Rejuvenating the Aging Face

By Orin Zwick, MD

Chesapeake Eye Care & Laser Center

. https://www.chesapeakeeyecare.com/

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Rejuvenating the Aging Face

The approach to cosmetic eyelid surgery and facial rejuvenation has undergone a change in recent years due to a better appreciation and understanding of the aging face. Thorough evaluations and photographic comparisons of patients in younger years help identify individual aging changes, such as loss of volume, drooping eyelids, unwanted puffy pockets and prominent lines. Patients no longer desire a drastic plastic surgery look. A natural result with noticeable improvement and youthful rejuvenation is the ultimate goal.

It is evident when reviewing past photographs of patients that two main issues occur with age decent and deflation. As children, our faces are plump and full of fat, the overlying skin is tight with strong elasticity and wrinkles are not present at rest. With time, fat tends to deflate and unfortunately sometimes becomes more prominent in other unwanted areas. Additionally, skin loses its elasticity and tight texture. After years of dynamic facial movement, wrinkles become deeper and sustained even at rest. This accounts for the deep furrows that occur in between the eyebrows, on the forehead and around the eyes. With descent and deflation, the folds along the sides of the mouth become more prominent, the lips become smaller and turn in, and lines above and around the lips are more noticeable. Aging changes of the upper face include eyebrow drooping, eyelid skin that hangs down over the eyelashes, sunken upper eyelid contours or prominent herniated fat, and sometimes a weak eyelid that drops over the pupil and can block vision. Changes of the lower lid can include puffy pockets, skin wrinkles, dark circles or pigmentation and laxity of the support structure. Genetics and environmental factors contribute to the variability of how each person ages.

Treatment requires an understanding of the individual concerns and addressing them with a multifaceted approach. From an outward-in concept, it is important to first address the skin. Many medical grade cosmetic skin products are available to help improve tone, texture, pigmentation and sun-damage that our skin sustains. This requires maintenance and protection from future damage. Chemical peels, facial treatments and microdermabrasions are slightly deeper ways to enhance the underlying appearance. Non-surgical treatments including botulinum toxins, such as Botox, and fillers like Juvederm and Restylane are the next logical step to improve both the dynamic facial wrinkles of the upper face as well as the deeper facial furrows of the lower face that occur from volume loss. Cosmetic upper and lower eyelid and eyebrow surgery can provide a significant refreshed appearance. Surgical procedures are specifically tailored to each individual to achieve the most natural result. When considering eyelid surgery, it is important to consult with an oculofacial plastic and reconstructive surgeon.