Every age has its unique beauties.
As a matter of fact, there are many beautiful individuals in every age group.
Imagine that we are organizing a beauty pageant exclusively for 55-year-old women. There are 100 participants. You and I are jury members and will name the top 3 contestants together. The most important criterion is that the candidates must not have had any plastic surgery or any aesthetic procedure. The pageant is over, and the top 3 are announced.
Our goal in the treatment of an aging face is to put you in this “best” 3% in your own age group. If you don't have an innate genetic advantage, you are unlikely to be in this 3% privileged group with your current facial anatomy. Our goal is to ensure you look like those unoperated, natural 55-year-old beauties in that imaginary pageant, and we can only achieve this goal through combined aesthetic surgeries that bring the facial anatomy to its ideal configuration.
It is impossible to achieve the right results without accurately setting the goals or perceiving them correctly. Advancements in magnetic resonance imaging (MRI), computed tomography (CT) and 3D surface imaging technologies have taken our knowledge of the anatomy of an aging face to new heights over the last 20 years. Plastic surgery used to focus on the superficial signs of aging in the period before the emergence of these technologies but has gradually become aware of the 3D volume changes in the aging process.
Indeed, when young faces are compared with aged faces, one of the most striking differences at first glance is the fact that the face loses volume significantly during the aging process. We can put this aside as a rule, but there are many exceptions to it. For example, not all parts of the face lose volume. Some areas indeed gain volume. For instance, while the surface volume increases, the deep tissue/bone volume may decrease.
Since young faces are generally voluminous and old faces generally lack volume, we expect the top 3 contestants in our pageant to hail from among the faces that maintain their fullness during the aging process, right?
No!!!
When we analyze naturally beautiful individuals at middle age and above, we see that their faces are more elegant, calmer, more expressive, more angled and more shadowy. In almost all of them, the skeletal structure of the face is extremely strong, the changes in volume are limited, the chewing and mimic muscles are very strong. When compared to their youth photos, middle-aged beauties have apparently lost a significant amount of volume, but this loss of volume seems to have "worked" for them. Therefore, when talking about the beauty of age 45 or 55, I think it is a philosophically faulty approach to select the plump and smooth facial anatomy of these beauties in their 20s as the baseline criteria.
All volumizing treatments (fillers, adipose tissue transfer, facial implants, lift surgeries) performed without fully understanding these major exceptions to the rule on volume loss result in faces that "lost the spirit of their age in an attempt to look younger".
We are living in an era when there are thousands of practitioners who are not sufficiently equipped to think about the conceptual dimensions of facial aesthetics but have the skills to inject things into tissues. I think this is a minefield. Better take our steps carefully.
If you want to be a beauty of your age, you must first be somewhat prepared to forget how you looked when you were young. The past is the past, and you can no longer restore your facial structure in youth. Many of my patients express during consultation that they want to look better but do not want their face to change. What they usually mean is that they do not want to have an unnatural facial structure. Everyone desires to have a natural beauty, but most plastic surgery candidates are a little confused about what "natural" is.
Secondly, if you want to be a beauty of your age, you should reconcile with some physical characteristics that are indispensable for all individuals in your age group. For instance, the “nasolabial fold” at the junction of the cheek and upper lip deepens in all 55-year-old individuals without exception. This is a sine qua non for a 55-year-old face. If you completely fill the nasolabial fold to restore its past version at age 20, the looks of this area does not fit the patient's face, contrasts with the rest of the face, loses its angularity and inevitably looks unnatural. Similarly, you can observe mimic wrinkles around the eyes and mouth in all 55-year-old individuals without exception. Mimic wrinkles can be eliminated through aggressive resurfacing and neurotoxin treatment, but a 55-year-old face without these does not carry the expression and spirit of its age.
Facelift candidates ask if these wrinkles will remain after surgery and they are quite surprised when they hear the answer "yes". Our goal is not to pursue individual wrinkles and eliminate them all. Wrinkles make the face look “mature and expressive” up to a critical level, while beyond that level, they give the face a “tired and pale” look. Our goal is to prevent surface wrinkles from exceeding that critical level.
I invite everyone interested in facial rejuvenation surgery to think about being a beauty of their age. That was the purpose of this post. I hope it was helpful.
Take good care...
... of yourself and your beauty.