Facial Aging- Steven Hoefflin, MD

THE FACIAL AGING PROCESS

by Steven Hoefflin, MD

You may first become aware of the aging process when gazing in a mirror, viewing recent photographs, or when family, co-workers or friends comment that you look tired.  While most skin aging is genetically predetermined, excessive sun exposure, smoking and poor health habits also affect it.  With the passage of time, there is a loss of elastic support, and gradually a tired look appears.  Fine lines and wrinkles develop.  The skin surface may develop irregularities in both color and texture.  While a facelift provides some improvement, lines and irregularities are best treated with a combination of good skin care, laser resurfacing, chemical peels and fat or collagen injections.

Aging of the face occurs not just in the skin, but deeper.  The nasolabial folds, the lines that run from the corner of each nostril to the corners of the mouth, develop over time.  We often see jowling, an accumulation of tissue and deep wrinkles around the corners of the mouth.  This sagging disrupts the naturally smooth jaw line that extends from our chin to our ears.  As we age, we tend to lose the layer of fat that supports and “plumps” out the skin of the face.  We may note “bands” in the muscles in front of our neck.  Hooding between the lower chin and neck or sagging of neck skin may occur.  Combined with very fine sun-related wrinkling of the skin, these are the first signs of an aged appearance.

The typical facelift patient is concerned not only with facial aging, but also with facial expression. They may feel their facial expression no longer portrays their actual feelings.  Appearing tired when feeling fresh and rested is the most obvious complaint.  Many patients also feel they look sad, angry or as if scowling.   These expressions are often due to drooping facial fat and skin creating deep folds and lines that obscure our true outward emotions.

This is where the facelift works its wonders.  It relaxes and softens the features providing a more neutral and pleasant overall facial expression.  While facial peels and laser peels remove fine wrinkles and collagen fills the valleys between wrinkles, the facelift addresses the deeper tissues of the face that fall over time due to the effects of gravity.

Treatment of facial aging is directed at different conditions.  First, excess saggy skin and deep underlying support tissue and fat are treated.   We treat this in much the same way you would “take in” a blouse or jacket that is too large.  The excess material is trimmed away and the garment is restitched (facelift). Second, any remaining wrinkles are then “ironed” (chemical or laser peel).  Your doctor will help you evaluate your face to determine how drooping, deep soft tissue as well as wrinkled skin affect your appearance.  This will help you understand treatment options and what to expect.

Remember, one important portion of all plastic surgery procedures is to educate yourself:  http://drstevenhoefflin.com/surgery-educating-yourself/