A plan of action for the three stages of facial aging

By April MacIntyre Oct 28, 2010, 23:13 GMT

Dr. Joseph Broujerdi is a Los Angeles-based physician and dentist, who sub-specializes in Cranio-Maxillofracial Surgery. He is also trained in Plastic & Reconstructive Surgery as well as Oral & Maxillofacial Surgery.

How is your face aging?  Are your eyes sinking in, or your cheeks starting to jowl? Apparently there are "three stages of aging," according to Dr. Joseph Broujerdi, M.D.

Dr. Broujerdi tells Monsters and Critics: "These days people attach 'anti-aging' as a moniker for everything from supplements to make-up."

But what exactly does the term truly mean, especially in terms of cosmetic appearances and specifically, the face?"

Monsters and Critics: What does happen to the face in the aging process?

Dr. Broujerdi: As we age, components of the face and neck - skin, muscle, fat, skeleton, dentition - are affected differently.

The aging process is also a reflection of our genetic makeup and our surrounding environment  -especially sun exposure and lifestyle choices including diet, smoking and alcohol consumption.

Some people develop wrinkling and excess skin on their entire face and neck, others do not. Some people seem to lose facial fat or volume, while others accumulate fat in the neck and maintain good skin tone. Still others may develop more exaggerated signs of aging in their neck.

M&C:  What are these "stages" of facial aging?

Dr. Broujerdi: The following describes the three typical stages of facial aging and recommended procedures for prevention, control or correction:

Stage One—Age 30 to 40: Minor wrinkle formation and loss of facial volume.

This is mostly the result of the melting away of facial fat from different fat compartments of the face. It typically translates into drooping of the facial components, which will lead to formation deep lines and grooves such as laugh lines and “parentheses” around the mouth.

Because each person ages differently, corrective aesthetic surgery must be customized to the individual. The first step is to conduct a facial soft tissue, skeletal (Cephalometric analysis), and dental/smile analysis.  Once a complete analysis of the face is performed then a comprehensive treatment plan can be created.

I recommended these procedures:

--Botox injections to control and prevent wrinkle formation

--Rx facial creams to prevent dryness

--Dermabrasion to smooth fine wrinkles

--Light laser skin resurfacing for the treatment of damaged skin and to prevent age related changes

--Synthetic dermal filler such as Restylane or Juvederm injections and fat grafting procedures to volumize and lift the face to maintain a youthful look.

Stage Two for age 40 to 55: Ongoing skin changes, loss of facial fat volume and sagging of the face.

The major event in this stage is the thinning and drooping of facial muscle, leaving deep lines and grooves resulting in a tired look to the face.

I recommended these surgical procedures:

--Upper and lower eyelid surgery to rejuvenate the eyes and surrounding area

--Endoscopic brow, mid-face and neck lifts with minimal incisions to reposition the droopy facial muscles eliminating the old and tired look

--Fat grafting to volumize and lift the face

--Skin laser resurfacing to wrinkles and tighten the collagen 

--Rx skin products to help maintain the healthy look of the skin

--Botox will to prevent the un-welcomed wrinkles

--Dermal fillers to maintain the facial volume

For older patients, Stage Three—Age 55 +,  Wrinkles become more pronounced and the skin becomes coarse and leathery.

Loss of most facial fat translates into los volume and thinning of facial muscles to drooping skin. The lips will become thinner and the sides of the mouth will turn down. In addition, the roundness of the facial skeleton turns flat which leads to accelerated sagging of the of face. The loss of dental volume by attrition (grinding down of teeth) is more pronounced at this stage, giving the appearance of a collapsed face.

I recommend these surgical and dental procedures: 

--Restore the skeleton and dental volume and position as these structures form the matrix for the soft tissue to be draped around. The plastic surgeon should collaborate with the aesthetic and reconstructive dentist so the results are a natural look with an aesthetically pleasing smile.

--Restore the facial skeletal lost volume either by facial implants in the chin and cheek; angle jaw implants or corrective jaw surgery

--Facial fat volume is still addressed with fat grafting in this stage

--Laser skin resurfacing to address wrinkles and smooth the skin

Dr. Joseph Broujerdi is a Los Angeles-based physician and dentist, who sub-specializes in Cranio-Maxillofracial Surgery. He is also trained in Plastic & Reconstructive Surgery as well as Oral & Maxillofacial Surgery. www.CMFSInstitute.com  & www.TotalBeautyBH.com