People in their late 30s to early 40s and older will often come in for a consult wondering about what they can do to improve the aging that they see in their face. Sometimes they start by saying things like,” I’m starting to look like my Mother (or Father) and I hate it!!!”
Part of what they are seeing and concerned about is due to age and gravity, part is how they may have taken care of their skin when they were young like sun and cold exposure (….like I worked as a lifeguard for 5 years….and used baby oil for my skin and lemon juice in my hair!), and part is unfortunately genetic from which you cannot escape!
The first few things to “go” tend to be the eyes and brow with some minor brow drooping which can give you the appearance of having more skin on your upper eyelids. Sometimes the fat around our eyes can also start bulging particularly in the lower lids giving us a tired look and “bags” under the eyes. The other things in the face noticed around this time might be worsening of wrinkles in the forehead and eyes, as well as loosening of the muscles and skin in the neck with mild jowls appearing.
So what can be done about these things?
Personally, I think it will depend on all the stuff the person brings to the discussion, how good is their skin quality and elasticity? Did they have a lot of sun exposure and do they smoke? All of which hurts the skin. How much fat do they have in their face? A slightly fuller/rounder face looks younger. What are they prepared to do? Some patients want to avoid surgery like the plague and others want to do only one thing which will last as long as possible.
From my perspective, Botox is truly an amazing product, it is the only thing (other than sun screen and medical grade skin care) that is a preventative. It improves fine lines that patients already have and prevents new ones from forming. It is effective if done on a regular basis, perhaps 3-4 times per year, it is relatively affordable and safe across ages. Of course, only doing it once in a while for special occasions can work but in general I feel that this is a waste of money since those patients are really not preventing the lines from coming back!
So, I would start most people concerned about seeing the effects of aging on their face with some Botox.
The next topic is filler. Fillers that we use at LPS are all resordable and a form of hyaluronic acid which is a naturally occurring substance in our skin. It attracts water and can be used to plump up and even sculpt portions of our face. It really fills depressions rather than eliminating wrinkles. In patients worried about aging it can be used to fill the dark circles around the eyes and fill cheeks to give a bit of a lift to the face. It can define the jawline and reduce the appearance of mild jowls. In patients with heavier jowls and laugh lines it can be used to soften their appearance.
Being made of hyaluronic acid however means that the effect will not be permanent but can last up to 12-18months. This is great for patients who have mild aging issues, do not want to consider surgery yet, and even in patients that have had surgery like a face or neck lift allowing them to maintain their result and even augment or improve it!
So, to summarize, there is a place for Botox in most peoples’ skin and face regimes as it smooths existing wrinkles, prevents new ones, and can be used to raise eye brows and the corners of the mouth. Meanwhile, fillers are useful in improving the early effects of gravity, filling depressions, treating mild sagging skin in the cheeks and jowls giving people a rested and rejuvenated look.
It goes without saying however, that any technique done poorly can have disastrous effects, things like the “deer in the headlights” look where the face doesn’t move at all, or the over inflated face that changes a person’s original appearance (Kenny Rogers and Meg Ryan….I’m talking about you!) must be avoided at all costs so people should spend time researching who to go to. Ask a friend, look at web sites and social media, ask the right questions, and perhaps go to places where there are physicians working who are experts at providing this type of treatment and care. There are a lot of places people can now go to have these procedures from basement apartments, to hair salons, and dental offices. After all, this is a buyer beware type of industry, be safe out there and choose wisely!