By Dr. Ritu Malhotra, Enhanced Image Center
Got “Jowls?” Got a “Turkey Waddle?” Got a “Double Chin?”
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Jowls: Skin laxity hanging from the lower aspect of the cheek and jawline. It is an aging change that creates a “W” of the lower facial profile instead of looking like the bottom of a heart in youth.
Turkey Waddle: Loose flabby skin in the midline neck under the chin which tends to wobble when the person moves.
Double Chin: A fatty fullness in the midline neck under the chin causing a fold and looking as though there is a second chin.
You don’t have to look your age. You should look as fresh and youthful as you feel, as young as you want others to see you.
Understanding facial aging can help you head off time’s effects. An awareness of rejuvenation treatments will help you to appreciate what will work best for the specific desired changes you want to make to your appearance.
The Elements of Facial Aging
Changes that transform your face into a tired and aged appearance:
- Skin changes
- Volume loss
- Muscle/ligament changes
- Fat accumulation
However, you can diminish or reverse these effects.
As we age, our skin loses elasticity and begins to retain lines where expressions cause it to fold, and wrinkles form.
The skin gains a translucent, crepe-like appearance. You can reduce the impact of sun damage and a loss of nutrition by utilizing a recommended Skin Care regimen—with a cleanser, toner, prescription strength skin lightener and exfoliator.
In addition, as you age, the skin’s normal process of rejuvenation slows so that more and more skin cells on the surface are older, and more damaged.
You can counteract these changes using Perfect Derma Peels ($195) Laser “weekend” peels ($350) or Fractional Laser treatment ($1000 & up).
Loss of Facial Volume
With age, the body changes its patterns of fat deposition. The face loses priority, so it begins to lose fat. This is worsened by the displacement of tissues by gravity (see below), creating a haggard, worn, or tired appearance.
This can be countered using dermal fillers such as Juvederm Volbella, Ultra, Ultra Plus, Vollure, and Voluma as well as Radiesse® ($450 to $750) or Bellafill – the 5 year filler ($950 & up) .
Changes in Facial Tissues
It’s not just skin and fat, even some of the facial ligaments can lose elasticity. This contributes to the displacement of facial tissues. Where the ligaments retain their tautness, it can create facial grooves.
These grooves can be concealed using dermal fillers such as Juvederm Volbella, Ultra, Ultra Plus, Vollure, and Voluma as well as Radiesse® ($450 to $750) or Bellafill – the 5 year filler ($950 & up).
Over time the muscles become conditioned to repeated responses and will anticipate routine contractions. In the face, this leads to the formation of permanent, inscribed folds where there should only be temporary ones.
The best treatment for relaxing these over-enthusiastic muscles is Botox Cosmetic ($55 per injection).
Displacement of Tissues by Gravity
Gravity works constantly to pull everything on the body downward. In the upper face, the brow and eyelids can begin to sag, creating a tired or angry appearance. Hanging skin and fat in the lower face produce jowls. Deep facial folds are formed around the mouth and nasolabial area.
The solution to tissues displaced by gravity depends on the degree—mild, moderate or severe.
Mild: Botox, Dermal fillers like Voluma, Thermage ($1800), Pelleve ($400), Chemical peels ($195), Laser peels ($275), Fractional laser resurfacing ($1000), Smart lift ($3000), Laser lift, Non surgical face lift (InstaLift – $1000-3000) Mini face lift and Mini neck lift (all $4500) and Around the eye laser treatments ($1000) for “eye bags” are all options.
Moderate: Mini facelift, Mini neck lift (both $4500), Lifestyle lift, Look Natural Lift (both $6650) upper ($2500) and lower blepharoplasty ($3000) or JPlaZty Face & Neck ($4500) are all options.
Severe: Lifestyle Lift ($6650), traditional Facelift, traditional neck lift, Lateral brow lift ($2500), Upper ($2500) and Lower ($3000) Blepharoplasty are all options.
Excessive Fat Accumulation
One of the first signs of facial aging is that your eyes get puffy. This is caused by an increase of fat in the upper and lower lids. One solution is to tighten the skin overlying the fat with a fractional laser treatment so that it acts like a “Spanks” garment and keeps the fat “tucked in.” Another option is Eyelid surgery or upper and lower blepharoplasty ($2500 & up) which removes these fat pockets or “bags.”
Fat also accumulates in the jowl, chin and neck area. This causes loss of definition of the neck and makes the chin appear weaker. Kybella ($600 &up) injected into the chin area destroys fat cells and eliminates that “double chin.” Smartlipo™ ($2500) laser lipolysis and traditional liposuction ($1500) are great options to be discussed.
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