When you go to your high school reunion, you don’t want your classmates to squint at your name tag in confusion. Instead, you want them to instantly recognize you and think that you look well-rested and “good” for your age. In the past there was only one way to resurrect your face: it took a scalpel, several weeks off from work and a nice chunk of change. But now, nonsurgical options that promise to turn back the clock are proliferating at a rate that can make you dizzy.
It is overwhelming to consider so many options on your own. Instead, schedule a consultation with a board-certified plastic surgeon seasoned in traditional approaches, but also equipped with the latest and greatest nonsurgical innovations. Face-to-face a doctor can present you with procedures that offer the results you want. Both surgical and nonsurgical options yield improvements but, as you may expect, the level of improvement will not be the same and the surgical option will yield more significant and longer lasting changes.
So you don’t go into your consultation totally “green,” here are, from hairline to the base of the neck, some of the surgical and nonsurgical approaches to common facial problems that occur with aging:
Surgical: A forehead lift involves incisions in the hair-bearing scalp to rejuvenate the upper third of the face through lifting.
Nonsurgical: Botox is injected in the forehead to soften frown lines. Botox and fillers may be injected around brows to lift and add fullness.
Dark Circles, Eye Bags, Hooding of the Upper Eyelid
Surgical: Blepharoplasty removes fat deposits, excess tissue or muscle from the eyelids to improve the appearance of the eyes.
Nonsurgical: Frown lines can be softened and Crow’s feet minimized with injections of Botox or Dysport; three times a year in both areas will do the trick. When injected above the eyebrows, Botox or Dysport can also give a ten-degree lift to the arch and a slight lift to the tail. To get rid of under eye bags, a plastic surgeon or dermatologist can inject your own fat, which will last 2 years or more, or hyaluronic acid, which will last up to a year.
Surgical: With aging, the distance between the eyes and cheeks increases. In the midface lift, the malar fat pad overlying the upper cheek is lifted to its youthful position with either sutures or an absorbable implant, restoring a youthful, heart shaped face.
Nonsurgical: A doctor can restore high, full youthful cheeks using injectables such as Restylane, Radiesse, Juvederm or other fillers. Injected over the cheekbones or in depressions, fillers can add fullness to sunken or sagging cheeks for more than 18 months.
Surgical: With aging, the tip of the nose may drop down and inwards towards the face. The drooping tip may cause a slight hump on the bridge and appear to cover up part of the upper lip, especially when you smile. A rhinoplasty procedure rejuvenates the nasal tip, which is resupported with a cartilage graft. An added bonus is that re-elevation of the tip can improve nasal air flow.
Nonsurgical: If Botox is injected at the base of the nose by a skilled injector, slight nasal tip elevation may be achieved, resulting in a nose that stays turned upwards, rather than droopy—even with big smiles. If your nose droops when your face is static, Botox will not help. Injectable fillers such as Juvederm may be used for nose shaping/augmenting purposes in a nonsurgical rhinoplasty.
Thinning upper lip and droopy mouth
Surgical: With age, the upper lip lengthens, sags and thins. An upper lip lift shortens the lip by removing a small ellipse of skin under the nose-lip junction, creating fuller mucosal show. The corner lift, removing a small triangle of skin above the corners of the mouth, elevates a downturned mouth, making you appear happier.
Nonsurgical: Volumizers, such as Juvederm Ultra Plus and Perlane, injected in the lips, can restore the ideal volume ratio of upper to lower lip, creating fuller plumped lips. “Smoker’s” or “lipstick bleed” lines can be treated every six months with Botox to soften them and micro droplets of fillers to plump them. Lips may also be injected with collagen or your own fat harvested from another site. Both liquid collagen and fat are absorbed, so repeat treatments are necessary to maintain results. Newer, longer-lasting options include implantable materials like AlloDerm and SoftForm.
Sagging jawline, neck, prominent neck cords
Surgical: Many different varieties of facelift approaches smooth the face and neck skin, tighten the underlying tissues and muscle and remove excess skin.
Nonsurgical: To camouflage a sagging jawline, Juvederm or Restylane may be injected, lasting up to 18 months. Botox or Dysport, fillers and laser treatments can be used to reduce the appearance of neck cords. Fillers may be injected to smooth a pebbly chin. Fillers can be injected to reduce smile lines between the nose and mouth corners. Botox or Dysport injections can make neck cords recede. Neckline appearance can be softened with mini doses of hyaluronic acid fillers combined with Botox or Dysport.
Get the best results by finding a medical professional with the appropriate board certification. Be sure to ask how long and how often this doctor has been doing the procedure you desire. In a tough economy, nonsurgical facial rejuvenation seems to offer a cost-effective alternative for looking good. But, does it really? Ask your doctor how frequently you’ll need to repeat the nonsurgical procedure. Then consider your age and do the math. You may find that a surgical procedure is more economical in the long run…or you may not. Some believe that fillers help skin regenerate natural collagen, and neurotoxins like Botox help retrain your muscles so the face creases less. Final advice: schedule your surgical or nonsurgical procedure far enough in advance of an important event, so that you are healed and look your best.