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The Secrets to a Youthful Face

What is it about the youthful face that we find attractive? This is the principle question that plastic surgeons seek to answer. Consultation with most patients interested in improving their appearance boils down to one request - "Make me look younger".

We all realize that a return to the appearance we had as a twenty-five year old is the stuff of fantasy novels. However, we can begin to tease apart the basic elements of a youthful face and apply this information to the reproducible techniques that aesthetic surgery has to offer.

I teach the plastic surgeons that I train that facial beauty is a combination of architecture, volume, and skin quality. So, what does that mean? Restoring a youthful appearance relies on our ability to reproduce youthful cues. The architectural features of youth include, for example, a strong jaw line, a firm neck, a naturally elevated eyebrow, and full, alert eyes. Many of these features can be restored effectively as we age with surgical interventions like the facelift. In facelift surgery, improving the jaw and neck line is a principle focus. Facelifts can, however, also improve the appearance of the middle face by repositioning facial structures which have become saggy with time. A brow lift is designed to return the eyebrows to their most aesthetically pleasing site slightly higher than the bony rim above the eyes in most women. In many cases a chemical brow lift can be affected with the use of botulinum toxin (BOTOX®). Exacting injections of BOTOX® can temporarily weaken the muscles which naturally pull down the eye brow and lead to a brow lift without any incisions at all. Eyelift or blepharoplasty surgery corrects excess skin and protruding fat pads in both the upper and lower eyelids. Modern blepharoplasty techniques afford reliable permanent changes with minimal post operative time away from busy work schedules.

As many of us already know, youthful facial architecture with poor skin quality is only a work in progress. There are many modalities which can be used to improve the appearance of our skin. Many are non surgical and as simple as the use of vitamin A (retinol) and fruit acid regimens. Skin care is obviously enhanced by avoiding harmful ultraviolet light, and the frequent application of sunscreens. Skin care can be taken to the next level with aFRAXEL LASER treatment. This skin rejuvenating treatment uses a computer driven LASER to create thousands of tiny holes in our skin. Down time is minimized because the skin heals like a deep sunburn with some redness and flaking. The treatments can be repeated to maintain the correction of pigmentation irregularities and fine wrinkling. Clear healthy skin is an important building block in the creation of a youthful appearance and surprisingly easy to accomplish with a little perseverance.

Finally, and most recently facial volume restoration has become recognized as a close ally to skin care and architectural restoration. Youthful faces are, in fact, full. As we age, we lose the natural fat that we all had in our faces as youths. The result is thin lips, loss of cheek height and fullness, and wrinkling around the mouth and eyes. In many, this leads to a generally hollow appearance. No amount of "lifting" is going to improve this. Hence, come the "fillers". Fillers are the most modern addition to the plastic surgeons' tool kit. Fillers range from hyaluronic acid products like RESTYLANE® and JUVEDERM® to injectable vicryl (SCULPTRA®), and even one's own fat. In my opinion, each of the filler products has a particular "best" use. Most are temporary, but may be long lasting. All share the common goal of plumping up an area which, through the aging process, has lost volume.

So, remember the three secrets of the youthful face: Architecture, volume, and skin quality.