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| Our Faces Age Three Ways - Drooping |
| by Austin-Weston Center for Cosmetic Surgery |
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We droop, we wrinkle, we gaunt. Our lineage determines whether we are in a line of droopers, wrinklers or gaunters. It also determines when aging begins and how fast it progresses. Smoking, sun and alcohol can speed the aging process. If we live long enough we are likely to develop all three types of aging.
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Cosmetic surgery can minimize these aging effects and have us look more like we feel inside.
Drooping
Drooping is the most common type of aging and it usually shows up earliest. It is also the type of aging cosmetic surgery corrects best.
Think of it this way: at the age of fifteen you had a size five face and a size five skin to match. At fifty, you still have a size five face…but now your skin size is seven or eight. It no longer matches. It droops because it has lost its elasticity. As one woman lamented, "My Spandex went and despanded". The smooth planes of the fifteen year-old face become the hills and valleys of time.
Often the first sign of drooping is a little bulge near the corner of the mouth. One of our patients referred to it as "my puffs", a name which has stuck.
As our lower cheeks loosen and droop, they carry the underlying fat with them, forming hills we call jowls. In turn, the jowls droop, erasing the jaw line. The neck skin can droop and may show up in the midline as a band, unkindly called the "turkey gobbler". The cheeks stretch forward, drooping over the smile lines. Other "droop-over" lines begin at the mouth corners and extend toward the chin. We call these the marionette lines.
Upper and lower eyelids can droop and bulge. The eyebrows can droop over their boney ridges and, combined with the aging eyelids, produce a tired, even angry look.
The good news is that our techniques are best for drooping - and 85% of our patients are droopers.
Facial Rejuvenation: Lifting
We treat drooping by freeing the extra skin, lifting it and trimming it away. Like artistic tailors we hide the seams (scars) wherever we can - in the scalp; at junctions, such as where the ear meets the cheek; in natural folds, as in the upper eyelid crease; in areas of shadow, like under the chin. In the case of one of our surgeons, his facelift scars are so hidden he must stretch the areas with his fingers to show them to his patients.
Lifting the cheek is called a cheek-lift. Lifting the neck is called a neck-lift. When we perform both, as is usually the case, we commonly call the procedure a facelift. As part of a
facelift we often lower the hills by sculpting the fat. And fill in the valleys a bit with your own tissue.
We lift the eyebrows back into their natural position with a brow-lift, smoothing the forehead at the same time.
We correct the drooping skin of the upper eyelids by trimming it. We correct the saggy-baggy lower eyelids much the same way and often trim bulging fat, using it to fill any hollows.
Together, the facelift, the browlift and the eyelid procedures are the three pillars of a facial rejuvenation. One patient used the analogy of building a birthday cake - and these are the three layers of the cake. Well, you may ask, what of the icing?
The icing on the cake - finesse procedures. Frequently the corners of the mouth droop, turning down so we look sad or bitter. We correct this with a corner lift. The upper lip may droop, lengthening to hide the upper teeth. We can shorten the lip with a lip lift. Sometimes we trim out the puff directly. We often remove raised spots on the skin using a simple technique called heat-wiping.
We will address the icing more fully in a future column. And some candles, too!
Related Articles
Our Face Ages Three Ways: Wrinkling
Our Face Ages Three Ways: Gaunting
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