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Understanding Facial Aging in the Twenty First Century
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Dermatologists have always sought to correct the outward signs of facial aging. There are two types of changes seen in aging skin: those caused by sun exposure (photoaging) and those caused by natural, or intrinsic aging. The religious use of sunscreen will only prevent the photoaged changes; intrinsic aging will still result in milder expressions of aging skin. Dehydration, roughness and dryness occur because of water loss and the loss of the normal lipid synthesis in the skin. The loss of collagen and elastic tissue leads to fine wrinkles. Genomic research confirms that as skin ages, the genes that regulate skin barrier function, skin growth and skin pigmentation begin to malfunction. This leads to sallow skin with brown spots and precancerous growths. Many solutions for these surface changes are available in the form of moisturizers, applied retinoid creams, bleaching agents and other self administered treatments. When these changes are more significant, they can be addressed with lasers, peels and other more aggressive treatments.
What has truly changed the playing field in recent years has been our understanding of facial volume. The biggest cues to an aging face are not the subtle wrinkles and pigment changes, but the changes in shape and formation of deep folds. These signs are due to the loss of skeletal bone and fat that we have come to recognize as critical in the appearance of facial aging. As we age, reabsorption of the bone in our skeletons begins, leading to osteoporosis and changes in the shape and structure of the skull.
The orbit of the eye widens and the cheek bones become less prominent. These changes lead to the appearance of hollowness under the eyes, and the apparent increase in the size of the nose. The jawbone is slowly reabsorbed, shrinking in size and shape, causing loss of chin projection, and deep wrinkles at the corners of the mouth, the jowls and in the neck. The loss of facial fat in the mid face, temples cheeks and chin all aggravate the changes in facial shape and fullness. Fortunately we have new substances and techniques for correcting this loss, ranging from fat injections, and synthetic materials that are bio compatible like hyaluronic acid (Restylane and Juvederm), poly L lactic acid (Sculptra), and Calcium Hydroxyl Apatite (Radiesse). For superficial wrinkles we can use various hyaluronic acid fillers or collagen, especially the new long lasting collagen, Evolence.
The new techniques allow for near facelift like results, in the office with little or no down time.
Although aging is inevitable, dermatologists have many tools available to keep your appearance as youthful as possible.
Sobederm Blog