What is Aging? What are the Signs that will dictate what Plastic Surgery I need?
Your Plastic Surgery Timeline.

Understanding the natural causes of facial aging allows us to understand what the correct solutions should be.

Since aging progresses over time, with different areas of the face affected at different stages of life, we should have different approaches and treatments at different times in our life.

To make this easier to understand and apply to yourself, I have created a timeline so each of us can evaluate our own changes and then together, with your plastic surgery doctor, can define what the correct solution will be at each given point in time.

Put simply, facial aging is mainly caused by one force: gravity. What is up must come down over time and this will explain the majority of what we see in the mirror.

Gravity stretches THE FACE throughout ALL of its layers. So, as times goes on we end up with more face piling up in a LOWER position.

The other aspect of facial aging is surface changes, such as hyper pigmentation, large pores and fine lines.

Unlike pure gravity changes, surface changes are a cumulative effect of sun damage and overall lifestyle. BUT, regardless of lifestyle, gravity changes affect everyone and truly define our overall age appearance at every point in our lives.

There are different solutions for early gravity changes vs. established gravity changes.

Surface treatments are entirely different and can be approached separately or at the same time as our gravity changes.

So in general, our surface changes affect the quality of our appearance, while gravity’s effect over time makes us appear a certain age…

As we progress through life on our timeline, we will see surface changes predominate first—with these changes, our skin quality, tone, color and texture are affected.

Then, as the effect of gravity on our face becomes more established, we will start seeing our actual facial shape change, creating tired, baggy eyes, worried, furrowed forehead or even a heavy, older look when our neck and jowls sag. Our face becomes square and we lose the tapered facial look of youth.

Looking at it as a timeline…

From 35-45, our facial changes are usually fairly limited -- Mainly some surface changes, with our skin being the main focus.

At this stage in our lives, gravity changes have clearly begun, which is why our look of 35 is not the same as 45, and some people will notice bags starting to appear under their eyes or furrows forming on our forehead and even folds appearing around the mouth. Cosmetic surgery procedures performed at this point can slow down the visible aging process and prevent greater sagging from occurring

From 45-55 further surface changes can occur, depending on both our genes and lifestyle. Those who protect themselves from the sun will likely have less cosmetic issues in this area.

But at this point, gravity changes become the main factor that changes our appearance and will be the main problem going forward.

Unlike surface changes that affect the texture of our face, gravity changes create folds, jowls and eventually a loose neck, which combine to affect the shape of our face.

Our gravity changes also have a strong emotional component to how we, and others, evaluate our face. As gravity changes progress, we will start to notice a constant tired look in our appearance, whether we are happy or rested. In some people, our gravity changes will makes us appear angry, sad or even worried. This is often the most bothersome complaint people have about their face changing over time.

Natural facelifts, necklifts or lower facelifts can alleviate this problem, erase years of gravity’s inevitable toll on your face, and give the face back its youthful, rested appearance.

In our 40’s, gravity changes are mainly focused on the eyes, which become baggy, and on the forehead, which furrows with creases or droops over our upper eyelid area. Cosmetic surgery procedures like eye lifts target these problems, giving your eyes, the centerpiece of your face, a naturally youthful appearance.

As 50 passes, gravity further affects the lower areas such as facial folds around our mouth, called nasolabial folds. This can give our mouth a downward appearance that produces a dour look. Jowling and drooping in our neck is just starting in many people. This is when many turn to cosmetic surgery doctors for necklift and lower facelift procedures. These proactive procedures help stop sagging and erase any damage already done.

From 55-65 the same process continues, with gravity changes becoming more pronounced in all the regions mentioned, producing the characteristic look of this age group.

Most people don’t actually complain about looking old but speak about looking tired, sad, angry or dour and hear it casually from the people around them.

What is happening is that the face is stretching out and we have more face in a lower position. This affects different types of faces differently...

Thin faces will have multiple folds and can have a hollow appearance. This is why some people think that the aging face is losing fat or volume.

But it is not that there is less fat or volume in our face but that the face, or the container that holds the fat and volume, is larger due to stretched skin and sagging muscles.

In fuller or heavier faces, gravity causes the face to take on a square or rectangular shape -- different from our earlier form where the cheekbones are the widest part of our face and the face tapers in a V shape.

For both facial types, cosmetic surgery procedures like natural facelifts and lower facelifts are a solution to bothersome sagging, as they pull the skin back to where it used to be and give the face back its youthful, V shape.

After 65, gravity has now taken away the distinction of where our face ends and where our neck begins!!! Our bone structure is no longer obvious and the neck is often the most troubling area of our face.

In most people, the majority of the laxity or looseness in our neck is not from fat deposition but from drooping muscle.

This is why when people over 55 lose a significant amount of weight, their face, and especially their neck, look worse, not better. The weight loss exposes the underlying loose muscle layer. Many people at this point opt for necklifts, which pull this weight back up and create the distinction between the neck and face again.

Still, excess tissue around the mouth, prominent nasolabial folds, extra eyelid tissue and a furrowed or drooping forehead have all continued to progress. This is often the point where we feel we look old.

It is normal to notice our lower face and neck changes more than we appreciate our forehead changes because we subconsciously use our muscles, by furrowing our brow, to keep our forehead from drooping over our eyes and affecting our vision.

So, we notice the furrows we unconsciously create but not the effect a loose forehead has on the appearance of our upper eyelids. Eye lifts and other cosmetic procedures can solve this problem by tightening the forehead and preventing further sagging on the upper eyelids.

Surface texture changes also progress but don’t create the change in facial shape that our gravity changes do…THAT is why our facial shape tells the world what age we are more than our fine lines.

We can’t get rid of gravity, but with a little help, we are able to maintain our youthful facial shape. Talk to your plastic surgery doctor about what you can do to fight the aging process.

Why do some types of plastic surgery look fake?

People will often ask where the word "plastic" comes from in the term plastic surgery. The word derives from the Greek work “plastikos” meaning to mold or shape. The interest in the word’s derivation is often because to lay people many types of plastic surgery looks plastic or fake. This is one of the biggest fears that prospective plastic surgery patients have when they think about facial rejuvenation and cosmetic surgery procedures.

Examples of obvious plastic surgery are not reserved for people who can’t access or afford better results. In fact, what is most troubling to many people considering plastic surgery is that we often see famous celebrities who we would expect can access and afford the best plastic surgery doctors, with some of the most obvious and “plastic- appearing” plastic surgery.

Why does this happen?

Since the majority of aging-related facial changes are due to gravity’s effects on the soft tissue, the best way to reverse these changes is to lift up what has fallen. If you need to lift something that has fallen, you need to be able to pull on a strong sturdy layer. So, the mechanism that all facelifting procedures used for years by plastic surgeons was to pull on the skin layer of the face to lift all of the drooping soft tissue that contributed to our aging look. The more lift needed or desired, the tighter the skin or top layer would be. In addition, the change in tone or tightness on the skin also produced the classic "windswept" look. Since there was no point in our life that the surface or skin layer of our face was tight, a tight face is noticed as being unnatural or plastic- appearing, and is associated with plastic surgery.

In the past, surface treatments such as facial peels also could create a plastic or tight look, but for different reasons. Deep peels, dermabrasion or even laser procedures remove loose or superficially wrinkled skin by burning off the surface skin layers so that the underlying layers of the dermis become tighter or less wrinkled. Similar to any burn that can occur due to an accident, a deep peel leaves the skin tighter appearing but also thinner with less color and texture, which is also often associated with an unnatural or plastic look. Unfortunately, since peels or dermabrasion do not approach gravity’s effects, the face will then just look tight on the surface but still be droopy.

Today, the most recent additions to facial rejuvenation cosmetic procedures are, facial injections such as fillers and botox, which are producing noticeable unnatural or plastic- appearing results when used too aggressively. When we are aging, because gravity has stretched out our face, the illusion is that we have lost fat or volume. When the face is overfilled with fillers, such as Rrestylane, Pperlane or fat, the face or the lips start to appear overfilled and look taught, producing a plastic appearance. Botox paralyzes muscles; when overused, the lack of facial movement produces a mask like appearance again interpreted as plastic or fake.

The good news is that looking fake or plastic is never the necessary outcome when plastic surgery procedures are well done and cosmetic surgery tools are used appropriately. Today, facelifts can be done completely secretly because newer deep-plane techniques do not tighten the skin layer for any reason. Deeper layers of skin, which do not show through the surface, are now used, producing a better, longer- lasting result and does not require the plastic surgery doctor to make the skin tighter in order to achieve the desired facial rejuvenation result.

As more plastic surgeons and their patients become familiar with deep-plane- based facelifting techniques, the need to mask or camouflage a droopy face by over-injecting with fillers, fat or botox will be avoided, and the days of aggressive peels that burn the skin but don’t address gravity changes will be a thing of the past.

Today, an educated cosmetic surgery consumer can restore their appearance without ever looking like they had a procedure!