February 24th, 2020
In my office, we see patients every day that are contemplating cosmetic enhancements to their face. Nearly all of them say the same thing:
"I am afraid that if I have anything done to my face, I won't look like myself."
The point of any cosmetic treatment is not to fundamentally change your appearance, but to restore and enhance what is already there - to improve "you." We strive to have our patients get reactions from friends and family like "Wow, you look great! Have you lost weight? Did you just get back from vacation?" They don't know what you've had done, but they know they like the changes they see.
Many Knoxville Plastic Surgery patients that come to see us don't need surgery. Advances in cosmetic treatments have come to a point that with some regular upkeep, especially with respect to skin care, the "need" for surgery can be delayed or eliminated completely. Here are a few (non-surgical) tricks to help turn back the clock:
First and foremost, good skin health is the key to a rejuvenated appearance. Your skin, especially in the summertime, takes a beating from ultraviolet (UV) radiation from the sun. Ultraviolet light is one of the primary causes of aging changes of the skin (this means wrinkles, "sun spots", and a leathery texture). Protection in the form of a good zinc oxide sunscreen will help slow the aging changes caused by UV radiation. Then, in the fall and winter, treatments to reverse the damage - chemical peels or laser treatments - can treat skin irregularities and eliminate much of the prior damage that has been done. Additionally, a good home skin care regimen is a must. Skin care at home should not break the bank, nor should it be overly complex. Most over the counter products, including many of the popular brands, are simply not worth the money. While they contain similar active ingredients as most physician-dispensed products, they only contain these active ingredients at a fraction of the concentration of those purchased at a physician's office, and cost about the same (if not more).
This area of the face is where Botox has set itself apart as a treatment (with good skin care as a close second). Many of the aging changes here - the horizontal lines across the forehead, the "11" lines between the eyebrows, and the "Crow's feet" wrinkles of the outer eyes - all respond beautifully to Botox. Botox works by relaxing the muscles that cause these lines to form, which effectively erases or softens them. This injectable treatment can be used not only to treat deeper lines that have formed, but can also be used to prevent those deeper lines from forming in the first place. A typical Botox treatment lasts about three months and should be repeated regularly for best results.
Treatment in the area from the lower eyelids to the bottom of the nose (the "midface") - focuses on replacing age-related volume loss in this area. Injectable fillers have revolutionized facial rejuvenation of the middle-third of the face. Until recently, this was an area that extensive surgical procedures were needed. Now, we can correct many early aging changes with an in-office injection and delay or avoid surgery all together. Injectable treatments in this area are common, but detailed knowledge of the intricate anatomy is needed by the injector. Not only do you want a natural result (who wants bicycle tire lips or cheeks that look overdone?), but you want to avoid un-necessary complications. As with any cosmetic treatment, knowing how to avoid complications is more important than knowing how to treat complications if they happen. Injections in this area can last up to two years or more, depending on the filler used and the area in which they're injected.
The lower face is still a difficult area to treat non-surgically, although we have some new tools available to postpone surgical treatment in some patients. Most recently, supporting the sagging jowls and skin of the lower face with threads under the skin (called, appropriately, a "threadlift") has shown promise in temporarily elevating drooping jowls. Combined with a long-lasting filler just in front of the jowls (and even extending forward to augment a weak chin), we can achieve benefits that are about the same as you would see with one of the numerous "lunchtime facelift" techniques out there, but without the need for surgery and the complications that have caused many of those quickie-facelift clinics to go out of business. A "threadlift" requires no incisions and takes about 30 minutes to perform with a small amount of local anesthesia. The results last anywhere from 6 to 18 months, depending on the patient and the area treated.
The take-home message here is that there are many options for facial rejuvenation that can significantly and naturally reverse age-related changes without the need for surgery. The important thing to remember is that these are medical treatments that depend on accurate diagnosis for you to have an effective treatment. Before treatment, seek consultation with an injector who has appropriate training and significant experience. A good place to start is to look at the American Society of Plastic Surgeons or the American Academy of Dermatology websites for board-certified physicians in the area, and seek advice from the injectors affiliated with those practices.