Harvey Austin
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How We Age...Drooping Classic Series...Number 3spacer gif

by Harvey H. Austin, MD

"The smooth planes of the fifteen year-old face become the hills and valleys of time."
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BEFOREspacer gif
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AFTERspacer gif
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How We Age

spacer gifOur 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.

spacer gifOur 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.


spacer gifDrooping is the most common type of aging and usually shows up earliest. It is also the type cosmetic surgery corrects best.

spacer gifThink 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.

spacer gifOften 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

spacer gifAs 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.

spacer gifThe 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.

spacer gifUpper 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.

spacer gifThe good news is that our techniques are best for drooping — and 85% of our patients are droopers.

Facial Rejuvenation: Lifting

spacer gifWe 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.

spacer gifLifting 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.

spacer gifWe lift the eyebrows back into their natural position with a brow-lift, smoothing the forehead at the same time.

spacer gifWe 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.

spacer gifTogether, 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.

spacer gifWhat of the icing?

spacer gifFrequently 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.

spacer gifAnd we have 30 or so other adjunctive procedures we can perform at the same time, all along the direction called looking younger.

spacer gifWhich 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
Box 1470
Berlin MD 21811

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