more severe. 

restore lost facial volume with botox in San Diego, CAIn Your 40s

Changes during this decade are similar to those seen in the 30s, but they become more noticeable. Specific changes during the 40s might include the following.


You may begin to lose some of the fat in your fat pads, creating a hollow look in the midface. Submental fullness under the chin can also be a concern, particularly since fat repositioning creates more jowl formation to exacerbate the problems along the jawline. 


You might see skin crepiness under the eyes, which adds to a tired appearance. The neck and jawline also start to show their age as skin laxity becomes problematic in these areas. 

This is the time to consider adding an ablative fractional laser to your treatment plan, particularly to address the crepiness under the eyes. The laser is also helpful in removing fine lines around the mouth.

anti aging skin treatments in San DiegoIn Your 50s and Beyond 

The arrival of menopause accelerates the aging process for women during this decade. Dr. Fabi encourages women to see a functional doctor at this point who can help them manage the hormonal fluctuations that occur during this time. Some of the changes you might see in your 50s include the following.


Menopause brings exponential bone loss which creates more prominent hollowing under the eyes and deepening nasolabial folds. Marionette lines also become deeper and jowls become more noticeable. 


This decade brings significant fat pad loss, allowing the midface to fall. The hollow effect is exacerbated by the flattening of the cheeks and creates deeper creases in the lower face. 


Skin changes are accelerating at an exponential rate now, necessitating a combination of therapies for patients who have not undergone cosmetic treatments before. Fortunately, Dr. Fabi and the other board-certified doctors at Cosmetic Laser Dermatology have more than 50 laser and energy devices to choose from, allowing them to produce dramatic results for their patients without the need for surgery.

Schedule Your Consultation in San Diego Today

Aging is not an option, but looking your age is, thanks to the many advanced treatments available today. If you are ready to shine with the best version of yourself through every decade, contact top San Diego dermatologist Dr. Sabrina Fabi at Cosmetic Laser Dermatology today to schedule your consultation. 

"Beauty By The Decade" webinar by Dr. Sabrina Fabi San Diego CA


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