How We Age
Our faces age three ways: they droop, they wrinkle, they gaunt. Cosmetic surgery can minimize these aging effects and have us look more like we feel inside.
Our lineage decides whether we are in a clan line of droopers, wrinklers or gaunters. We jokingly blame it on "your great grandmother's deal with God." Our lineage demands when aging begins and how fast it progresses. Smoking, sun and alcohol can speed the aging process. If we live long enough we are likely to develop all three types of aging.
Drooping is the most common type of aging and usually shows up earliest. It is also the type cosmetic surgery corrects best.
Think of it this way: At the age of fifteen you had a size five face and size five skin to match. At fifty, you still have a size five face
but now your skin size is seven or eight. It no longer matches. It droops because it has lost its elasticity. As one woman lamented, "My Spandex went and despanded". The smooth planes of the fifteen-year old face become the hills and valleys of time.
Often the first sign of drooping is a little bulge near the corner of the mouth. One of our patients referred to it as "my puff", a name which has stuck.
From Old to Young
As our lower cheeks loosen and droop, they carry the underlying fat with them, forming hills we call jowls. In turn, the jowls droop, erasing the jaw line. The neck skin may droop as a midline band, unkindly called the "turkey gobbler". In the lower neck it droops over its cross-wrinkles.
The cheeks stretch forward, drooping over the creases extending from the nose to the corners of the mouth, slowly forming gullies. Other "droop-over" lines begin at the mouth corners and extend toward the chin.
Upper and lower eyelids can droop and bulge. The eyebrows can droop over their bony ridges and, combined with the aging lids, produce a tired, even sinister look.
The good news is that our techniques are best for drooping and 85% of our patients are droopers.
Facial Rejuvenation: Lifting
We treat drooping by freeing the extra skin, lifting it and trimming it away. Like artistic tailors we hide the seams (scars) wherever we can in the scalp; at junctions such as where the ear meets the cheek; in natural folds, as in the upper eyelid crease; in areas of shadow, like under the chin. My own face lift and eyelid scars are so hidden I must spread the areas with my fingers to show them to my patients.
Lifting the cheek is called a cheek-lift. Lifting the neck is called a neck-lift. When we perform both, as is usually the case, we call the procedure a face-lift. As part of a face lift we often lower the hills by sculpting the fat with liposuction. And fill in the valleys a bit with your extra tissue.
We lift the eyebrows back into their natural position with a brow-lift, smoothing the forehead at the same time.
We correct the drooping skin of the upper lids by trimming it. We correct the saggy baggy lower lids much the same way and often trim bulging fat, using it to fill any hollows.
Together, the face lift, the brow lift and the eyelid procedures are the three pillars of a facial rejuvenation. One patient used the analogy of building a birthday cake these being the three layers of the cake.
What of the icing?
Frequently the corners of the mouth droop, turning down so we look sad or bitter. We correct this with a corner lift. The upper lip may droop, lengthening to hide the upper teeth. We can shorten the lip with a lip lift.
And we have 30 or so other adjunctive procedures we can perform at the same time, all along the direction called looking younger.
Which procedures we choose depends on the unique way you have aged, what you focus on and how much you wish to enhance. At your consultation, I ask lots of questions so you and I can work together to get your best results.
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Harvey W. Austin, MD
Berlin MD 21811
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