Health Features

Fresh Faced

Your face is the first thing others notice about you, so it’s important that it makes the right impression. Sometimes that can mean making a few adjustments. Whether it’s turning back the clock or fixing something that has always bothered you, local experts can help.

As we age, we naturally experience a loss of bone mass, including in our face. Skin also has less collagen and elastin. Many signs of aging are a result of these processes, according to Dr. Richard Moore of The Lifestyle Center and The Edge for Men. He explains that loss of volume around the cheeks and eyes creates a sunken appearance, and a smaller mandible combined with skin laxity forms jowls. Both facelifts and nonsurgical options are available to combat these changes.

125,997 face-lifts performed in 2017, down 1 percent from 2016

2,691,265 soft tissue filler procedures in 2017, up 3 percent from 2016

587,903 laser skin resurfacing procedures performed in 2017, comparable to 2016


A face-lift involves tightening underlying tissue and removing excess facial skin to address sagging and loss of volume. “Face-lifts play a major part in rejuvenation of the face,” says Dr. Frank Simo, a SLUCare facial plastic and reconstructive surgeon. “Other procedures don’t tighten the face and neck as effectively.”

He notes that many people have a misconception that face-lifts address the entire face. In reality, the surgery usually is done only on the cheek and neck areas, but it can be combined with other procedures like fat transfer and eyelid surgery. “Chin implants also are very common with a face-lift,” he adds, explaining that bone loss means people with smaller chins lose soft tissue support and see the signs of aging more quickly. “Balancing improvements in the lower and upper face creates a more natural appearance.”

An important element to any face-lift is the incisions. “If properly placed, the incisions should be virtually impossible to see, especially if you don’t know to look for them,” says Washington University facial plastic surgeon Dr. Emily Spataro. She adds that recovery includes significant swelling and bruising for two weeks, and residual swelling may need several more weeks to resolve.

less invasive alternatives
While face-lifts are still common, nonsurgical options are increasing in popularity, according to Spataro. “It depends on the patient, but noninvasive procedures can be good options for younger people with less skin damage,” she says. However, she adds that patients with high skin laxity won’t see the same tightening effect found with a standard face-lift.

Moore says people are moving toward procedures that lift and improve the quality of the skin to restore a more natural, youthful appearance. One alternative he suggests is the Renuvion face-lift, which uses J-Plasma radiofrequency energy to resurface and tighten the skin. “It shrinks the skin tissue and lifts things back in position,” Moore explains. He adds that while it’s a good solution for wrinkles and skin laxity, it doesn’t restore volume. He suggests pairing Renuvion with dermal fillers for the best results. Recovery for the procedure is around two weeks. “Some noninvasive procedures have very minimal recovery times, but anything that resurfaces the skin is going to vary from five to 14 days,” he notes.

other less invasive options:

  • Botox and Dysport
  • Ablative and nonablative laser resurfacing
  • Thread lift
  • Radiofrequency ablation
  • Ultrasound therapy
  • Facial peel
  • Microneedling

skin care
Want to make the most out of any rejuvenating procedure? Simo advises his patients to focus on skin care. “Wrinkles, blotchy pigmentation, sun damage—these issues may not be addressed by your procedure,” he explains. “Undergoing surgery without properly caring for your skin is like baking a cake without icing it.” Look for skin care with ingredients that pack an antiaging punch.

sunscreen: Sun exposure is the No. 1 reason for signs of aging on your skin. Protect yourself (and prevent future wrinkles) by choosing products with built-in sunscreens. Make sure they’re broad spectrum, meaning they block both UVA and UVB rays, and have a SPF of at least 15 to 30, depending on the amount of time you spend outside.
retinoids: The superstars of antiaging skin care, these vitamin A compounds are antioxidants, which means they neutralize free radicals, increase collagen production and stimulate the production of new blood vessels in the skin. This means fewer wrinkles, improved skin color and softened rough patches.
alpha and beta hydroxy acids: These exfoliants remove the upper layer of old, dead skin and stimulate new growth, leaving your face smooth and more evenly pigmented. And unlike with traditional face scrubs, your skin won’t be damaged by abrasives. Look for products with glycolic acid. Its molecular size means it penetrates the skin more easily to create more dramatic results.
vitamin C: Another powerful antioxidant, it repairs damage done by free radicals and the sun. Plus, it comes with the bonus of protecting against future damage.
hydroquinone: This compound fades hyperpigmentation by blocking the enzyme that triggers melanin production. Think of it as an eraser that tackles age spots and blotchy skin. Using sunscreen as well is key, because if UV rays hit unprotected skin, they may undo any fading.

There are two general types of rhinoplasties: cosmetic and functional. The former is done to improve the nose’s appearance. Spataro says common concerns include eliminating bumps on the nasal bridge (also called dorsal humps) and rotating or decreasing the size of the nose tip. She adds that technology and social media may be contributing to people’s awareness of potential flaws. “Thanks to selfies, we’re seeing more patients noticing asymmetry or crookedness that they want fixed,” she says.

Simo says patients generally want the size of their noses reduced. “They may want the bump taken off or think their nose is too wide,” he explains, adding that if a surgeon doesn’t properly evaluate the changes, narrowing the nose may create breathing problems. “It’s very important to pay attention to the internal structure to maintain or even improve breathing.”

Correcting impaired breathing is the purpose of functional rhinoplasty. Spataro notes that the procedure usually means fixing narrow nasal passages or deviated septums (which also can be addressed by a septoplasty). While this may mean widening parts of the nose, patients shouldn’t be worried about it negatively impacting appearance, according to both doctors. “In many cases, form follows function,” Simo says, explaining that a straighter nose breathes better than a crooked one. “In a functional rhinoplasty, creating the best results includes keeping the nose aesthetically pleasing.”

According to the American Society of Plastic Surgeons, 218,924 rhinoplasties were performed in 2017.

on the nose

Keep expectations reasonable. Both Simo and Spataro advise against looking to celebrities for inspiration when it comes to your desired results. “You can’t expect to have someone else’s nose after the procedure,” Spataro explains. “During consultations, I discuss with patients how little tweaks can make a big difference in appearance.”
Fear not. Simo suggests patients ignore horror stories they may have heard about rhinoplasty and other nasal surgery, noting that there have been dramatic improvements in recent years. The use of long-active numbing medications during surgery and moving away from nasal packing (placing a gauze-like material in the nasal cavity to absorb fluids) have reduced patient discomfort and made recovery easier. “Most patients feel comfortable on a pain reliever like Tylenol two days after the surgery, are back to work in five days and have returned to full physical activity, including the gym, by two weeks,” he says.
Wait for results. Spataro advises patients to be prepared to wait weeks before seeing final results. “Swelling in the soft tissues of the nose can be evident for up to six weeks, and in some cases, changes still can occur up to a year later,” she says.

Fresh Faced
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Fresh Faced
Your face is the first thing others notice about you, so it’s important that it makes the right impression. Sometimes that can mean making a few adjustments. Whether it’s turning back the clock or fixing something that has always bothered you, local experts can help.
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