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Ask The Surgeon, Cleveland Magazine, 9/1/2011

Start Date: Thursday, September 1, 2011
Last Modified: Monday, March 26, 2018
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Question: I've been hearing people on TV and radio talking about “facial rejuvenation” and I was wondering what they meant by that exactly, do they just mean face lifts?


Answer: Facial rejuvenation is a broad term used in Cosmetic Surgery to refer to procedures that make a person look younger. The aging face is defined by a loss of tissue volume (thickness) in the mid face and a decrease in overall skin elasticity. The result of these changes is a more hallowed look around the cheekbones, wrinkles, jowls, and/or loose draped skin under the chin and on the neck. The rate at which a person's face matures is dependent on a combination of genetics and lifestyle. The genetic factor is a difficult if not impossible thing to alter but lifestyle choices such as poor nutrition, smoking, excessive alcohol consumption and sun exposure will greatly increase the rate at which a person ages. There are number of ways to delay or erase these signs of aging and they are based on two factors; first, the extent of the individual's signs of aging and secondly the aggressiveness of the treatment desired.


A person who is just starting to notice facial changes due to aging may only want to make subtle adjustments. These can be attained with the use of injectable products such as Botox and Juvederm, which are used to prevent further wrinkling of the skin, to release deep lines caused by muscle contraction, and to fill hallowed areas, deep wrinkles, and thinning lips. These procedures take little if any recovery time. A method that is more invasive than the injectable products is laser dermabrasion; this is when a laser is used to resurface the skin. By removing the top layer of the dermis the fine lines and superficial wrinkles are removed or greatly reduced. These less invasive measures will work well to delay or reduce the signs of aging for a decent amount of time but aren't going to help if the problem that needs to be addressed is loose and sagging skin.


For the person who has more advanced signs of aging, jowls or loose skin under the chin and neck, a surgical procedure is the most effective way to bring back a youthful appearance. A number of surgical options are available these days and range in complexity from blepharoplasty of the upper or lower eyelids (removal of excess skin or fat) to endoscopic brow-lift, neck-lift, or as you suggested, a face-lift. All of these procedures address loose and sagging skin, which make a person look older and tired. The key to excellent facial surgery is a natural and balanced appearance. A patient should look better, not different. The face should appear balanced and natural, not harsh. It's very important that when you choose the surgeon to perform any of the aforementioned procedures, that you choose a doctor with experience, after all, this is your face! Referrals from friends who've had surgery or doctors who have sent patients previously for surgeries with a specific doctor are excellent ways to find the right surgeon for you.