“How do you feel you look?” is a question I like to pose to people who come to see me to discuss facial rejuvenation. Whether they are in their 30s or 70s, the same question applies to all, and the answers they give are key.
Whether they say the look tired, sad, ageing, angry or even that they feel their facial features or expression gives people the wrong impression about them (mistrustful, exhausted), there is often a solution. In many cases the solution will be surgical – a facelift or neck lift, particularly in the ageing lower face once over 60, but often there will be a non-surgical approach that can be extremely beneficial.
The modern understanding of facial ageing and changes, combined with the very latest hyaluronic acid fillers and their advanced use has seen a sea-change in the approach to facial rejuvenation.
We now understand far more about the changes to volume (particularly bone and fat) that happens with age, as well as the sagging. Addressing facial ageing is not simply about lifting and tightening (which still remains an important part) but also about restoring volume and giving back support.
For example, the heavy nasolabial (nose to mouth) lines and the eye bags are created by changes in the mid-face. This is the triangle of the cheek below the lower eyelid. Not only does a reduction in support cause this to descend, but also the fat in this compartment withers with age, and the underlying bone shrinks back. Therefore addressing this area needs to bear all of this in mind.
The non-surgical approach using filler can help restore the lost volume and provide support to the tissue, in addition to subtly filling any residual contour defects. Typically, when I see someone in their 30s to 50s with mild to moderate signs of facial ageing, in whom we are going to take a non-surgical approach, I will use carefully placed filler to restore their freshness and youthfulness .
The filler is placed in a variety of areas – on the cheek bone (deep down, right on the bone, which is surprisingly painless), as well as to the tear trough (the lower eyebag groove), and deep in the upper corner of the nose to mouth nasolabial folds.
Other excellent targets to restore freshness and offer support to the face include the hollowing at the temples (which can also offer support to the outer eyebrow that starts to droop with age), the jawline (to support the development of early jowls), the chin and the angle of the jaw, just below the ear.
These all work best when combined with the use of carefully placed Botox (botulinum toxin), which complements the filler, and avoids the frozen or surprised look.
The use of filler in this way is not a cheap alternative to surgery, and that is important to say. The filler should last 12-18 months, and to perform a comprehensive rejuvenation as I have just described would normally cost in the region of £2000 (particularly if combined with Botox).
However, for many people, particularly the younger cohort of facial rejuvenation patients, this can be a far better approach than surgery. Surgery will have an important role at some point, but not initially.
For more information, come to see me for a consultation and review – just to find out about what the best approach in your individual situation might be.