by Erfani, Sadi
By M. Sadi Erfani, MD
Over the last several years, plastic surgery has come to recognize the finest standards of facial beauty and numerous aspects of the aging process. This understanding has lead to the conclusion that there are three basic elements to performing a natural and beautiful facial rejuvenation.
1) Re-suspending the musculature of the face is best performed using one of several available face lifting techniques. Whether a deep plane facelift or a mini lift is done, the basic tenet is to reduce the laxity of the muscles of facial expression. This will allow the overlying skin of the face to manifest a smooth and youthful appearance. In the past, this was the only element of facial rejuvenation that was focused upon. Now, with a greater understanding of the aging process, two other elements need to be assessed and treated in order to provide the most optimized and youthful results.
2) With the advent of injectable fillers and with the reemergence of fat grafting to augment areas of facial atrophy, there has been a renewed appreciation of the importance of strategic volumization of certain keystones of facial bone and soft tissue structure. The aging process very frequently will lead to depletion of the fat pads on the temples, the lower cheeks, the lower eyelids, as well as the lips. Also there will be unattractive accumulation of fat in areas of the face such as the mid jaw lines and mid cheeks. In the ’80s, appreciation of these aging changes was limited and often not addressed. This is why older facelift techniques tend to be associated with a windblown, emaciated and drawn appearance. With this simple addition of volume filling to provide a more luxurious padding of the patient’s existing bone structure, the results of muscle resuspended from face lifting have now produced remarkably natural and youthful results.
3) The final element to performing a comprehensive and youthful facial rejuvenation treatment will involve some form of skin resurfacing. If you were to compare the rejuvenation of the face with the repair of a damaged car, the facial resurfacing component is like the paint job after all the dents have been fixed. Simply doing a facelift and volume augmentation will never fully address the intrinsic blemishes that may be present on most people’s skin. These blemishes may include fine or deep lines, brown spots and age spots, uneven texture, acne scarring, and localized moles or other growths. The most aggressive forms of facial resurfacing include laser skin resurfacing and phenol chemical peeling. However numerous intermediate resurfacing methods do exist including erbium skin resurfacing and lower concentration medical grade chemical peels.
By combining various elements of facial rejuvenation and adding post operative adjuncts such as oxygen emulsion and non-ablative lasers, the most comprehensive, least invasive and most efficient means of rejuvenating many people’s faces is possible. The combination of these techniques will consistently offer outstanding results giving people the opportunity to enjoy the benefits of a youthful appearance as they continue to lead longer and more productive lives.