Turning Back the Clock Without Surgery
The appearance of age occurs from loss of elasticity, but equally important is the loss of volume. You have heard the comment, “You’ve lost your baby fat,” usually made to someone in their twenties. The problem is you never stop losing it. Your face literally deflates and this loss of support causes sagging. Our faces lose volume in cheeks, below the eyelids, below the corners of the mouth, the lateral chin area, jaw line, and just about everywhere. In youth our cheek mound extends to the nose, the lower eyelid, and the bottom of the nose. With aging the cheek loses volume and literally shrinks. This creates shadows and hollows that we don’t see in youth. The fine wrinkles that we often see are from sun exposure, smoking, lots of animation, and loss of volume.
Injectable products such as Restylane, Juvederm, Perlane and now Voluma (a Juvederm product) are hyaluronic acid products (called HA’s) and used mostly for wrinkles such as the nasolabial creases between the corners of the mouth and the side of the nose—the smile lines or the marionette lines dropping down from the corners of the mouth.
Another product commonly used in my practice for re-volumizing (inflating) the face is Sculptra. Sculptra is a powder that must be mixed with water for injection. It can be used in most areas of the face and lasts for up to 2 years. Typically, it takes two to three injection sessions for maximum benefit, but some amazing results can be achieved with lots of lift. Topical anesthesia cream and ice are used prior to these injections to minimize any discomfort.
The most common product presently used by me is Voluma, which was first released in January, 2014. It has the advantage of giving an immediate result and 65% of the product is still present at two years. Typically I will inject Voluma in the cheeks and mid-face where most of the volume is lost and Restylane in the hollows under the eyes and in the wrinkles of the upper lips. To re-volumize the lips, I prefer Juvederm. Face lifts tighten skin, but do not replace volume (unless fat injections are used). So far my results with these products and combinations have been very impressive.
Botox, the most common injectable product, paralyzes injected muscles, such as the corrugator muscles, which cause the frown lines. Other areas are the “Crow’s feet” just outside of the eyes and the forehead furrows. Very small amounts can be injected into the muscles of the upper lip to diminish the vertical lines.
Often combinations of injections can be used if the patient has many different problem areas, such as deep frown lines plus lots of deflation in the cheek area. This may require inflation with Voluma, Sculptra or other products plus Botox.
For loss of elasticity, if one does not want surgery, a Fraxel laser is the best non-surgical opinion. Combining of fillers with a Fraxel laser can reverse the appearance of age from 10-15 years or more.
