Guide to Timeless Beauty

Jenifer L. Henderson, MD
Article by
Silverdale Facial Plastic Surgeon


It is always fun for me to look at a person’s face and try to determine what about that person’s face makes them look youthful and attractive versus aged, unhealthy or “operated on”.  Most of the changes seen in the face as we age are the result of loss of support and fullness in combination with hereditary factors, smoking history, and sun exposure.

Facial surgery has really evolved over the past fifteen or so years.   Gone are the days of the overly tight face, the “wind tunnel appearance”.  When rejuvenating a face, we now strive for a soft, natural appearance this is achieved using modern surgical techniques. The “skin-only removal” type of facelift is a thing of the past. The skin provides no structural support so this type of lift only lasts one to two years and, because so much tension is placed on the skin, it gives an overly-tight appearance that is unacceptable to most people.

Newer facelift techniques involve a two layer approach, called a “deep plane” or SMAS facelift.  The facial skin is lifted, but an additional second layer, deep to the skin, is also lifted.  This second layer, the SMAS layer, is a fibrous - fatty layer that attaches to the lower facial muscles.  Tension is diverted to this deeper layer during the lifting process and results in a more natural look with a much longer duration.  With this technique and proper incision placement, once the healing process is complete, there will be little, if any, tell-tale signs that surgery has been performed.

A newer procedure that has really enhanced my face lifting results is fat injection.  Fat injections, or “lipostructure”, add volume to the face on a more permanent basis.  We “borrow” fat from areas of excess – saddle bags, love handles, inner knees; process it, and actually re-inject it into the face to fill it out.  If you look at little child’s face, it is a full face.  As we age, we lose volume in the face.  Deep valleys in the face, volume loss, and sagging skin create the appearance of aging or poor health.  By removing excess skin, tightening facial muscles and re-volumizing the face we can recreate the appearance of youth.

Typical areas for fat injections are the cheeks, temples, nasal folds, jaw line and even in the hollows underneath the lower eyelids.  It never ceases to amaze me to see how adding back facial volume makes one look so much younger.  I frequently recommend fat injections in combination with deep plane face lifts; it takes what would normally be a good surgical outcome and just makes it better.  Interestingly current scientific research has demonstrated that harvested fat cells actually also contain an abundance of stem cells and various growth factors.  Stem cells and growth factors show promising results for mending sun damaged and aged skin by improving skin texture, elasticity and color. Stem cells are the new buzz in facial rejuvenation and I look forward to exciting new procedures combining them in the rejuvenation process.