Patients often come to me asking what treatments I would recommend to help them appear more youthful and refreshed. While my specific recommendations will certainly vary from patient to patient, the number one factor that I find helps with rejuvenating facial appearance is improving facial volume loss. “Facial volume? What about lifting or trimming excess tissue?” you may ask. While these modalities certainly have a role, the over-riding factor contributing to facial aging is volume loss.
Let me start with an analogy. If we start with a grape, it will become a raisin as it loses volume. Similarly, volume depletion with facial aging results in redundant, drooping skin. The effect of a facelift, then, can be seen as transforming our raisin into a pea by removing some of this excess covering without addressing any of the grape’s volume loss. Therefore, to more naturally return our raisin into a grape, or our aging face into a more youthful face, we must work to restore the volume loss that is contributing to these changes.
Facial volume loss generally starts when we’re in our 20s – where we begin to lose our “baby fat”. It is the change in facial shape that occurs with this gradual decrease in the naturally appearing fat under our skin that allows us to pretty quickly gauge about how old someone is. This fat loss is usually evident initially in the lower eyelid and cheek area. It can contribute to the appearance of bags under the eyes as the already thin skin in this area becomes even thinner and fails to camouflage the normal lower eyelid fat pads. This process is analogous to trying to hide a pillow by covering it with a thin sheet versus a thick comforter.
As volume loss progresses one will find that the cheek skin will be less well supported and will tend to sag, leading to more prominent nasolabial folds (smile lines). A similar process occurs on the outer eyebrow area (which can cause some drooping of the brow down onto the orbital rim), prejowl region, lower cheek, and even the temples. The overall result is a transition of a youthful heart-shaped face into a more masculine-appearing elongated rectangle.
With volume loss comes concavities that tend to create shadowing which further redirects our focus away from someone’s eyes. The goal of facial volume enhancement is to recreate the convex contours of youth, converting these shadows into highlights, and return the face back to the ideal heart shape. This serves to redirect attention from the lower face back to the upper face and eyes. It is this reframing of the eyes that becomes crucial in any rejuvenative endeavor.
Want to learn more about the importance of facial volume and how to improve it? Click here to learn about Injectible Fillers or Fat Grafting. To schedule a consultation with Dr. Lamperti click here or call 206.505.1300.
Dr. Lamperti is very passionate about his work and spent a lot of time answering my questions and educating me.
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