The Surgeon Minute

Combat Facial Aging with a Multipronged Approach

Combat Facial Aging with a Multipronged Approach

“We all start aging as soon as we’re born,” says board certified plastic surgeon Dr. Adam Hamawy of Princeton, NJ. While a certainty, it does not mean that there aren’t steps that we can take to slow down the process.

First come the fine lines and the wrinkles, many of which can provide some “wisdom” and “elegance” crossing from the 20s into the 30s. Sadly this is short lived, and the real enemy begins to show itself: volume loss and loosening skin.

Thankfully, plastic surgeons today have a wide array of non-surgical modalities for turning back the clock. The important thing to understand is that despite what a marketing campaign may tell you, no one procedure can address all of your facial aging issues. The key is to work with your plastic surgeon to find the right combination of procedures for your individual needs. Dr. Hamawy walks us through some of the options available to combat the march of time.

Facial Aging Does Not Just Happen on Top of the Skin

Once patients start hitting 30, they begin to see changes on their face when they look in the mirror. They start to worry about fine lines and wrinkles, which first appear in the following places:

  • around the eyes
  • across the forehead
  • on the sides of the mouth

Next up is a combo of skin aging and volume loss, which makes the skin look “worn and saggy,” according to Dr. Hamawy. This is typically around the time that a patient makes an appointment to come in and see him. This first thing that he does in any facial aging consultation is to assure you that this happens to everybody. “We all start aging as soon as we’re born,” he shares. “These changes are normal.”

Aspects of facial aging.

Even so, this does not mean that you must accept these changes; there are many things that can be done to slow down the aging process, some better than ever. The important thing is to address your facial aging piece by piece. “Aging doesn’t just happen on top of the skin” explains Dr. Hamawy. It is one component of an aging face, certainly, but so is a loss of facial volume.

As we celebrate yet another birthday, we start to lose fat from the face. Ironically, we gain it in other places (hello, muffin top!) while our face just gets thinner. It is the loss of volume, possibly even more than sagging skin, that makes your face look aged. Add to this loosening muscles and receding bone structure and you have the recipe for a face that looks older than you feel.

Sunscreen is the First Line of Defense

When combating facial aging, it is critical that you address each issue independently. However, if you start this process early enough, you can actually slow down the aging process. The first line of defense is great skincare. This starts with a healthy diet; eating right and drinking enough water are two of the best things that you can do for your skin. Next is a good skincare regime, one that includes the daily use of sunscreen. You want to find a sunscreen that is specifically designed for the face. It should not be too greasy or oily, it must block both UVA and UVB rays, and have an SPF of 30 or higher.

Fillers, Fat & Ultherapy

Once you have your skin looking radiant, the next area to address is volume loss. This can be done either using your own fat, in a process called fat grafting, or with a synthetic filler. Each has its pros and cons. However, one of the advantages of a synthetic filler is that there is such a wide array that the treatment plan can be fine-tuned. These include fine lines across the forehead, crow’s feet, dark circles under the eyes, sagging around the mouth and hollowing at the temples. It is also possible to use a deep filler such as Voluma to fill where the bone is receding.

Ultherapy for facial aging.

While fillers and fat are great for filling, they can not tighten loose muscles. This requires more energy, such as a non-surgical modality like Ultherapy. The device utilizes focused ultrasound energy that generates heat deep beneath the skin in order to promote collage production, and tighten loose muscles. It’s not going to deliver the same results as a surgical facelift, but you may not need a facelift just yet. The goal of these non-surgical modalities is to push off the “need by” date for a facelift by 5-10 years.

Addressing Facial Aging is Not One-Stop Shopping

“One of the biggest parts of my job is talking about the aging process and all the different components to aging, because it’s not just one thing and there’s not just one tool that will fix everything,” explains Dr. Hamawy. A laser will clear up your brown sun spots, but it won’t address deep lines. Ultherapy can tighten up the skin, but it can’t do anything for those “11” wrinkles between your brows. Aging is simply multi-factorial.

A plastic surgeon luckily has a toolbox of different devices, techniques and procedures, and it’s a toolbox that continues to grow in size. Even as exciting as some of the options can be, it’s crucial to keep in mind that you, personally, may only require a few. The pitfall that many patients fall into is buying into the marketing scheme of the latest “magic” machine; no one machine can do it all. The trick is to select a board certified plastic surgeon who “can look at the big picture and then individualize it to what is happening to you, ” concludes Hamawy.

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