Rejuvenating Your Face with Minimally Invasive Procedures

Have you been wishing lately for a way to look as young and refreshed as you feel? But at the same time, perhaps you worry about the cost of surgery or a long recovery time. Today, more affordable and less-invasive options are available. Nonsurgical and minimally invasive facial plastic surgery procedures have become an ever-increasing part of the facial plastic surgeon’s toolkit. In fact, recent data from the American Academy of Facial Plastic and Reconstructive Surgery reveal that the number of nonsurgical procedures has increased 45 percent in the last two years.

In this regard, patients often come to me asking what treatments I would recommend to help them appear more youthful and revitalized. 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 the loss of facial volume. “Facial volume?” you might ask. “What about lifting or trimming excess tissue?” While these approaches certainly have a use, the overriding factor contributing to facial aging is volume loss.

Let me explain 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 traditional 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 lost volume that is contributing to these changes.

Facial volume loss generally starts when we’re in our twenties—when we begin to lose our “baby fat.” It is the change in the face’s 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 small pads of fat below the lower eyelids. 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), prejowl region, lower cheek and even the temples. The overall result is a transition of a youthful heart-shaped face into a more elongated rectangle appearance.

With volume loss also come concavities that tend to create shadowing, which redirects our focus away from someone’s eyes. The goal of facial volume enhancement is to re-create 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.

Fortunately, several nonsurgical or minimally invasive treatments are available to those interested in improving their facial appearance. In-office treatment with skin fillers such as Restylane, Juvederm or Radiesse give results that last from about 6 to 12 months. Restylane and Juvederm are composed of hyaluronic acid, a naturally occurring component of skin, whereas Radiesse is a calcium-based product that works by both filling the tissues and by promoting new collagen production. Treatment with any of the fillers takes just about 15 minutes and can be done with local numbing medicine only.

More durable volume enhancement can be achieved using advanced fat grafting techniques. Many patients appreciate being able to donate fat from an unwanted part of their body such as the abdomen or hips to achieve an improved facial appearance. Fat harvesting and injection is done using access points just a few millimeters long that do not require sutures to close.

No matter the method used, facial volume enhancement provides a powerful means to achieving a natural, non-operated improvement to the face.

Dr. Thomas Lamperti is a board-certified otolaryngologist and facial plastic and reconstructive surgeon. He received his medical degree from Columbia University College of Physicians and Surgeons in New York and did his training at the University of Iowa Hospitals and Clinics. Dr. Lamperti has clinic hours at PacMed’s Canyon Park and First Hill locations. To make an appointment or to learn more about Dr. Lamperti, click here.

Thomas A. Lamperti, MD

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