Don’t worry. It took us plastic surgeons decades to understand what makes us look old and tired. For years, we thought it was only gravity, but we soon realised that facelifts, which pull skin and soft tissues upwards, didn’t always make our patients look younger – just tight and pulled.
Then in the early 1990s, we realised the key element was deflation or volume loss. From our mid-20s, we begin to lose bone from our facial skeleton, especially around the eye sockets, the side of the nose and the cheekbones.
In our 30s and 40s, the soft tissue also begins to diminish and slacken, causing certain supporting muscles to become more active (thus creating wrinkles).
In our 50s to 70s, these factors gather momentum resulting in the typical features of the older (shrunken) face.
Take the original Charlie’s Angels, Farrah Fawcett, Jaclyn Smith and Cheryl Ladd. They all looked gorgeous when young. Now 20 years on, Jaclyn and Cheryl still look great, but Farrah has aged considerably. The reason – cheekbones! Farrah never had big cheekbones to start with and as she aged, this accentuated the natural deflation of her soft tissues. The high cheekbones of the other two allowed them to age more gracefully.
Young faces have a smooth convex contour from the lower eyelash margin over the cheekbones and down to the upper lip. As we age and deflate, this contour breaks up into a series of unflattering bulges and hollows. The earliest sign of ageing is a thumb sized depression just under the eyes. It gives us a pinched, tired, washed-out look, and draws attention to the eyebags, another marker of early ageing.
Thankfully, there are various treatment options which help fix problems easily.
| Fillers | The simplest technique of injecting a Hyaluronic Acid (HA) filler directly into the depressed area, plumping it up and restoring the youthful convexity of the cheeks and mid face. The results are temporary. Fat injections: Fat is harvested from another part of the body, processed and then injected into the hollows. It can last longer than synthetic fillers, but the results are unpredictable and annoying lumping and clumping of the fat may occur. |
| Fat Redistribution | The fat of eyebags is surgically pushed downwards to fill out the mid-face hollow. A great deal of skill and experience is required of your surgeon as complications can occur. In the right patient, the results are lovely. |
| Implants | A superb technique for permanently restoring the fullness of the cheekbones and mid face. However, it is an operation with downtime and bruising, and implants come in fixed sizes so there is less flexibility. |
| APTOS | Anti-PTOSis (“against gravity”) is the latest rejuvenation technique. Under local anaesthesia, a long needle is pushed into the face area and a specially-designed thread with small barbs is passed through into the tissues. The needle is removed, the thread tightened, lifting the sagging tissues. It takes 30 minutes, swelling is minimal, and patients are back to work within 48 hours. It is ideal for younger patients who want to look fresher, but are not ready for a full facelift. |
