Sofwave and Pure Impact: A Structural Approach to Modern Ageing – by Dr Anjali Mahto, London Dermatologist
Ageing is often framed in aesthetics as a matter of surface: lines, wrinkles, a slight softening around the eyes or jaw. But to any clinician who truly understands the anatomy, ageing is not a surface problem. It is a structural one.
At Self London, we approach this from first principles. Skin does not sag in isolation. The dermis thins, collagen and elastin degrade, subcutaneous fat diminishes and shifts. Muscle mass, the foundation of our posture, gait, and physical function, declines steadily with age. Bone density alters. Hormones shift. The face and body change together, layer by layer. And if these layers are not treated in an intelligent, coordinated way, aesthetic results will always fall short.
That is why we pair Sofwave, our mid-dermal ultrasound platform, with Pure Impact, a doctor-led protocol for deep muscle activation and restoration. These treatments work on different areas of the body, but they address the same underlying problem: structural decline. This is not a cosmetic combination. It is a clinical strategy.
Ageing Is Not Just About the Skin
From our mid-twenties onwards, the biology of ageing accelerates in quiet, cumulative ways. Collagen synthesis slows by around 1 percent per year. Elastin fibres lose their recoil. The dermis becomes thinner, more fragile, less capable of supporting the superficial layers of skin. Subcutaneous fat begins to atrophy or redistribute, particularly in the midface, temples, and jawline. Bone reabsorption at the mandible and orbital rim can lead to shadowing, volume loss, and collapse of support. These changes are well established in the dermatologic literature and visible every day in practice. But they are only part of the picture.
What is often missed, or ignored, is the profound impact of muscle loss. After the age of thirty, skeletal muscle mass declines by an estimated three to eight percent per decade, a process known as sarcopenia. It becomes more pronounced with inactivity, chronic stress, and hormonal changes, particularly during perimenopause and menopause. Muscle is not just about aesthetics or strength. It underpins balance, metabolic health, and structural alignment. A weakened gluteal complex or under-recruited core does not simply affect athletic performance. It alters how we stand, how we move, and how our skin sits on the frame of the body.
Structural Collapse Presents in Subtle Ways
In the clinic, this often presents as a vague sense of “collapse” — posture shifting subtly forward, the jawline softening, neck skin appearing crepey or heavier. These changes are frequently misattributed to isolated skin laxity or volume loss. But they are almost always compounded by muscular weakening and postural adaptation.
This is particularly relevant in the current landscape of aesthetic care, where a growing number of patients are on GLP-1 medications such as Ozempic, Wegovy, or Mounjaro. These agents, while effective for weight management, can accelerate both facial fat loss and muscle depletion, creating a presentation that is more hollow, less defined, and often challenging to treat through conventional aesthetic means.
Sofwave: Collagen and Elastin Stimulation Without Surface Damage
For these reasons, our approach at Self London is layered and evidence-based. Sofwave delivers ultrasound energy into the mid-dermis at a precise depth of 1.5 millimetres — where collagen and elastin synthesis occur. It stimulates neocollagenesis without damaging the epidermis, using a parallel beam technique and integrated cooling to maintain safety across all skin types.
It is FDA-cleared for lifting the eyebrows, jawline, and submental area, with additional approvals for improving fine lines and wrinkles. In practice, we see marked improvement in lower face definition, brow position, and skin firmness over a period of 8 to 12 weeks following treatment.
At Self London, we do not use standardised settings. Every Sofwave treatment is adjusted for dermal thickness, anatomical variation, and patient goals. We are not a clinic that chases speed or throughput. Our protocols are designed for outcome, not convenience. One session is typically sufficient, although some patients benefit from a second treatment at the six-month mark depending on baseline skin integrity and their broader treatment plan.
Pure Impact: Muscle Rebuilding from the Ground Up
Where Sofwave addresses dermal support in the face, Pure Impact is used to restore strength, tone, and function to the body. It is a high-performance neuromuscular stimulation platform that activates muscle fibres through targeted, high-intensity electrical impulses.
Treatment is typically delivered over four sessions in two weeks and is led by our senior laser therapist, who is also a qualified personal trainer. Settings are not cosmetic. They are clinical — adapted for each patient’s physical baseline, training history, and anatomical response.
Pure Impact is used in a variety of presentations. Some patients are in their forties or fifties and notice the early signs of postural shift, such as glute deactivation or lower back stiffness. Others are perimenopausal and beginning to experience subtle muscular decline, despite regular exercise. A growing number are active GLP-1 users who are concerned about unintended muscle loss alongside their fat reduction. And there are patients who simply want to support their long-term strength, aesthetics, and physical health in an intelligent, proactive way. What unites these groups is a desire for deeper structure not surface tweaks.
A Dual-Modality Strategy Based on Anatomy
The decision to combine Sofwave and Pure Impact is grounded in physiology. These devices are not used on the same anatomical areas. Sofwave is a facial intervention. Pure Impact is used on the glutes, hamstrings, core, and lower body. But together, they restore two of the most essential elements of structural integrity: collagen and muscle.
Skin laxity, jowls, nasolabial folds, and neck sagging are not just caused by changes in the dermis. They result from volume loss, postural shift, and weakened support. Similarly, a body that appears older or more fatigued is rarely improved through skin tightening alone. Without muscle tone, particularly in the posterior chain and pelvic stabilisers, the frame begins to lose its architectural strength.
Designed for Patients Who Want More Than Surface Change
This combination is particularly powerful for patients who feel their face and body are ageing out of sync with how they live. High-functioning individuals who eat well, train regularly, and look after themselves often feel that their outward appearance no longer reflects their inner energy. For some, that is hormonal. For others, it is driven by GLP-1 weight loss. In both cases, we see a disconnect, one that cannot be resolved by superficial treatments.
Why Most Clinics Cannot Offer This Approach
At Self London, we are deliberate about how and when we combine technologies. Many clinics offer Sofwave. Some offer muscle stimulation. Very few integrate the two within a medical framework. Fewer still understand the clinical physiology that underpins visible ageing, or the consequences of overlooking it.
We do not believe in following trends. We believe in designing treatments around what we see in practice and what we understand from science. This approach is not a package. It is not a marketing protocol. It is a decision to treat the real problem rather than the most visible one.
What Intelligent Aesthetics Actually Looks Like
For patients seeking non-surgical facial rejuvenation, Sofwave remains one of the most effective mid-dermal stimulators available. For those experiencing physical decline or structural loss in the body, Pure Impact offers a rare opportunity to regain strength without the risks or inefficiencies of surface-led EMS. But it is the combination, the insight to use both with clinical judgement, that defines our work.
These are not technologies we bought to meet demand. They are tools we researched, tested, and now use because they work. And we use them with restraint. No two treatment plans are the same. Some patients require a single session of Sofwave annually. Others build Pure Impact into a quarterly strength maintenance protocol. For certain profiles, such as perimenopausal women experiencing both facial laxity and muscular decline, this dual strategy becomes a foundation for feeling physically restored.
The aesthetic outcomes are secondary. What patients tend to notice first is feeling more stable. More upright. Less drawn. The face appears fresher, the jawline more defined, the eyes more open, not because of filler or lifting threads, but because the underlying structure has been supported again.
A Final Word
In an industry increasingly driven by trends, we are proud to take a different path. Self London is a doctor-led, protocol-based clinic. We do not outsource decision-making to manufacturers or marketers. We are here for the patients who want long-term results based on evidence and who are willing to invest in their structure, not just their appearance.
If that is you, we would be glad to welcome you.
