The aging process is slow, relentless and irreversible. It occurs at different rates from individual to individual as well as in each person at any given time. Facial aging is unrelated to general physical activity unless one is very ill and bed ridden. General changes that occur with aging include: Resorption of bone along the inferior orbital rim (boney rim under the eye) and in the region of the alar/nose cheek junction. The remaining upper and lower jaw bones do not change as long as teeth remain intact. Facial and other fat atrophies or is absorbed. Skin elasticity decreases and the skin also thins. Dermal papillae become blunted with loss of rete pegs so the skin is more easily abraded. Over time the effects of gravity and the longitudinal pull of muscles cause drooping or sagging of the skin and deeper structures of the cheeks, eyelids, nose, chin, legs etc. from areas of deeper attachment. The result is wrinkles and jowls in the face and cellulite in the extremities

1. 40 - 50 YEARS
• Cheek begins to flatten. Malar fat pad
descent becomes more obvious. Nasolabial
lines deepen. Facial fat atrophy or wasting
becomes evident with concavity of the
surface contour in the temple area and
cheeks appearing. In some individuals
the eyes become sunken as a result of
fat atrophy rather than forming eyelid
bags. Correction: Hyaluronic acid such as
Sub-Q, Evolence or Radiesse to central
face to hold malar fat pad in place and
achieve voluminisation. Fat grafting such as
autologous fat transfer. Marionette lines and
jowls now appear.
• Double chin appears. Correction: Vaser
LipoSelection, SmartLipo or Lipodissolve.
• Collagen and elastin levels continue to
fall resulting in eyelid bags and lines start to
appear in upper and lower lips. Forehead
wrinkles deepen. Gravity and the pull of
muscles cause drooping or sagging of the
skin and deeper structures from areas of
deeper attachment. Correction: Hyaluronic
acid fillers to upper lip. Botox to upper face.
Radiofrequency skin tightening treatments
such as Polaris, ReFirme and Thermage.
Infrared skin tightening such as Titian
and LuxIR. Resurfacing skin lasers such as
ActiveFx.
• Collagen and elastin levels continue to
fall resulting in eyelid bags and lines start to
appear in upper and lower lips. Forehead
wrinkles deepen. Gravity and the pull of
muscles cause drooping or sagging of the
skin and deeper structures from areas of
deeper attachment. Correction: Hyaluronic
acid fillers to upper lip. Botox® to upper
face. Radiofrequency skin tightening
treatments such as Polaris, ReFirme and
Platysmal banding appears in the neck.
Thermage. Infrared skin tightening such as
Correction: Hyaluronic acid fillers to upper
Titian and LuxIR. Resurfacing skin lasers such 50 - 60 YEARS lip. Botox of diminishing effect. Face lift,
as ActiveFx.
Brow lift, Blepharoplasty or Neck lift often
• Menopausal effects. Fat hangs in saggy
• Collagen and elastin levels continue to required.
skin. Nasolabial and marionette lines
fall resulting in eyelid bags and lines start to substantially deepen if not corrected.
appear in upper and lower lips. Forehead • Menopausal effects. Bone density gets
Marionette lines and jowls become more
wrinkles deepen. Gravity and the pull of less as combination factors such as reduced
obvious. Double chin and ‘turkey neck’
muscles cause drooping or sagging of the growth hormone and oestrogen levels occur.
appears. Correction: Short scar facelift.
skin and deeper structures from areas of Correction: Many cosmetic doctors feel the
MACS facelift. Anterior neck lift.
deeper attachment. Correction: Hyaluronic changes are too subtle to require correction.
acid fillers to upper lip. Botox® to upper • Excess fat appears under eyes. Correction:
face. Radiofrequency skin tightening Blepharoplasty. 60 - 70 YEARS
treatments such as Polaris, ReFirme and
Thermage. Infrared skin tightening such as • Menopausal effects. Fat hangs in saggy • Facial skin thins. Skin pigment cells increase
Titian and LuxIR. Resurfacing skin lasers such skin. Nasolabial and marionette lines in number and size in a blotchy pattern
as ActiveFx. substantially deepen if not corrected. Neck giving rise to brown spots of the back of
wrinkles. More of the eyebrow droops. The hand and face (senile lentigo). Correction:
• Chin area continues to enlarge. Eye sockets
nasal tip droops. The lips thin so there is IPL lasers. Skin cancer screening.
begin to widen. Correction: Many cosmetic
less dry vermillion (pink area where lipstick is
doctors feel the changes are too subtle to
applied) showing. Perioral wrinkles deepen.
require correction.
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