Facial Fixer-Uppers: When To Use Fillers And When To Go Under The KnifeFacial Fixer-Uppers: When To Use Fillers And When To Go Under The Knife

Over time, the facial skin undergoes many changes that increase its fragility. As a person ages, the cells comprising his or her body begin to divide and renew more slowly, and the supportive middle layer of skin, or dermis, thins as a result. The production of natural oil (sebum) decreases, causing the skin to become drier and less supple. Proteins found in the connective tissue, such as collagen and elastin, which serve to keep the skin taut and elastic, also start to break down - and years of sun and ultraviolet light exposure will accelerate this process. Finally, the fat found in the deep layers of the skin, which helps to provide a plump, youthful appearance, begins to diminish as well.

All of these factors can cause the skin to wrinkle, loosen, and become more susceptible to the effects of gravity. Plus, repeated facial expressions and movements, such as smiling, squinting, and chewing, can lead to the formation of lines in the skin's surface. The reason is simple: As the skin ages, it loses flexibility and becomes less able to "spring back," resulting in permanent grooves along the facial muscles and in other areas.

For a patient who would like to soften the wrinkles, enhance the contours, and restore the youthful fullness of his or her face, there are options. Several innovative cosmetic procedures are available to rejuvenate the facial appearance and help reverse the ravages of time.

Injectable Fillers

In recent years, improved technology has led to an increase in the use of injectable dermal fillers, such as Restylane®, Radiesse®, and Expression, to soften the appearance of wrinkles and improve the contour of the face. A facial filler treatment entails a series of tiny injections under the surface of the skin. Fillers, which consist of various substances, including hyaluronic acid, are no longer considered to be merely superficial solutions; rather, these products are now available in a wide variety of strengths and consistencies, and they can be mixed together to ensure the best possible result for each individual patient.

Fat fillers and Botox® can also be used to reduce facial lines. During a fat filler procedure, a patient's own fat cells are harvested from his or her buttocks, thighs, abdomen, or other problem area. The fat is then purified and injected into the lips, forehead creases, nasolabial folds ("laugh lines"), and sunken areas under the eyes to provide a rested and refreshed appearance. Botox involves injections of botulinum toxin to relax facial muscles and lessen the appearance of lines and creases. Botox can also be used to address thinning lips.

In general, the best candidates for fillers are patients in their 30s and 40s who are just beginning to see the initial effects of aging. Sometimes referred to as "liquid face lifts," dermal fillers offer many of the benefits of a surgical face lift with minimal downtime. However, a patient needs to understand that even though the results produced by fillers are now lasting longer than ever before, they will still eventually expire and must be repeated and maintained to ensure optimal and continual results.

Further, while fillers can be effective for adding volume to the face and treating certain lines and wrinkles, they cannot be used to tighten sagging skin or reposition deep tissue. Therefore, for certain patients, cosmetic surgery remains the best option.

Face Lift

A facelift is a surgical procedure designed to correct sagging facial skin and muscles, as well as remove excess fat, in order to restore an overall firm and youthful appearance. To accomplish this, a surgeon will create incisions along each temple in the hairline, around the ear, and into the lower scalp. After any excess fat is removed from the jowls and neck and the underlying muscle is repositioned, the skin is draped over the new contours and the excess is trimmed away. As the incisions heal, the scars should fade into the hairline and natural contours of the face and ears.

A minimally invasive and less costly alternative to a full face lift is a mini face lift. Designed to focus on and rejuvenate a specific facial problem area, such as minor sagging around the cheeks, jawline, or neck, a mini face lift is best suited for patients who have lost skin laxity and are experiencing the initial signs of aging (it cannot be used to target the forehead or eye areas). In general, a mini face lift will produce a rested appearance that can be expected to last for five to 10 years.

Additional Procedures

Depending on a patient's specific needs, any combination of additional procedures - including blepharoplasty, a brow lift, and a neck lift - may be recommended to restore a youthful appearance to the face. Blepharoplasty, or an eyelid lift procedure, involves the removal of excess fat and skin from the upper and/or lower eyelids to address drooping, puffy, and/or overstretched eyelids. A brow lift procedure, also known as a forehead lift, involves the repositioning and tightening of forehead and eyebrow tissues to reduce the appearance of lines and creases in the upper facial region. Finally, a neck lift procedure involves the removal of excess, sagging skin

and fat from the neck and chin to combat "turkey wattle neck."

Consult with an Experienced Surgeon

Patients who are interested in facial rejuvenation are advised to consult with an experienced cosmetic surgeon who is Board Certified by the American Board of Plastic Surgery. The surgeon can assess needs, answer questions, discuss expectations, and recommend a course of treatment to produce the desired result.

by Katie Perry
References and Bibliography
Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including plastic surgery topics and procedures, including full face lift and mini face lift surgery and other cosmetic procedures.
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