Dr Rozina Ali is an internationally recognised, multi-award-winning consultant plastic, reconstructive and aesthetic surgeon with more than three decades of experience. With a deeply patient-centred approach and a particular focus on skin health and regenerative medicine, she believes that ageing should be supported and optimised, not simply resisted.
In the first blog in this series, Dr Ali introduced her layered approach to facial rejuvenation, explaining why ageing must be addressed across multiple tissue layers to achieve natural, lasting results. In this second blog, she turns to the most fundamental of those layers: skin quality,
hydration and cellular health. This is the essential foundation upon which everything else is built.
Why skin quality is the starting point
When patients come to see me, many are focused on lifting, tightening or restoring volume. But before we address structure, we must first look at the quality of the skin itself. As we age, the skin undergoes profound biological changes. Collagen production slows, elastin fibres weaken, and hyaluronic acid – the molecule responsible for retaining moisture, gradually diminishes. At the same time, fat pads deflate, ligaments loosen and gravity takes effect, creating a visible sense
of tiredness, dullness and laxity.
Skin becomes thinner, drier and less resilient, losing its ability to reflect light evenly, which is often why people say they look “tired” even when they feel well. If the skin is not healthy, hydrated and functioning optimally, no amount of structural work will achieve a refined result. This is why I alwaysbegin here.
Restoring hydration from within: the role of Profhilo
One of the most elegant ways to restore hydration is through treatments that work with the skin’s own biology. Profhilo is a treatment I use frequently in this context. It is not a filler in the traditional sense, but a highly purified hyaluronic acid injectable designed to disperse evenly beneath the skin, deeply hydrating tissues while stimulating collagen and elastin production. What I particularly value about Profhilo is its subtlety. It does not change the shape of the face or create volume. Instead, it improves skin quality, restoring luminosity, softness and elasticity. Patients often describe their skin as looking fresher, more hydrated and more “alive”. It can be used on the face, as well as the neck, décolletage, hands and arms, areas where skin can become crepey and
dehydrated over time. For many patients, particularly from their mid-30s onwards, it forms part of a proactive, ongoing approach to ageing well.
Hyaluronic acid: more than just volume
Hyaluronic acid plays a central role in skin health. It is naturally present in the body, binding water and maintaining hydration, tone and elasticity. As levels decline, the skin loses not only volume, but also suppleness and radiance. While dermal fillers are often associated with structural
enhancement, they also play an important role in restoring hydration and skin quality when used thoughtfully.
In my practice, I use different formulations depending on the tissue and the objective. Softer products hydrate delicate areas such as the under-eyes, while more cohesive formulations support areas such as the cheeks, temples or jawline. The goal is never simply to “add volume”, but to restore balance, improve hydration and enhance the way light interacts with the face. When done well, the result is subtle, a fresher, more rested appearance.
Feeding the skin: Mesotherapy and skin boosters
Beyond hydration, the skin often needs nourishment. Mesotherapy delivers a tailored combination of vitamins, amino acids, antioxidants and hyaluronic acid directly into the dermis, stimulating fibroblasts to produce collagen, elastin and glycosaminoglycans. In practical terms, this improves texture, hydration and overall skin resilience. Similarly, advanced formulations such as NCTF provide a complex blend of active ingredients that support cellular metabolism and regeneration. These treatments act almost like a “multivitamin” for the skin, helping it function more effectively in the face of ageing, environmental stress and
hormonal change. They are particularly useful for patients whose skin appears dull, tired or depleted.
Regenerating from within: the power of Polynucleotides
One of the most exciting developments in regenerative aesthetics is the use of polynucleotides. These treatments work at a cellular level, stimulating fibroblasts to increase collagen and elastin
production while improving hydration and providing antioxidant protection. The result is stronger, more resilient skin with improved tone and elasticity. They are particularly effective in delicate areas such as the under-eyes, helping to reduce crepiness, improve texture and
soften discolouration. What aligns them with my philosophy is that they encourage the skin to repair and regenerate itself, leading to subtle, natural and progressive results.
Supporting skin health beyond the clinic
Skin quality is not only influenced by what we do in clinic, but also by how we support the body more broadly. I often recommend evidence-based supplements such as Skinade, designed to support collagen production and improve hydration from within. By delivering key micronutrients in a bioavailable form, it helps reinforce the skin’s structural matrix over time. Patients frequently report improvements in hydration, radiance and overall skin quality, as well as benefits for hair and nails. This “inside-out” approach is central to regenerative aesthetics,
recognising that the skin is part of a complex, interconnected system.
Building the foundation for natural results
When we invest in skin quality, everything else becomes more effective. Hydrated, healthy skin responds better to treatment, heals more efficiently and reflects light in a way that conveys vitality and wellbeing. This is why I rarely rush to more invasive or structural interventions without first establishing this foundation. It allows us to build results that are not only beautiful, but sustainable.
In the next blog in this series, I will move deeper into the face, exploring how we restore structure, volume and support, lifting and rebalancing the tissues beneath the skin to complement the improvements we have already made at the surface.
