DORE LIFTING INDEX™

What Stage Is Your Face?

A Personalized Guide to Choosing the Right Lifting Treatment

Facial aging is not simply about "sagging."

Some people develop a heavier-looking face.

Others notice thinner skin.

Some experience downward movement of facial fat.

Over time, wrinkles and changes in the facial skeleton also become part of the aging process.

Because every face ages differently, the same lifting procedure is not the right answer for everyone.

The DORE LIFTING INDEX classifies facial aging into four stages, helping identify the most appropriate treatment based on your current facial condition rather than your age alone.

STEP 1

Volume Type

"Your face isn't truly sagging—it simply looks heavier.".

At this stage, the skin has not significantly loosened. Instead, excess fat around the jowls or nasolabial folds creates the appearance of sagging.

The priority is not tightening the skin but repositioning or reducing the heavy soft tissue that makes the lower face appear bulky.

HIFU-based treatments (such as Ultherapy, Shurink, and ONDA) deliver focused energy to the deeper layers of the face (including the SMAS and subcutaneous fat), helping refine the jawline and improve facial contours.

Simply put,

this stage is less about "lifting" and more about reshaping and contouring the face.

STEP 2

Skin Quality Type

"Your face may still look youthful, but your skin has already begun to age."

Beginning in the mid-30s, collagen gradually decreases even before noticeable sagging appears.

The skin becomes thinner,

drier,

and more prone to fine lines.

These changes occur even earlier in individuals with naturally thin skin and lower facial fat volume.

At this stage, the goal is to improve skin quality by rebuilding collagen and increasing skin thickness.

Recommended treatments include:

Skin Boosters
Potenza
Thermage
SERF (RF)

These treatments stimulate collagen production and help maintain skin firmness.

Healthy skin is the foundation of successful lifting.

STEP 3

True Laxity

"This is when the face truly begins to sag."

From the late 30s onward, declining skin elasticity allows facial fat pads to gradually descend.

As a result,

the nasolabial folds deepen,
the jawline loses definition,
and the face may appear longer than before.

At this stage, a single treatment is rarely sufficient.

A customized combination approach is often recommended:

HIFU to reposition sagging tissue
Radiofrequency (RF) to improve skin firmness
Thread lifting when additional tissue repositioning is needed

Rather than relying on one device, the most important factor is developing a personalized treatment plan based on each patient's facial anatomy.

STEP 4

Advanced Aging

"Both lifting and volume restoration are necessary."

As aging progresses, changes occur beyond skin laxity.

Bone volume gradually decreases,

facial fat atrophies,

and the face loses structural support.

The result is

a flatter facial appearance,
deeper wrinkles,
more pronounced changes around the mouth,
and loss of jawline definition.

At this stage, lifting alone cannot completely correct established wrinkles and volume loss.

The most natural and long-lasting results usually require a combination of:

Lifting laser treatments
Thread lifting
Dermal fillers for volume restoration
Surgical facelift when appropriate

The Core Concept of the DORE LIFTING INDEX™

Everyone ages differently.

Some people appear older because of excess facial fat.

Others experience collagen loss and thinning skin first.

Some develop downward displacement of facial volume, while others show age-related changes in the facial skeleton earlier.

The key is not pulling harder—

it is accurately identifying which structure has changed first.

The DORE LIFTING INDEX™ is not simply a guide for choosing a device.

It is a comprehensive framework for analyzing the underlying causes of facial aging and selecting the most appropriate, personalized lifting strategy for each individual.

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