I always say, to age gracefully one needs to avoid or treat the deformities of aging. The most obvious deformities are the hanging neck, the very exaggerated jowls and nasolabial folds. My patients don’t seem to care about wrinkles. They think those are normal after a certain age. They like to eliminate the gross signs aging. Those are some time obvious to their grand children. One patient told me “my three-year-old grand child grabs the skin under my chin and asks me what is this grandma”. Another patient told me my grand daughter puts her index finger on my jowl and pushes in every time I pick her up. These are deformities of aging that are apparent to even an innocent child and this is why my patients try to correct them.
The two components of facial aging are:
1) Skin laxity and redundancies. For example Jowls, nasolabial folds, marionette lines.
2) Changes in skin texture and fine wrinkles.
The second component is primarily sun related and will require skin resurfacing as primary mode of treatment, even though the wrinkles improve with skin tightening procedures such as face lifting.
The skin resurfacing procedures in general will cause loss of pigmentation and are problematic in patients who are tan or can tan. After resurfacing, on close inspection, the skin will have a different appearance.
In northern New Jersey, specifically in Morristown area my patients want to eliminate the gross sign of aging without changing the character of their skin. My patients want to look natural. They don’t want anyone to know they had surgery. I have talked about the natural look at length. It is buzz word on most web sites. Every one claims to create a natural look, but what makes the so called natural look is the harmony and balance in the facial structures as well lack of visible scares and abnormal textures of the skin. To achieve this harmony and balance, I may have to do more than just a facelift. A combination of procedures like a facelift, brow lift and upper and lower eyelid surgery is occasionally necessary. Restoration of facial volume by fat grafting or fillers like Radiesse is sometimes mandatory to create that harmony and proportion that is so important to achieve the so called natural results. A detailed evaluation of your face is necessary to determine how much surgery or combination of surgical and non-surgical procedures is needed to achieve optimal results.