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Why faces age: the anatomy behind the lines

Faces change in four layers: bone, fat, muscle and skin. Understanding which layer is driving your concern is what determines whether a treatment will work.

Published independentlyLast reviewed 2026-07-31 Section 02

The short answer

Facial ageing happens in four layers at once. Bone loses volume and projection, particularly around the eye socket, midface and jaw. Fat compartments shrink and descend. Muscles shorten and some become relatively dominant. Skin loses collagen, elastin and hydration. A line on the surface is usually the visible end of a change in one of the deeper layers, which is why treating the line alone so often disappoints.

What to Stop Before Injectable Cosmetic Treatments

Before injectable treatments, certain medications, supplements and habits may increase the risk of bruising or complications. Stopping some products at least a week prior is commonly advised, but always consult your practitioner before making changes, especially with prescription medicines or where medical conditions apply.

Medications and Supplements: What to Pause Before Injectables

Many commonly used medications and supplements can increase the risk of bruising or bleeding after injectable cosmetic treatments, such as fillers or botulinum toxin. Anticoagulants (blood thinners) like warfarin or aspirin, as well as non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, can contribute to this risk. Over-the-counter supplements such as fish oil, vitamin E, garlic, ginkgo biloba, and St John’s wort may also have mild blood-thinning effects.

It is important never to stop a prescribed medication without discussing it first with your GP or prescribing clinician. Pausing non-prescription supplements is generally considered safe for most people, but always confirm with your practitioner. The standard recommendation for many supplements is to stop them at least seven days before your appointment, unless otherwise directed.

Product TypeExamplesWhen to StopConsult Required?
Blood ThinnersAspirin, warfarin, clopidogrelCase by caseAlways
NSAIDsIbuprofen, naproxen3-7 daysYes
SupplementsFish oil, vitamin E, garlic7 daysAdvised
Herbal RemediesGinkgo, St John’s wort7 daysAdvised

Decision rule: If a product is prescribed, consult your doctor. For over-the-counter supplements, a 7-day pause is typical, but confirm with your practitioner.

Alcohol, Smoking and Caffeine: Lifestyle Factors to Adjust

Lifestyle habits can impact both the outcome and recovery from injectable treatments. Alcohol can increase the likelihood of bruising and swelling, while smoking may impair wound healing and skin health. High caffeine intake can contribute to dehydration, potentially affecting skin appearance post-treatment.

Decision rule: Avoid alcohol for 24-48 hours before and after injectables. Reduce or pause smoking where possible. Limit caffeine on the day of treatment.

Timing: How Far in Advance to Stop Products or Habits

The timing for stopping medications or supplements varies:

Screenshot rule: If in doubt, pause supplements seven days before and check with your practitioner about any medicines. Lifestyle habits like alcohol are best avoided 24-48 hours before and after.

Skin Care Products: Actives and Treatments to Pause

Some topical skin care products, especially those containing strong active ingredients, can increase skin sensitivity or the risk of irritation around the time of injectables. Retinoids (retinol, tretinoin), alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs) and exfoliating products are common examples. It is generally advised to stop these products for two to five days before and after your treatment.

Decision rule: If a topical product causes peeling or tingling, pause it for two days before and after injectables unless your practitioner says otherwise.

Allergies, Illness and Immunisations: When to Postpone

If you are experiencing an active infection, illness, or allergic reaction, it is usually recommended to postpone injectable cosmetic treatments. Similarly, recent immunisations (such as the flu or COVID-19 vaccine) may prompt practitioners to suggest a short delay, often one to two weeks, to allow the immune system to settle.

Decision rule: If you are unwell or have had a recent vaccine, inform your practitioner. Delay treatment until you feel fully recovered or as advised.

The Six Week Clock: Timing Your Preparation and Recovery

The Six Week Clock is a practical tool for timing your preparation and recovery around injectable cosmetic treatments. It highlights four key checkpoints:

  1. 24 hours: Immediate reactions (swelling, bruising, redness)
  2. 72 hours: Early signs of complications (persistent pain, unusual swelling)
  3. Week two: Assessment of results and healing progress
  4. Week six: Full recovery and final result review

Three signs to contact your practitioner today: severe or increasing pain, rapidly spreading redness, or visual changes. This framework helps patients know what to expect and when to seek advice.

Limits: Who This Guidance Does Not Apply To

This information is intended for adults considering elective injectable cosmetic treatments. It does not apply to individuals with complex medical conditions, those who are pregnant or breastfeeding, or anyone under 18. For prescribed medications, always seek advice from your GP or consultant before making any changes. This guide does not cover surgical procedures or non-injectable treatments.

FAQs

Questions readers ask

Should I stop aspirin before injectables?

Only under the direction of your GP or prescriber. Never stop prescribed medication without medical advice.

Can I have injectables if I have a cold?

It is usually best to wait until you are fully recovered before proceeding with treatment.

Is it safe to continue taking supplements before fillers?

Many supplements increase bruising risk; pausing for seven days is common, but check with your practitioner.

When can I restart my skincare actives after treatment?

Most people can resume gentle skincare after two days, but wait up to five days for stronger actives like retinoids.

Can I drink alcohol the night before injectables?

It is advised to avoid alcohol for at least 24-48 hours before and after treatment to minimise bruising risk.

What if I forgot to stop a supplement?

Inform your practitioner before your appointment. They can assess whether it is safe to proceed.

Do I need to stop all medicines before injectables?

No. Only certain medicines may need to be paused, and only under medical advice.

How long after a vaccine should I wait for injectables?

Many practitioners recommend waiting 7-14 days after vaccination before having cosmetic injectables.