Understanding The Aging Face

Now that we better understand the aging process of the face, how is a patient evaluated? The most important aspect of a proper evaluation is understanding the patient’s concerns. Listening to the patient can properly guide and focus the evaluation. Though our overall goal is to achieve harmonious facial rejuvenation, each patient has different perspectives, needs, and expectations. Thus, patients with very similar anatomic features, may desire completely different treatment plans.

First and foremost, our team addresses the patient’s concerns: “What is bothering you the most? What would you like improved? Once those concerns are fully appreciated, an evaluation is performed.

An evaluation typically begins with the eyes and upper face, which includes the eyebrows and forehead, the upper and lower eyelids, as well as the cheek. The upper eyelids cannot be properly evaluated without considering the eyebrows, as their positions are intimately associated. The eyebrow position and projection can determine the fullness of the upper eyelid, so it cannot be ignored when examining the upper eyelid. Furthermore, it is essential to understand the gender differences in facial anatomy and ideal aesthetics, as this determines proper evaluation of eyes and eyebrows. Similarly, the lower eyelid cannot be properly evaluated without examining cheek position and volume. A volume deficient and descended cheek mound can accentuate the lower eyelid bagginess by creating a visible depression between the two, commonly named the “tear trough”. Cheek descent can also lead to more prominent “nasolabial folds,” the fold of the smile line that extends from the bottom edge of the nose down to the corner of the mouth.

Once the upper face is properly evaluated, the exam transitions to the lower face. Though the eyes are often the central focus of the face, the idea facial rejuvenation has to address the lower face and neck to achieve upper-lower face harmony. The lower face aging changes that are typically evaluated include loss of lip volume and projection, wrinkling and deepening of folds around the mouth, jowling seen at the jawline, fat accumulation and laxity within the neck.

Throughout this evaluation, skin changes such as wrinkling and pigment changes, are being evaluated as these features cannot be ignored if one is to achieve ideal rejuvenation.

After the evaluation is complete, we work with you to create a plan that meets your goals and needs in the safest way possible.