The Aging Face 101: A Plastic Surgeon’s Perspective by Dallas, Texas-based Board-Certified Plastic Surgeon, Ramsey J. Choucair, M.D.
Aging is inevitable. But there are factors as well as various modalities to take into consideration regarding the Aging Face.
Assessing skin quality is an important part of evaluating the aging face. In addition to facial volume loss and skin laxity, the quality of the skin surface is an essential consideration when contemplating treatment options.
What is Skin Quality? Skin quality is the surface appearance of the skin. In youth, the skin possesses great elasticity and typically has a uniform color with little sun damage. Youthful skin is typically devoid of irregular pigment, scaly patches, broken blood vessels, and wrinkles. Aging skin often exhibits an irregular surface texture, fine lines or wrinkles, increased pore size, and unnatural pigment deposits from years of environmental exposure. Genetic influences also contribute heavily to the loss of skin elasticity and the speed of aging.
Recommendations to reverse the aging skin surface may vary widely and are based on individual factors which may include simple skin care products or more aggressive resurfacing procedures like the following:
Skin care products: Topical skin care products are often the first line of defense for aging skin. Retinoid products such as Retin-a are scientifically proven and time-tested to reverse certain aspects of skin aging. Skin care products such as antioxidants, fruit acids, and sophisticated growth factor formulations are also beneficial in restoring a more youthful appearance to the skin surface.
Non-ablative resurfacing: Non-ablative treatments do not create an open wound of the skin. By definition, there is minimal “downtime” associated with non-ablative procedures. Non-ablative methods may include technologies such as radio frequency, photofacial, microdermabrasion and mild chemical peels. Microneedling procedures are unique, creating a micro-puncture of the skin without true destruction of the skin surface. These treatments stimulate the skin to produce collagen that restores a more youthful texture to the skin. Most non-ablative techniques are indicated for early and mild skin surface aging.
Ablative skin resurfacing: These modalities rely on a precise, controlled depth skin injury and a subsequent healing process that lays down a new layer of surface collagen to diminish wrinkles, fine lines, and pigment abnormalities. Chemical peels, lasers, and various dermabrasion techniques may ablate or destruct the skin surface to varying depths. The greater the depth of the skin injury (ablation), the longer the recovery or “downtime”. By the same token, the deeper the skin injury, the greater the degree of skin rejuvenation.
Injectable treatments: Finally, injectable treatments may also improve the appearance of fine lines and wrinkles. Botox® injections temporarily decrease specific muscle movements and thus reduces animation that creates wrinkles. Injectable filler products such as Restylane® or Juvederm® are used to fill lines and wrinkles. Judicious use of fillers may diminish lip lines and cheek wrinkles, however, overuse of fillers may create distorted and unnatural appearances.
Armed with these multiple treatment options, a logical strategy is formulated to ‘turn back the clock’ based on each patient’s desires and expectations. Patients are encouraged to obtain more than one opinion and proceed after confirming that their expectations are reasonable and achievable. In most instances “what to do” is more relevant than “how it is done”. Remember, you are relying on the JUDGEMENT of the physician as the most important ingredient for a successful outcome.
To Book a private consultation with Dr Choucair, in Dallas, Texas, call 214-389-9797.