Doc, just make me look better…

A patient recently came to me and asked me ‘Doc, just make me look better…’. This patient just wanted to look refreshed and revitalised, but didn’t really exactly what could be done or what they wanted. I started discussing some ideas including the possibility of some dermal fillers when the patient asked me, ‘but how will this make me look better?’

It was the answer to this question that prompted me to write this blog entry…

So, this is what I told the patient;

Basically, there are a few aspects to facial ageing that should be addressed in order to achieve a more refreshed and revitalised appearance.

Firstly, there is the issue of volume. Volume is gradually lost from our faces as we get older (unlike our bodies which tend to get fatter!). Volume loss can occur in any part of the face, and can be due to reduction in fat in the face as well as bone resorption. We usually see it in areas like the cheeks, lips, and brows. Volume can be replaced in the face through many methods. Dermal fillers are one of the most common and simple methods of replacing lost volume in the face, and this can be done as a simple office procedure. Other alternatives include fat transfer from other parts of the body to the face. This is a more involved procedure as it does require the patient to have liposuction first to harvest the fat for injection, but the longevity of this treatment tends to be longer than most dermal fillers.

Secondly, there is the skin. The skin is the drape that covers the face and its appearance is paramount to someone’s perceived age and appearance. UV radiation from sun exposure or solariums increases the rate of skin ageing, pigmentation problems and wrinkles. To improve the skin itself, there are number of things that can be done. Lasers can be used to remove specific problems such as broken capillaries, sun spots / pigmentation, and wrinkles. Also good skin care including a good topical retinoid and sunscreen are important to maintain the skins appearance. Anti-wrinkle injections are also a good method of helping to stop expression lines and creases such as those around the eyes and between the brows.

Thirdly, there is the effect of gravity on the face, which causes the face to sag. This leads to a descent in the cheeks, jowl formation, the formation of folds from the nose to the mouth (nasolabial folds), and a more square appearance to the face. In most cases, a surgical procedure is required to properly correct this descent. Face-lifting and brow lifting are examples of these surgical procedures.

So it is important to address all of the above three aspects of facial ageing when rejuvenating the face. Addressing one of the three issues without the other can sometimes lead to an unusual appearance. We all know of Hollywood stars who still look their age despite having a facelift (or two). The reason for this is that often the issue of volume loss hasn’t been addressed, so they are tight, but not full like a younger person would be. Similarly, addressing facial sag and volume without addressing the skin can also create an appearance that is inconsistent. Ima1gine a person with a youthful shaped face, with lots of sun spots, broken capillaries, and wrinkles!

Usually a specialised cosmetic doctor is the best person to advise you on what you might need. We can tell you where you are doing well and which parts might need to be addressed. Good facial rejuvenation will make you look refreshed and revitalised … naturally!

Dr. Gavin Chan
Dr. Gavin Chan

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