The Changing “Face” of Facelifts

In the most recent issue of Clinics in Plastic Surgery, Dr. Val Lambros wrote about how as human faces age, tissues not only shift but they also deflate!  This means that as we age, our faces lose volume and as we lose volume, we lose the fullness and shape of a youthful facial appearance.  In the past, we as plastic surgeons, had limited means to treat these aging changes but as Dr. Lambros points out, now we have more than just the tissue redraping and skin excision of a facelift to achieve a more youthful and balanced facial appearance.  Many of our newer facial procedure techniques also will include some form of volume replacement to fill in those areas that have lost their fullness as we mature.  There are many options for volume replacement including soft tissue fillers and fat transfers using the patient’s own fat to fill in the desired areas.  The areas that demonstrated the most benefit of volume replacement for correcting aging changes according to Dr. Lambros were the brows, the tear trough region-that area under your eyes next to your nose, the cheeks, the anterior jaw line-that areas just in front of your jowls, the posterior jaw line, the nasolabial folds-those hollows on the side of your nose above your lips, and of course, the lips.  As Dr. Lambros noted in his article, just like surgery, volume replacement therapies alone will not correct all the signs of the aging face and the best results often come from a combination of the two techniques.   It should be noted that Dr. Lambros is probably the world’s foremost expert on the changes associated with aging in the human face.  He developed a very complex computer program that allows precise mapping of the facial tissues using serial photos taken from different stages as his subjects’ age.  His study group includes thousands of patients including me.  This program is so complex that much of the technology was developed with the assistance of NASA.

So, it is very possible these days that patients looking into facial rejuvenation may not only have a facelift recommended by their plastic surgeon but also a fat transfer or other similar technique to achieve their best result.

Herluf Lund MD

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