Proper nutrition, regular exercise and improved health care have lengthened the lifespan in modern America. Most people feel vigorous and energetic despite advancing age. We all want to look as fit as we feel. It is understandable; therefore, that many individuals are seeking facial plastic surgery to reverse the undesirable signs of aging and recreate a youthful, natural appearance.
What causes premature aging?
The rate at which your body ages is determined by a number of factors:
- Genetic influences from your parents or grandparents
- Prolonged exposure to the sun
- Chemical insults from soaps, astringents, and creams
- Cigarette smoking which causes premature skin wrinkling
The aging process is not limited solely to the skin. Changes in fatty tissue, muscle and bone are also noted. Evaluation of all these tissue layers is essential in our preoperative analysis and surgical planning.
The Facial Aging Process
The changes noted in the aging process do not occur all at once. At about age 35, the skin begins losing elasticity, causing it to progressively wrinkle and sag. This results in deepening of the lines of expression in the forehead and at the side of the mouth, the creation of “crow’s feet” at the outer corner of the eyes, the development of “jowls” along the jawline, and the development of a “double chin” or “turkey gobbler” deformity in the neck region.
Underlying the skin, fatty tissue may accumulate along the jawline and in the neck area. This accentuates the deformities created by the initial skin sagging. The natural process of fat being resorbed may give your face an uneven appearance. The muscles and deeper tissues of the face and neck gradually stretch and weaken, no longer maintaining their supportive function. Weakness of the muscles and tissues around the eyes results in the prominent bags or pouches so frequently associated with aging.
If you are considering surgery for correction of the aging process, you will need to undergo a careful evaluation before your operation. We will determine the extent of wrinkling, skin sagging, fat accumulation, and muscle laxity that you have. These findings will then be demonstrated and discussed during your consultation. We will present surgical options to you that will best manage those areas that you want corrected.
Many people feel that a facelift will correct their entire problem. Actually, a facelift only supports the sagging tissues and muscles of the mid and lower face as well as the upper neck. We may recommend additional procedures in order to manage other undesirable signs of aging.
These may be:
- Forehead/eyebrow lift
- Eyelid rejuvenation (blepharoplasty)
- Facial liposuction
- Nasal surgery (rhinoplasty)
- Chin, cheek or lip augmentation
- Chemical peel
- Laser skin resurfacing
- Collagen and/or fat injection
- Botox injection
We will explain the benefits and limitations of each procedure and give you our recommendations. Any decision about surgery will, of course, be yours.
When is plastic surgery indicated for aging?
That depends on the individual. The best answer is probably when the wrinkling, laxity and sagging of the facial tissues are no longer a temporary condition relieved by rest or the application of skin care products.
The surgical management of aging encompasses two basic approaches: maintenance and rejuvenation.
The maintenance program uses a series of small cosmetic operations. These are performed as aging changes first appear and are usually begun by men and women in their early 30’s and 40’s. Friends and relatives may comment on a fresher, more vibrant appearance without realizing that plastic surgery was the source of your “new” look. This has become the most commonly utilized approach.
The rejuvenation approach is used if you have more noticeable signs of aging. Correction in this case is generally more dramatic. Often multiple procedures are recommended to achieve the results you want.
You must realize that facial plastic surgery does not stop the aging process, however, you can expect to have a more youthful appearance that will remain for years. Temporary swelling and discoloration in varying amounts always develop after these operations. You must be prepared for this and accept it as inevitable. The swelling and discoloration may persist for several weeks to months following surgery, depending upon the procedure. Most people recognize it as the small inconvenience that you pay for the physical and psychological improvements you get from the surgery.
As with all surgical incisions, postoperative scars will be present. However, incisions are planned and placed so that they fall in natural skin creases, behind the ear, or in the hairline where they remain inconspicuous. Once the skin incisions have healed, we will discuss techniques for camouflaging these scars with cosmetics and hair styling. Rarely do we see prominent scarring around the eyes, face or neck. In such cases, we may suggest pressure dressings, cortisone injections or excision, the surgical removal of the scar.
In order to protect your skin from premature aging, avoidance of sun exposure is important. We recommend staying out of direct sunlight during the peak sun hours (10-3). If outdoor activities cannot be avoided, then the use of protective clothing and a hat is essential. Also, the use of a strong sunscreen (SPF 15 or greater) can allow you greater enjoyment of the outdoors, limiting your risk of sunburn. These measures not only prevent undesirable signs of aging, but also reduce your risk for facial skin cancer.
Finally, there are no medications, creams, cosmetics, or exercises that significantly prevent or reverse the aging changes on a lasting basis. Skin softening creams may temporarily plump the skin and keep it in a healthy condition. Chin supports or facial muscle exercises, also, have not shown any long-term benefits. None of these have been shown to prevent the progressive laxity and wrinkling of the aging facial tissues.