The Surgeon Minute

The Five R’s of Facial Rejuvenation

The Five R’s of Facial Rejuvenation

The key to looking refreshed while still looking like yourself is taking a maintenance approach to facial rejuvenation. To best address the signs of aging as they appear, you will need a plan in place – the good news being that you have lots of options! The bad news is that with so many options, it can become overwhelming.  

“We want to start early. We want to do small procedures to hold back aging,” shares Dr. Kevin L. Smith, a board certified plastic surgeon of Charlotte Plastic Surgery. “We want our patients to frustrate their friends, because they wonder why their friend isn’t aging and they are!”  

If you devoted your time to trying every anti-aging product and procedure you read about online or in a magazine, you would have very little time left for anything else. How do you when it is time to do something to rejuvenate your face, and what are the best options for your needs? According to Dr. Smith, a comprehensive plan will include more than one type of rejuvenation procedure.

Let’s Break it Down

Facial rejuvenation treatments can be broken down into five main categories. Here, Dr. Smith explains what he refers to as, “the Five R’s of Rejuvenation,” and the role each piece plays in setting back the clock of your aging face. “Not everyone is going to get every R,” says Smith. “As we consider rejuvenation, there’s a different level that we apply all these R’s for every age.”

#1: Relaxation

Many of the wrinkles on your face are what doctors refer to as dynamic wrinkles. Dynamic wrinkles are caused when the muscles of your face are active. For example, when you squint, the action in the muscles around your eyes cause crow’s feet wrinkles to appear. When you scowl, the muscles between your eyebrows cause vertical lines to appear above your nose. Sure, you frowned and squinted in your younger years, but decades of action have made your facial muscles strong, and as a result those lines become more noticeable.

Facial rejuvenation plan - #1 Botox.

“When we talk about relaxation, this is where our neurotoxins, classically Botox, are used,” shares Smith.  “When we inject Botox to take care of these deep lines, these deep elevens or these crow’s feet, it defeats the muscles that pull the brows down, so we actually get some brow lift.”

#2: Refill

Facial fillers are used to refill areas of the face where volume is lost over time. Dr. Smith adds volume to the cheeks using a filler called Juvederm Voluma. Voluma has a thick, firm texture, making it ideal for adding volume to the deep parts of the cheeks, just above the cheekbones.

In areas closer to the surface of the face where volume is lost, such as the nasolabial folds or the lips, he prefers softer, lighter fillers like the new Juvederm Vollure or Volbella. “Volbella is an interesting filler, because it’s not a plumper, it’s a smoother. It’s very thin, we can inject it very superficially, it’s beautiful to reconstruct the architecture of the lip, the shape of the lip, without making it bigger,” shares Smith.

Facial rejuvenation - #2 Filler

The goal with facial fillers is to restore lost volume, but not to make a facial feature appear large or puffy, says Smith.  “There are so many examples where fillers are done poorly and people look big.  The key to fillers is that if somebody knows what we’ve done, I think we’ve done a poor job.”  

#3: Reduce

At the same time you are losing volume in your cheeks and lips, you are often gaining volume along the jawline and below the chin. “What we’re trying to accomplish with rejuvenation is to restore that youthful facial shape which has full volume across the midface, and a sharp, lighter jawline,” explains Smith.

Facial rejuvenation - #4 the neck.

Liposuction is a surgical option to reduce fat, but there are several less invasive options. In his office Smith uses an injectable called Kybella to remove fat below the chin without surgery or downtime. CoolSculpting has also introduced an attachment for the neck, making it a second non-invasive option for reducing fat in the lower face.  

#4: Resurface

“As we age, a lot of things happen with our skin,” says Smith. “The next R is all about resurfacing. We resurface skin to improve the texture, tone and color.”  Tools for resurfacing the skin fall within a broad spectrum, ranging from skincare products that you apply at home to a deep laser peel requiring a two week recovery. “We equate results with how much energy you get into the skin,” explains Smith.  “If you need a lot of result, you’re going to be imparting a lot of energy, and of course that takes more downtime.”  

Facial rejuvenation - #4 resurfacing.

Tools to Resurface the Skin:

#5: Reposition

Facial Rejuvenation - #5 facelift.

Finally facial aging reaches a point where facial fillers are no longer achieving a crisp jawline or youthful cheeks, it may be time for a facelift. “We can get subtle repositioning with our fillers and with Botox, but true repositioning is a surgical event,” says Smith.

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