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"Give Me Six Months And I"ll Give You Ten Years"

Of the myriad effects of aging, perhaps the most noticeable occurs in the face. As we age, hormonal changes and years of ultraviolet light exposure take their toll. Normal repair mechanisms are slowed. Collagen and fat, which are responsible for the elasticity and roundness of the face, are lost. Ultraviolet light further damages the surface of the skin, producing fine lines, wrinkles and brown spots.

The net effect is a brown, irregular, sagging, hollowed-out appearance. To a greater or lesser extent, these effects are seen in all of us. As we age, we all "Sink", we all "Sag" and we all develop an irregular skin surface with brown spots. It is only the extent of one process over another that accounts for the variations in facial appearance seen in the general population.

Thankfully, there are exciting, new procedures that effectively limit and partially reverse these effects.

The visual effects of the aging face are compartmentalized. The skin's outermost level is called the Epidermis. Below the Epidermis is the Dermis. Underneath the skin is the Subcutaneous Space. The effects of sun damage are seen in the epidermis. Collagen loss predominates in the dermis and fat loss occurs in the subcutaneous space. Fat loss in the subcutaneous tissue causes a sinking effect. Collagen loss, and its decrease in tensile strength, causes sagging.

Prior to a few years ago options for dealing with these universal aspects of aging were limited. Though effective, most treatments caused significant downtime and were plagued with side effects. In the last few years, exciting new techniques have been developed that effectively treat the brown, irregular, sagging, hollowed-out appearance.

Fat loss has been addressed by the introduction of volumizing agents. Although several options exist, the most common centers around volume replacement with Poly-L-Lactic Acid (Sculptra®) and Calcium Hyroxylapatite (Radiesse™). Performed in a series of corrective procedures, these agents both produce an excellent volumizing effect with minimal downtime.

Sagging skin largely seen around the jaw line and cheeks responds quite well to the Thermage® Procedure. In a single session, radiofrequency is delivered to the deeper layers of the skin. This causes the skin to tighten due to heat-induced shortening of, and production of, new collagen fibers. Collagen loss and Laxity in your face is addressed through the use of Thermage. This procedure tightens the skin by heating the collagen in the dermis. The result is a lifting of sagging areas. There is no downtime.

Finally, the recent introduction of Fraxel® technology to the medical aesthetic armamentarium allows for safe and reliable resurfacing of the face. Using Erbium-YAG laser energy delivered in a microscopic grid pattern (think pixels), this treatment allows a relatively high percentage of the skin surface to be treated while simultaneously limiting the discomfort and appearance of the injured area. Results are seen even after the first of a series of four treatments. There is minimal downtime.

No discussion of aesthetic procedures would be complete without considering Botox® and filling agents such as Restylane®. These well known treatments play an important but limited role in the aging face. Taken together they are quite useful for smoothing certain lines and wrinkles. While their effects are comparatively short-lived- months instead of years, they are agents of choice for smoothing lines around the eyes and forehead and enhancing lip volume.

Volumizing agents, Thermage® and Fraxel® are cornerstone treatments for the aging face. While no therapy actually reverses aging, the rejuvenation seen with these therapies reliably produces a more youthful appearance that gives you back that ten years.