Explaining volume loss & its role in the aging process
As we age, skin may appear to droop as if gravity is pulling it down. However, it’s not just gravity that changes your face, it is biological ageing, sunlight exposure, lack of hydration and smoking. These factors can influence all layers in the structure of our face and contribute to the appearance of ageing.
The first facelift was done by sir Harold Gillies, a London based New Zealandplastic surgeon. Indeed Sir Harold is considered the father of modern dayplastic surgery. When the first facelifts were done in the 1930’s the procedure consisted of the removal of excess skin and tightening of the residual skin.
In the 21st century further study has revealed that part of the problem of ageing is not just thinning skin and loosening of skin but the loss of volume. The loss of volume is a combination of shrinkage of fat and migration. Plastic surgeons have also recently recognized that there is a subgroup of patients in whom the loss of fat is profound and in such patients doing a facelift will give them a severely gaunt appearance.
The emphasis in facial-rejuvenation has shifted somewhat and replacement of volume has become just as important as removal and tightening of loose skin. There is significant clinical research being performed on fat transfer particularly fat transfer to the face. However there is still a level of unpredictability with fat transfer an it may be a number of years before plastic surgeon can offer this as a solution with a high degree of predictability.
Currently replacement of facial volume is primarily being done with injectable fillers. Fillers have several advantages over fat. They are done as a walk-in-walk-out procedure in the plastic surgeons office. There is no downtime, the results are instant, predictable and will last for several months. In most cases patients fillers will enhance any surgical procedure.
Replacement of facial volume with fillers has become so popular it is nicknamed “the liquid Facelift”. As aplastic surgeon I believe that the replacement of volume in the face has become just as important as the “lifting” element of facial rejuvenation.
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