“My face is falling, I look like I’m melting” is a common concern as we age. Our driver’s license photo shows our changing shape and contour. It seems as if the cheeks migrate down to the jowls. Heart shape becomes pear shape. How do our faces age and can we improve this without surgery? Absolutely, with non-surgical face lifting
Natural aging reduces collagen, fat and even bone in everyone’s face. As fat reduces and falls, skin loses elasticity and the cheeks migrate downwards. Defined cheekbones and beautiful S-curve are lost. Jowls enlarge and change the jawline. From the front the face becomes pear-shaped. Chin fat builds up and neck skin loosens. From the side, the chin and neck lose their definition, insultingly called a “turkey neck”. Temples hollow, creating another insult … “peanut head”.
Vanity or valid concerns?
Are aesthetic concerns only fashion and frivolity? Facial aging bothers us because humans are aesthetic creatures. In fact, most animals and plants have cosmetic needs. Plumage and foliage in nature create colour and shape to attract a mate or someone to pollinate. Looking younger helps us feel vital and desirable. We feel better with a new haircut, outfit or even with makeup. There is evidence that Botox has an antidepressant effect.
Modern technology in drugs, lasers, and injectable gels have recently evolved to allow non-surgical interventions. With little downtime and minimal risk, experienced doctors can reshape the face, improve skin quality and restore an appearance of health and vitality.
Non-Surgical Face Lifting
Recreating the triangle
Cheeks and jowls are key determinants of a triangular or heart-shaped face. As the cheek fat drops, hollows under the eyes make us look tired. Judicious injection of dermal fillers restores this volume to cheeks and tear trough, reducing a tired look. Fillers also help to lift fallen cheeks and jowls, softening the grooves from the nose to mouth (nasolabials) and mouth to jowl (marionettes). Teeth clenching causes the jaw muscles (masseters) to widen the lower face. Botulinum toxin injections can shrink these muscles and narrow the lower face. Three brands available in Canada are Botox, Dysport and Xeomin.
When the jowl sags, the jawline becomes wavy and curved, hence the term “S-curve”. Strategic placement of dermal filler at the jaw angle subtly retracts the jowl skin. A filler can also be threaded along the jawline behind and in front of the jowl. This helps create a definition between face and neck. Dr. Frame has refined these techniques, now called “Uplift and Backlift”.
Chin side-view reshaping
Under chin fat doesn’t shrink with aging, unfortunately. As skin loosens the angle between chin and neck is lost. Recent inventions allow this “submental fat” to be permanently shrunk without surgery. Coolsculpting technology freezes the fat (without harming the skin). Belkyra injections dissolve the fat. Both techniques cause fat cells to rupture, allowing the body to naturally remove loose fat. Other medical devices using radiofrequency (such as Thermage and Infini RF) can then tighten the skin.
Neck front-view narrowing
When we clench our teeth, the muscles that run from our jawline to the base of our neck, pop out. Sometimes these muscles have over-developed from chewing or grinding our teeth when we sleep. Using small amounts of a neuromodulator such as Botox, Dysport or Xeomin, we can relax those neck cords which will help bring back definition to the jawline.
Who notices temples? We may not consciously see temple hollowing, but when improved the aging face looks less skeletal and wasted. Dermal fillers can smooth the hollows for about 12 months. These fillers are made of the same hyaluronic acid found in all our faces. For longer effects, the regenerative technology uses poly-L-lactic acid. Sculptra injections trigger the body to make collagen that can last 2-4 years.
Skin elasticity restoring
Aging and sun damage brings loss of collagen and elastin in the skin. Hyaluronic acid is lost and cannot hold moisture in the skin anymore. We have platelets in our blood that can be used to trigger growth factors and healing in the skin. A physician draws the blood, spins it down and extracts platelet-rich plasma (PRP). New techniques allow PRP or hyaluronic acid to be injected all over the face through microneedling, using the Introfill device. These are placed in hundreds of tiny droplets forming a thin layer beneath the entire face and neck. The microneedling triggers the skin to heal and create collagen. Adding energy to the microneedling helps to smooth and tighten. A device called InfiniRF sends radiofrequency (microwaves) down insulated needles, triggering collagen production. With 3 or more treatments, the face and neck skin can be tightened.
We are fortunate to be aging in the 21st century. Facial reshaping and contouring are now possible. Injections and medical devices can now restore lost volume, recreate appealing triangular and heart shape, reshape temples, jawline, and neck. These subtle treatments can effectively achieve a refreshed, more youthful and happy look. This can be achieved with minimal downtime in an office procedure.
Dr. Gidon Frame
Age is a state of mind. Aging is a treatable condition.