AGING AND THE EVOLUTION OF FACIAL AESTHETIC SURGERY
Naturally, the skin shows the most obvious changes of aging because that is what we see. With advancing age, the skin becomes thinner, discolored, wrinkled and redundant. This is accelerated by ultraviolet damage from the sun and other factors that affect circulation. Health conditions like collagen vascular diseases or hormone imbalances, poor nutrition and the use of nicotine are other key factors. So there is much more going on below the surface. Of course you already knew that beauty is really more than just skin deep!
Just a century ago, a face lift was a simple removal of excess skin. Techniques to tighten the loose muscle and connective tissue layers were added in the mid 1970s. Liposuction techniques to reduce undesirable accumulations of fat were developed in France in the 1980s and eventually incorporated into face and neck procedures. More refined sculpting became possible to achieve smoother contours. Then a wide variety of more extensive lifting techniques were pioneered to achieve stronger lifting and greater tightening of the tissues. In many cases, these proved to be effective in achieving this goal, but with greater risks of complications and unnatural results.
Why did the results become unnatural when the lift became stronger? The advancement of new X-ray imaging techniques like 3 dimensional CT scans and MRIs, demonstrate that the skin and the connective tissues are not the only structures to change with age. Facial skeletal defining points and fat compartments are also diminishing with age, affecting the 3 dimensional contours of the face. Techniques to restore volume with fat transfer and injectable fillers have since been developed along with facial implants. Simultaneously, lasers to resurface the skin and other treatments that stimulate collagen growth have been evaluated and refined. The goal is to find techniques that are safe and effective, and to shorten recovery times. These facial rejuvenation modalities in the proper combination and balance can enhance and in some cases produce a synergistic effect on reversing the visible signs of aging. Individual procedures when taken to extremes, result in long recovery times, risks of permanent complications and unnatural results. Components of aging should be addressed independently, though procedures can be performed simultaneously to effect the desired improvement. When appropriate procedures are performed with experience, the result is an improved and natural appearance.