Flip through the pages of this magazine (or any magazine) and you will see advertisements for a myriad of beauty products enticing you with the latest and greatest anti-aging miracles. However, despite the vast amount of marketing dollars aimed to get you excited about some fat-reducing device, magic skin cream, or whizz-bang injectable treatment, cosmetic medicine is still medicine, delivered (mostly) by trained professionals who have dedicated a significant portion of their life learning the nuances of anatomy and the aging process. In medicine, any successful treatment starts with making the right diagnosis. This article will discuss common aging changes and the best ways to treat them.
Even though each of us are unique and special (your mother was right about that!), all of us experience the changes associated with the aging process in very specific ways. From outside to inside, the following changes occur:
Years of ultraviolet radiation contributes to the aging of the skin, appearance of “dark spots”, the loss of the elasticity of the skin (it gets saggy), and a leathery texture. In addition, the skin’s production of growth factors slows after about age 35, which causes the skin to thin over time.
- The best treatment is prevention – sun protection is foundational here (EltaMD Clear is the one my family and I use). Adding a topical vitamin A (SkinMedica’s Retinol 0.5 is my personal favorite) is important starting about the mid-20s. A growth factor becomes important around age 35 and up to prevent the changes from a decrease in the skin’s production of growth factors (SkinMedica’s TNS Essential Serum, the industry leader, is a personal favorite).
- Neurotoxin – Botox, Dysport, and the newest on the market – Jeuveau – work by weakening muscles in the face that cause wrinkles, making them good for both treatment and prevention of the signs of aging.
- Chemical Peels – these treatments can be varied by depth, which make them great “adjustable” treatments for almost everyone.
- Lasers – again, “adjustable” based on desired outcomes. Downtime (hiding out at home) can be considerable for more aggressive laser treatments, but the benefits are outstanding.
- Surgery – removing excess skin is sometimes the best option. It is discussed further in the next section
The soft tissue under the skin (fat and muscle tissue mainly) loses support over time, causing it to become loose and descend. There is also a notable age-related loss of volume of the soft tissue – it gets smaller over time, especially in the central face and around the mouth and eyes. This causes an accelerated aging look, and contributes to the “sad” appearance many people complain about as they age.
- Injectable Fillers – these serve to replace volume lost over time, and work wonderfully around eyes, lips and in the cheeks, although we also use them “off-label” in about every part of the face (temples, chin, jawline, etc). Contrary to what some injectors (and manufacturers) will tell you – fillers FILL, they DO NOT LIFT, so they only address a small part of the aging changes seen.
- Fat Injections – your own body fat can be used in much the same way injectable fillers are to augment areas of volume loss. Not only are the results permanent (fillers need to be re-done every year or two), but the fat helps to rejuvenate the overlying skin, as well! Also, no-one complains about getting a little liposuction…
- Surgery – contrary to popular belief, a facelift isn’t a “skin” operation. Instead, what it does is tighten and reposition the muscles and soft tissue under the skin to help rejuvenate and reshape the face. Loose skin is elevated along with the soft-tissue underneath; this prevents the “windblown” look of skin-only facelifts and allows the scars to heal very nicely. Fat injections are often added to facelift surgery to replace volume loss in the cheeks and around the mouth. Surgery remains the only way to lift and rejuvenate tissues that have sagged with time.
While we don’t tend to think about bone changing with time, it does. These changes are most pronounced around the eyes, nose, and lower jaw; as the bone shrinks in these areas, the overlying soft tissue and skin lose their “foundation”. This contributes to the soft-tissue descent (the “saggy look”) and hollowing of the eye-sockets.
- Camouflage – bone loss is something that can be camouflaged by augmenting the soft-tissue that is on top of it. We are able to use either injectable filler (“off label”) or fat injections to hide the areas of bone loss and make them less noticeable. This is far and away the most common treatment for this issue, and most injectors treat signs of bone loss without actually knowing they are.
- Surgery – Replacing bone that has been lost can be done with the aid of a synthetic implant. Most commonly, chin implants are used, but there are implants that can be used to treat bony loss in all parts of the face – around the eyes, nose, jawline, temples, and brow.
Contact Your Cosmetic Surgeon
In the end, cosmetic medicine and surgery is still that – medicine and surgery. One of the basic principles in medicine is that in order to choose the right treatment and have any hope of success, you have to start by making the right diagnosis. That said, it is important to choose a health care provider with detailed knowledge of anatomy and the changes associated with the aging process.
Give us a call at (865) 973-9500 to learn more information about these treatments or to take the first step in turning back the clock on the aging process by scheduling your consultation.