Towards a Global, Preventive and Sustainable Approach to Aesthetic Medicine
Dr Alexandra Colombo Turell
For many years focused on the visible correction of aging signs, aesthetic medicine is now evolving towards approaches that are more progressive, more physiological and more respectful of living tissues.
Over the past twenty years, aesthetic medicine has undergone a major transformation, both in its techniques and in its philosophy. From an approach initially centred on the visible correction of aging signs, it is now moving towards a vision that is more subtle, more comprehensive, more progressive and, above all, more respectful of living tissue. This evolution is not based solely on technological innovation, but also on a transformation in the way we look at the face and aging itself.
A Global Approach: The Face as a Single Entity
In my practice, established in the Grand Duchy of Luxembourg for nearly twenty years, I have always favoured a global approach to the face. From the outset, I was reluctant to “segment” the face into independent areas to be treated separately. In my view, the face is a unique and dynamic entity whose balance depends on the interaction of its various structures. Dividing it into isolated indications exposes patients to the risk of imbalance and even a certain standardisation of results.
This global approach aims instead to preserve:
• Harmony
• Balance
• Facial identity
• The patient’s personality
It is within this framework that skin quality has progressively emerged as a central element.
Skin Quality: A Major Determinant of Aging
Skin aging cannot be reduced to the appearance of wrinkles or volume loss. It corresponds to a progressive deterioration of tissue trophicity:
• Reduced fibroblast activity
• Alteration of the extracellular matrix
• Loss of hydration
• Degradation of collagen and elastin fibres
These phenomena affect the overall quality of the tissue and condition the subsequent appearance of visible signs of aging. With experience, it has become clear that these alterations are much more difficult to correct than to prevent. It is easier to fill a wrinkle than to restore deteriorated skin quality. This observation led me, very early on, to favour maintenance and preventive strategies.
What Patients Are Looking for Today
Patients’ expectations have evolved profoundly in recent years. Today, patients seek natural, progressive results that respect their identity. They wish to preserve the freshness and harmony of their face without visible transformation or standardisation of their features. This demand is particularly evident among active women with significant social and professional commitments, who are looking for effective yet simple treatments involving minimal discomfort, little or no downtime, and compatibility with their lifestyle. The discreet and physiological nature of these approaches also contributes to patients’ positive perception. Progressive results that respect facial expressions and individual personality often foster a long-term therapeutic relationship based on trust and ongoing support.
Tissue Ecology: Towards a More Respectful and Sustainable Approach
This evolution in expectations is accompanied by a broader reflection around what could be described as “tissue ecology”. This concept is based on the idea that modern aesthetic care should preserve, as much as possible, the integrity, quality and physiology of living tissue within a sustainable framework. The objective is no longer merely to correct a visible sign of aging, but to maintain high-quality tissue over time, enabling it to age in a more harmonious and stable manner. This approach involves favouring tissue-respectful treatments that are minimally aggressive, progressive and integrated into a comprehensive maintenance strategy. It also responds to a growing demand from patients, who are increasingly sensitive to natural-looking outcomes and to the potential consequences of treatments that are overly aggressive, repeated too frequently or insufficiently respectful of living tissue.
Twenty Years of Clinical Experience
For nearly two decades, I have incorporated skinbooster-type techniques into my treatment protocols. At a time when volumising treatments largely dominated aesthetic practice, this approach may have appeared marginal.
With hindsight, this orientation has proved particularly relevant.
Among patients followed on a regular basis, particularly in Luxembourg, where patient loyalty is strong, I observe:
• More progressive and harmonious aging
• Better skin quality over time
• A significant reduction, or even near disappearance, of the need for corrective treatments
This observation remains empirical, but it is consistent. It is part of a longitudinal follow-up approach in which regularity and prevention play a decisive role.
Profhilo®: A Major Development in Tissue Stimulation
Within this context, the emergence of technologies such as Profhilo® has represented an important evolution.
The specificity of IBSA lies in its NAHYCO® technology, which combines high- and low-molecular-weight hyaluronic acid through thermal stabilisation without the addition of chemical cross-linking agents, allowing:
• Deep hydration
• Fibroblast stimulation
• Improved collagen and elastin synthesis
• Optimal tissue integration
Unlike traditional fillers, it is not a volumising product but a genuine tissue bioremodelling agent. This dual hydrating and stimulating action improves the overall trophicity of tissues without altering facial volumes or features. A post-marketing study¹ conducted between 2015 and 2018 on nearly 40,000 patients treated with Profhilo® also confirmed the product’s high tolerability, with a very low rate of adverse events. These data reinforce the value of approaches based on tissue quality, natural-looking results and respect for living tissue.
Profhilo® Structura further extends this philosophy by addressing the restoration of superficial fat compartments, whose progressive atrophy directly contributes to the loss of facial harmony. Modern aesthetic medicine is moving towards a more respectful approach to tissue and aging. Skin quality and tissue ecology are now central elements of this evolution. Tissue stimulation approaches, particularly technologies such as NAHYCO®, help meet this requirement. They fit within a global, sustainable and coherent vision in which the objective is no longer to transform the face, but to preserve its balance, identity and vitality.
References ¹ Cassuto D, Delledonne M, Zaccaria G, Illiano I, Giori AM, Bellia G. Safety Assessment of High- and Low-Molecular-Weight Hyaluronans (PROFHILO®) as Derived from Worldwide Postmarketing Data. Biomed Res Int. 2020;2020:8159047. Safety profile of Profhilo® demonstrated after 3 years of post-marketing experience in 40,000 patients. Twelve minor adverse events were reported.
Dr Alexandra Colombo Turell
Practising aesthetic medicine and laser treatments in Luxembourg since 2008 and in Metz since 2022. A general practitioner graduated from the University of Nancy, she holds several university diplomas in aesthetic medicine, medical lasers, hair loss treatment and micronutrition..
Infos: docteur-colombo.fr
