If grocery checkout lines are any reflection of our society, we are fixated on sex and appearance! Perhaps I can offer some suggestions for improving the latter. Advertising would have use believe that there is a quick, painless fix for everything including our aging faces. Unfortunately, there is no shortcut to a quality result.
The good news is that surgeons in several fields along with dermatologists, have developed significantly improved techniques for not only altering the texture and pigmentary irregularities of our skin, but also for removing unwanted sagging and other stigmata of aging:
1. Laser Resurfacing/Chemical Peels - Best used for the removal of pigmentary irregularities and less severe wrinkling. There are various surgical procedures that are better designed to re-suspend the brow, remove excess skin and bagginess around the eyes, lift the face, and when necessary, augment the chin and cheek areas.
2. Forehead lifts - efficient and safe for rejuvenation. They simultaneously weaken the central forehead muscles to alleviate the deep creases between the eyebrows without the need for repeated Botox injections.
3. Eyelid procedures - There are also better techniques for improving the lower eyelids with much less risk of the telltale lid sag and flattening of the lid margin
4. The Standard facelift - the latest modifications due to an improved knowledge of facial anatomy has led to improvements. Dissatisfaction with the lack of correction of the cheek lip fold was a major complaint prior to the introduction of the "deep plane" facelift. In this procedure, the cheek fat pad is returned to its prior position allowing flattening of the offending fold.
5. Upper face procedures - First, the aged appearance begins in the forehead with a simultaneous descent to the eyebrows accompanied by a redundancy of the upper eyelid skin. Depending upon the patient's inherited facial characteristics, these changes may also be accompanied by fullness in the lower lid. The initial changes usually begin around age 40, but in some patients may begin much earlier.
6. Combined procedures - Within 4-5 years, accompanying changes begin to appear in the lower face and neck. These lower facial changes are the ones most likely to be noticed by the patient. However, in most cases simultaneous correction of the upper face is also required to achieve a pleasing balance. When indicated, these combined operations can set the clock back 20 years in the ideal patient!
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