The Truth about Face Lifts and Facial Fillers
Written by Randy Alvarez show host of The Wellness Hour
Don’t ruin that face! Many doctors have told me, the goal of most patients is to look younger, refreshed or look great for their age, but more importantly to look natural.
So what is the truth about face lifts, facial fillers and lasers etc? I will tell you what to look for in a surgeon that is doing low down time face lifting, or a full face lift and what to look for when considering any type of facial rejuvenation but first we need to discuss the aging face and what makes it look young! Let’s start with an 18 year old person, think of the brows, they are not high or highly arched; the face has a few wrinkles but the mid face around the nose is plump. The neck is firm but not tight or if a double chin exists, it’s a little fatty bulge under the chin.
The skin over the eyes is there, but not saggy and the forehead has some expression lines. The face is full and the jowls are in place, unless a person is very overweight, then they are just plump not saggy. The lines around the mouth, the nasal labial folds are small lines if any. 18 year old girls don't have big giant lips!
It is an interesting fact that you can identify a person’s age from twenty yards away or even thirty yards. Let me give you an example, if you are walking along the beach and you see a woman in front of you even sixty feet away, you can pretty much tell whether the person is over 40 or under 40. How is this? Our brains by the time we have reached our late twenties have seen and met enough people who have told their age that your brain develops certain associations and classifications which help you determine the approximate age of the person. It is the fallen facial structures of the person, their hair line, style of hair, clothing often times, the speed in which they walk or their skin that allows your brain to put it all together. It is not the absence of nasal labial folds around their mouth, or the fact they have no forehead wrinkles that give away their age. It’s the position of the face and all of the things mentioned above. Let’s take a closer look, now you are five feet away. An 18 year old has skin that is pretty even in tone – all of the skin matches with the exception of birth marks or freckles or a few moles. That look makes you look younger. Intense pulse light treatments or fractionated laser treatments, etc., can remove uneven pigment. The 18 year old does not have small wrinkles or crapiness on their face, these small surface wrinkles can be taken care of with laser or fractionated lasers or peels, all minimally invasive rejuvenation. Their young appearance does not have deep lines around the mouth so facial fillers can take care of that, but and it’s a big but, if the filler is raised above the surrounding tissue it does not look natural, now you look strange and people won’t know why you just look strange or odd. Your brain will just pick up that something is not right. Lack of wrinkles does not make you look young! And your eyes, under and over your eyes, excess skin over the lids and bags under the eye, often times it’s not a brow problem but a gravity problem over the eyes, the skin starts to sag and a blepharoplasty can take care of that. In the case of saggy brows a good endoscopic procedure can slightly raise brows, too much and you look like an old person with a brow lift or if you take too much skin over the eyes now you look hallow which is an old look. I have seen so many 40 year olds get unnecessary brow lifts or blehporoplasties and they get too much raised fillers above the rest of their skin, big lips, and now they look like a "over-done" 52 year old. Adding volume with fillers under the eyes is one option and a very conservative bleph, not too much skin removal, where less is more, can usually do the trick. Remember, 18 year olds, 30 year olds or 40 year olds don’t have high brows, only over surgerized people have high brows. It’s not natural or young looking. Thin brows show age, thickening those with makeup helps with that. Taking care of under the eye bags or hollowness is tricky and must be tailored to the individual, this is what surgeons tell me, either a person has a hallow appearance or a fat bag; either problem can be addressed with a number of procedures.
As for facial cheek implants, I have had about 300 hours of discussions over this topic over the past 10 years and the theory here is to drape the skin over the hollow area, unfortunately as you age the implant shows and looks very unnatural. It’s very confusing; I’m even confused on where to begin…so let’s back up. When you reach the point where you are not happy with the way you are aging in the face, if you start young you can use intense pulse light treatments to get rid of spots that pop up, fractionated lasers to keep the skin looking great and facials from an aesthetician to keep your skin looking good. The new radio-frequency technology that applies heat to the under lying tissues can keep those jowls from becoming jowls and keep that neck tight. Early intervention is always best. Drink good water and eat quality organic protein, good fats and good carbohydrates and don’t over exercise. Lower your stress levels and you will age slower as you reduce stress hormones. Botox is great to keep the wrinkles away.
Now for those of you who have waited or put off minimally invasive facial rejuvenation and your jowls are sagging, your eyes are droopy and your neck is saggy and your skin is damaged from the sun, then a face lift may be in order.
How to choose a surgeon? Pick a surgeon that does at least one to four face lifts a week. A board certified plastic surgeon, or board certified facial plastic surgeon is my advice. The exception to this would be a cosmetic surgeon that has been doing face lifts for more than 10 years and does them frequently, 1-4 a week. I have been told that face lifting and most surgery is like golfing, you have to practice a lot to be good or maintain your good game. Demand to look at their work, at least fifteen of their face lifts or don’t bother. I am fully aware they are showing you their best work but you need to see at least fifteen samples. Do they look natural? You must ask yourself when viewing their work. It’s not always about experience or training when it comes to artistry, we all have had a bad haircut from a stylist that has been doing cuts for 20 years. Look at the doctor’s office; is it hip and stylish, neat and clean? How do they dress, how is their hair? Are they up to date with the latest fashions? What is their safety record? Look at their work! The bible says you will know them by their fruit. Good before and after photos are important. I know they show only their best stuff, but if their best 15 face lifts are not so good and their excuse is they can’t get people to give them photos don’t go to them. One other thing, make sure your doctor has done at least fifty or more face lifts before you schedule yours. Ask, always ask.
The face ages in five ways: Loss of volume, skin wrinkling, uneven skin color, the muscles under the skin start to sag, and the fat under the skin droops. You need to go to a surgeon that addresses all five of the ways your skin ages! I don’t give referrals, you need to check out a doctor that you like on your own. The key is to go to a doctor that does not pull skin, but a doctor that repositions tissues to where they used to be when you where younger.
My advice is to look great for your age! Chances are, if you are reading this you will have to look at your face for another forty years. Be very choosy when you pick a surgeon or doctor that is going to do any minimally invasive procedure or a face lift. It’s not about low down time; it’s about what’s the best result. If it’s done right no one will know you had anything done. If you smoke, are unhealthy or eat poorly don’t do it, you won’t heal properly. Go to a doctor that not only does great surgery but has the newest and greatest technology to address the skin. My opinion is, if a woman has great skin for her age that is sexy. The bonus is a nice smile, fit, smart, honest, a great personality, and confidence…that is beauty.
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