Facial Aging: “Piece by Piece” or “The Whole Enchilada”

Dr. BrahmeA recent article in the blog “mashedplastic” explores the unique features of facial aging. We used to think that all components of the face (cheeks, chin, jowls, neck, eyes, and forehead, etc.) aged in a uniform, predictable manner.

However, in reality what we are finding is that is that in some people the neck tends to age more than the eyes, or the cheeks tend to fall more than the forehead. The cause of this is poorly understood but may relate to genetics. It is only reasonable to suspect that if your mother or father had a “turkey neck” you may be at risk for this as well, if you look like them to begin with.

What does this mean for plastic surgeons and the reversal of aging with facial rejuvenation? I believe it means that we can intervene earlier and more selectively if we know that a particular facial component will tend to age faster.

I have personally seen patients in their 30s with very deep naso-labial folds (the smile lines on either side of the mouth), out of proportion to the rest of their facial anatomy. These patients may be a good candidate for fillers such as Perlane or Sculptra.

Some patients with a fat pad under the chin may be candidates for liposuction earlier in life when the skin has more resiliency and will respond better to liposuction than it will later on in life.

We know that early intervention is more long-lasting and yields a more natural result then corrections when we are older. It’s just like the old adage “an ounce of prevention is worth a pound of cure.” Of course, the sad truth is that we are all getting older, but the good news is that we are learning more and our interventions are less radical, more effective and give the more natural result. I am sure the best is yet to come.