Who wants to age in today’s age and world?

So many times, we have looked at those beautiful faces in those glossy magazines and envied that these people never age. But a lot of efforts, makeup and money have gone into it.

As we age some external and some internal factors work on our face. Patients come to us with problems varying from uneven pigmentation to wrinkles to small bumps around eyes, double chin and so many … Plastic surgeons have researched to uncover the true facts behind facial aging in their quest to restore attractive, youthful facial characteristics in their patients. External environmental factors such as body mass index, hormones, alcohol consumption, cigarette smoking, and unprotected sun exposure have all been associated with contributing to an accelerated appearance of facial aging.

Being a multi-dimensional structure with skull bone as a base on which the face has been sculpted, all the layers are affected with age.

Skin

The skin is the envelope or canvas of the face, revealing the deflation and atrophic changes of the underlying bone and soft-tissue compartments. As skin ages, the middle layer of skin (dermis) thins due to collagen loss. The skin’s ability to retain elasticity (from elastin) and moisture (from hyaluronic acid) also reduces with age. Due to this loss the skin becomes-Drier, loses elasticity, becomes less supple and thinner. Sun exposure damages the outermost layer leading to uneven pigmentation, melasma and thinning of skin components. Ultra violet A (UVA) and ultra violet B (UVB) radiation causes direct and indirect damage to skin through absorption of the Ultra violet (UV) energy. Genetic component is also an unquestionably powerful factor in facial skin aging.

Fat and soft tissue

In the face, fat is organized into fat pads. As we age, the fat is lost and the fat pads shift relative to each other. Over time, bony features, lines, and wrinkles become more visible. Deflation and loss of the normal anatomic subcutaneous facial fat compartments gives the appearance of increased skin laxity or prominent folds. Gravitational forces act on it leading to dropping eyelids, eyebags, sagging face, loss of volume and fullness in upper face, and small bumps skin in lower face like jowls.

The understanding of fat compartments of the face has revolutionized the approach to facial rejuvenation. Targetted fat injection and/or soft-tissue filler into individual compartments has a dramatic effect on restoration of facial volume and reshaping the soft tissues of the face.

Bone

We lose significant amount of facial bone with age. Aging of the craniofacial skeleton may be due to changes in the relative proportions in terms of expansion of lower jaw bone and resorption around eyes. Bone recession leads to thinner bone, removing structural support for the overlying tissues leading to thinning of face with increased orbital volume with enopthalmos. Enopthalmos means sunken eyes that we commonly see among elderly. This loss of support leads to sagging and droopiness and noticeable changes in the other layers of overlying soft tissue and skin.

Even if you have great genes and look much younger than you are, age-related changes in our facial appearance are unavoidable.

As the physiology the trends in treating the aging face is also multidimensional. It varies from protection from sun exposure, to non-invasive to invasive and surgical treatments. Even if you don’t wish to go under knife the anti-aging results from non-invasive treatments are impressive and beneficial.

Sun protection- Protecting your face from the sun is the single best way of keeping it youthful. You can use good sunscreen with sun protection factor above 30.

Creams and lotions- Moisturisers soothe the dry skin and may temporarily make wrinkles less noticeable. Tretinoin, vitamin C and E creams help in giving even tone to the skin. They act by repairing the collagen in the skin.

Botulinum toxin injections- These injections are used to treat the expression lines over face. Botox temporarily paralyses the underlying muscle and so the wrinkles are diminished. It gives unmatched wrinkle reduction over forehead creases, frown lines and crow’s feet. It takes two weeks to see results of neurotoxin. Benefits may last from six to nine months.

Fillers- Youthful face has full look – not pulled out flat, two dimensional look. So fillers are used, to give fullness and to treat deep lines created by lost collagen and fat. These smooth-gel injectables immediately restore volume along the cheeks, temples, lips and under the eyes.

Fat injection- Here fat is suctioned from other parts of body like abdomen or thigh and fat cells are processed and cleaned of oil and debris. This can be injected in facial compartments to give you the fullness back and facial rejuvenation. Fat cells will integrate well with the face and bring the youthful contours back for years to come,

PRP(platelet rich plasma)- Here blood is withdrawn, centrifuged and concentrated plasma rich in platelets injected back in face for facial rejuvenation, vampire facelift and dark circle correction.

Laser treatments- Lasers can be used to remove certain pigments: Q switched Nd YAG is used to get rid of blue and green tattoes and black pigments. Same Laser with another filter is used for red pigment and liver spots also.Fractionnal CO2 or Nd YAG with carbon peel can be used for resurfacing of facial skin. Ultherapy, in which Ultrasound concentrated energyis used for the deep layers of skin giving firming and tightening.

Chemical peels- The modern day peels gives you good quality skin back, glow back and improves your open pores.

Facelifts- A face-lift lifts the lower face and neck giving fullness to midface and narrowing the lower face, producing the ‘inverted cone of youth’.

Non-surgical facelift- They are fast and economical but needs to be repeated regularly and gives moderate results. They include fillers, botox, fat injections, dermabrasion and PRP treatments as well as threads.

Surgical facelift- They come with downtime, need general anaesthesia, are costly but gives dramatic results and its one time procedure with long lasting results. The surgical scar is hidden in front and behind the ear and in hairline.

It should start with a consultation with a board-certified plastic surgeon.

If you are interested in looking young, speak with a qualified, board-certified plastic surgeon. Do your homework. With a qualified team, aging face can be treated in many ways that can quickly take years off your appearance and no one will ever know you had anything done.

Dr. Varsha Bundele

Jaipur

( The opinions expressed here solely belong to the author and do not represent collective view of the association)