Heading Off the Ravages of Time
Some people take great care to fight off the effects of age-related face changes. The American Society for Aesthetic Plastic Surgery estimates in 2010, more than 2.26 million skin rejuvenation procedures were performed in the U.S. They include ablative procedures (like chemical peels and dermabrasion) and nonablative procedures (like IPL laser and radiofrequency ablation).
Injectables are treatments that are injected into the skin. BOTOX injections temporarily paralyze target muscles that pull on the skin and form wrinkles. More than 2.4 million BOTOX injections were performed in 2010. A second category of injectables are fillers, or products injected under the skin to fill in crevices made by fine lines and skin dimples. Injectables may also be used to provide extra volume in areas of fat loss. Last year, more than 1.5 million filler procedures were done in the U.S.
The most extreme type of facial rejuvenation is a facelift. Generally a long incision is made around the hairline and ears, the skin is pulled back tightly, excess tissue is cut away and the incisions are closed. Last year, 127,512 facelifts were performed in this country.
Robert Shaw, M.D., Plastic Surgeon with the University of Rochester Medical Center in Rochester, NY, says people get facelifts with the intent to restore the same looks as when they were younger. However, the traditional facelift, with its pulled back skin, often makes the face look like it's been windswept. It's not a natural outcome and, in most cases, doesn't end up look anything like the patient in younger days.
Shaw suspected that as people age, there are other, underlying changes to the face. To study those changes, he used facial CT scans from men and women in three different age groups: 20 to 36, 41 to 64 and 65 and older. The scans were analyzed by a computer to look for differences in facial structure.
The study found that as people age, there are definite changes to the bone structure in the face. The length and height of the jaw decreased significantly for both men and women, decreasing both profile and definition in the lower portion of the face. There were changes around the eyes as well. Bone loss around the rim increases the size of the socket, giving the eyes a deeper, hollow look. This also decreases support under the eyes and in the upper cheeks, causing the soft tissues to sag.
Shaw says the scans show the facial bones continue to undergo changes (remodeling) throughout the lifespan. Those changes appear to happen earlier in women than in men. When planning a facelift, doctors need to take into consideration changes in bone structure and restore volume (using fillers, fat or implants) as well as tightening of the skin.
Research compiled and edited by Barbara J. Fister
American Academy of Dermatology, http://www.aad.org
The American Society for Aesthetic Plastic Surgery, http://www.surgery.org