Our understanding of how to create a more youthful appearance without plastic surgery has evolved dramatically over the past two decades. Years ago we filled the deepest wrinkles with collagen injections (which only lasted about three months), and used aggressive lasers (which could involve weeks of recovery time). Happily, there have been significant advances in both the materials and technologies we now employ, as well as a much better understanding of how to globally approach the skin as we age.
Studies by anthropologists across multiple cultures have revealed that the perception of a young and beautiful face relies on the fullness of the cheek, with preservation of the “apples” at the top. In addition the jawline is defined and the neck smooth. As we age, we tend to lose these characteristics. Our collagen fibers, which create the basic structural strength of our skin, become thinner and begin to fragment. Similarly our elastic fibers, which keep the skin firm, diminish in both number and strength. The end result is that the skin shifts downward and sags. Our cheeks lose their “apples”, become hollow looking, and the lines around the nose and mouth deepen. The lower cheeks sag onto the jawline so that definition is lost, and the neck similarly grows lax.
Because of newer and more versatile options, we can now approach changes looking at the structure of the whole face, rather than just an individual wrinkle. Creating pleasing contours and enhancing volume are now easily attainable goals in this new era of cosmetic dermatology.
In addition to their traditional role of filling in nasolabial folds and marionette lines, fillers such as Juvaderm and Radiesse can be injected to recreate the “apples” of the cheek and fill in hollows in the sides of the cheeks and chin. This creates the immediate effect of lifting the lower half of the face. Fillers can be injected in areas along the jawline to give a more defined silhouette. Bumps on the nose, folding earlobes, and hollows under the eyes can also be improved. Reshaping these areas can take years away from the appearance of your face.
Another new and exciting technology for lifting and recontouring both the face and neck is Ultherapy. This procedure uses focused ultrasound to lift and tighten the skin. The ultrasound waves, which are delivered to two different depths in the skin, stimulate your body’s own collagen production. Areas that can be treated include the brow, beside and under the eyes, the cheeks, and the neck. The end result, which reaches its maximum effect after three to six months and can last for several years, is to diminish sagging by lifting all of these areas.
There are, of course, many other excellent and more familiar treatments, such as Botox for crow’s feet and forehead lines, chemical peels and microdermabrasion for enhancing the skin’s surface, and Fraxel for addressing dyspigmentation and fine lines.
All of the treatments outlined can be used alone or in various combinations to meet your individual goals without surgery and with little to no downtime.
– Dr. Lydia Evans