Facelift, Botox, Or Both?
One facelift or Botox injection does not fit all when it comes to looking younger. In fact, plastic surgeons analyze facial features and configurations to individualize results based on the decade of life a patient is in, say presenters today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2007 conference in Baltimore.
"The composition of the human face varies person to person. As we age and enter certain decades of life, these variations become more distinct," said Malcolm Paul, MD, ASPS Member Surgeon and panel presenter. "Different facial configurations require different surgical and non-surgical approaches to achieve optimal results in facial rejuvenation. The decade of life one is in has tremendous impact on whether surgery, injectable wrinkle fillers or a combination delivers the best results."
Patients in their 30s, who have had limited sun exposure, often show signs of aging first in their eyes and temple area with crow's feet and some bulging of the eyelid. With minimal loss of volume at this point, fillers or Botox often smooth out the unsightly lines that people dread quickly and easily.
As patients enter their 40s, the midface begins to shift as the cheeks lose fat and laugh lines set in. Much like a balloon losing air, the cheeks become deflated toward the late 40s and the jowls begin to sag. To help restore their youthful appearance, patients can expect a combination of fillers as well as minimal lifting procedures such as a mid-face or short-scar lift.
By the mid-50s, the skin has relaxed and requires the most attention around the neck. In addition, the skin around the face usually has fallen and repositioned itself, needing a more extensive combination of a facelift, fillers or implants to rejuvenate the face.
In the 60s and 70s, individuals often battle hollowness from losing a large quantity of facial fat and having a sizeable amount of hanging skin. Facelifts during these decades often replace some of the volume but also remove excess skin to present a smoother, fuller face.
"Only plastic surgeons have the full range of expertise to offer patients a complete consultation on all available cosmetic options," said Richard D'Amico, MD, ASPS president-elect. "Under the care of a plastic surgeon, patients are not wasting their time and money on the wrong procedures."
Although the appropriate procedural approach can often be determined by age, personalizing a procedure requires plastic surgeons to analyze a patient's individual facial configuration and bone structure also -- including eye shape, cheek width and face length.
"By basing the cosmetic approach on one's decade of life, personal degree of facial aging, and bone structure, patients can look 10 to 20 years younger without appearing like they've had surgery," said Rod Rohrich, ASPS past- president and course presenter. "That's the hallmark of good plastic surgery."
More than 104,000 facelifts, 53,000 forehead lifts, and 233,000 eyelid surgeries were performed in 2006, according to ASPS statistics. In addition, 5.3 million non-surgical procedures involving injectable wrinkle fighters were performed.