State of the Art Treatment of the Aging Face
Dr. Benjamin Schlechter has returned from attending the 2015 Aesthetic Surgery Symposium held in Las Vegas, Nevada. This 3-day intensive program reviewed techniques to improve the aging face. Internationally renowned presenters lectured on and showed new cutting edge techniques. Included were new techniques for rejuvenation of the upper and lower eyelids, face, neck and forehead. The premise for the aging face involves loss of skin tone, volume loss, and descent of the tissues. Obviously, the treatment of the aging face involves restoring volume, ascending the tissues and improving the quality of the skin.
Over the past several years, a hot topic in the plastic surgery cosmetic surgery circles has been fat grafting to the aging face. This meeting presented a plethora of information regarding this exciting subject, as well as, the science to support the procedures. Most interesting was the topic of micrografting and nanografting fat to the aging face. This involves sterilely harvesting one’s own fat, preparing it, and then injecting it into areas of volume loss. Studies have shown that the areas treated with fat grafting have improved volume, skin tone, color and elasticity. Of note, fat grafting also appears to help improve acne scarring. The mechanism for this is not completely known, but studies have shown that adipose derived stem cells remain viable in the grafted fat. It is believed these cells have a role in improving skin tone.
Also presented were new, less invasive face lifting techniques. This procedure still requires an incision that is camouflaged around the ear. The approaches involved a 2-layer correction of the aging tissues. The results appear to be long lasting and very natural looking.
As we age, the eyes tend to be the first area of our face to show aging. New techniques incorporating fat grafting to the upper and lower eyelids were presented. This involved the more traditional blepharoplasty procedures, as well as, techniques that involve no external incision. There is evidence to show that nanografting of fat to the lower eyelids helps to improve dark circles.
In terms of improving facial skin consistency and integrity, it has been shown that good skin care in conjunction with laser resurfacing is quite beneficial. This can be in the form of aggressive CO2 laser resurfacing or less aggressive fractional resurfacing. Laser treatments and skin care can be an ongoing process to maintain skin. This equates with going to the gym to keep your body in shape. It’s not once and done. The Picosure laser with focus lens array has been shown to be a non-invasive facial skin treatment that significantly improves skin texture and discoloration. This may also help improve acne scarring. Again, periodic treatments are necessary to maintain the quality of your skin.
Also presented at the meeting in great detail was the use of fillers (ie. Juvederm, Restylane, Perlane, Voluma, Radiesse, Restylane Silk, and Sculptra) and neurotoxins (i.e. BOTOX, Dysport or Xeomin) to shape and improve the face. The neurotoxins are used to help erase wrinkles, but can also be used to help shape the brow, corners of the mouth, or to decrease the bulk of certain muscles of the face to create a more contoured, defined look. The choice of a certain filler is dependent on the desired results. For instance, Restylane Silk was recently FDA approved for treatment of the lips. This hyaluronic acid filler is composed of smaller molecules to create a softer, natural full look. The goal of treatment with these products is to create a nice, natural rejuvenated look. Different fillers are used for different purposes.
Treatment of the declote was also touched on in the lectures. Treatment using micro and nano fat grafting, along with skin care has been shown to improve the wrinkles and texture of the sun damaged chest.
What was most refreshing was that I have been performing many of the procedures utilizing these newer techniques and technology in my practice for quite some time. This coincides with my philosophy of providing state of the art care and the latest in technology.