Dr. Edward Buckingham: When you look in the mirror at someone when they're 30 and compare that, to say, when they're 50 or 60, you're going to see several key features related to how their faces aged. You're going to see things that have been affected by gravity such as jowling, as it develops along the jawline, where the fat pad of the face has descended and has now interrupted the contour of the jawline. You're going to see the brow, perhaps it has descended. It is now causing hooding or covering up part of the eyelid.

The other thing you're going to see is facial volume loss. We think this is an unbelievably important part of facial aging, but many people who do a smattering of facial plastic surgery really miss out on and don't rejuvenate. In fact, people who go in and have three and four facelifts, they're just missing the boat. People don't really need to have three or four facelifts to create that unnatural appearance.

What they're really missing is facial volume. And what I mean by that is as you age, especially the area under the eye and in the cheek, you lose volume, you develop double-convexity, as we call it, of the lower eyelid where you have a slight pouching of the orbital fat or the fat within the eyelid and then, a groove underneath the eyelid with a deflated cheek.

So, I challenge you to look at a picture of yourself in youth and really see what that lower eyelid cheek contour looks like. I think what you'll notice is that the eyelid appears short or, in other words, the cheek is built up and forms a nice convexity as it flows into the lower eyelid which appears very short. Older surgical techniques, namely blepharoplasty of the lower eyelid, that just removed fat from this region, really just converted a convexler eyelid to a concaveler eyelid. But it still has a long appearance and the face still appears deflated, and it doesn't have the youthful volume that it needs.

The third aspect of facial aging is really the skin itself, and that it relates to wrinkles, brown spots commonly known as dyschromia, red spots, other features that are just affecting the skin and its appearance and not making it look uniform, primarily related to time and sun damage. The skin is treated through a variety of methods that start with good skin care. We feel strongly about our skin care regimen which is known as PCA. It's a physician only skincare line and it really does wonderful things to tone the skin and prepare it for, perhaps, some other more aggressive procedures such as Fraxel laser or skin resurfacing with chemicals that will really give you a boost to rejuvenate and decrease the amount of wrinkling and brown spots on your skin.

So as you come into our office and we ask you to tell us what your concerns are, we're really going to go through the areas of your face, starting with the upper face, which consists of the brow and the upper eyelids and then, the middle face, which is the lower eyelid and cheek, and then the lower face, which is the jaw-line and the neck. And we'll listen to your concerns about which one of these areas are affecting your desire to look in the mirror and look a little bit more youthful.

Related to each one of these areas, we can then talk about how gravity, how volume has changed, and what procedures we can do to affect those areas. The gravitational changers are typically corrected with things like blepharoplasty, brow lifts, and lower face lifts. Volume is corrected usually by using your own adipocytes or fat cells from another part of your body, which we harvest through a very small incision and implant into the deep structures of the face using small hollow tools known as cannulas. This really rejuvenates and restores the lost volume of the face and brings back that nice convexity extending into the upper cheeks and lower eyelid. And then, we may look at some sort of a surgical procedure to address the skin changes that have occurred.

So, all of those things will happen during your consultation, that's our philosophy on facial rejuvenation; both gravity, volume changes, and skin related issues. And throughout the rest of our website, there are other videos and informative areas that can talk about the individual procedures. There's many before and after pictures of patients who have had these procedures done and I think, if you look at those you'll see they really strive to achieve youthful, natural results, turning back the clock. We don't anyone to be able to look at our patients and say, "Gosh, that person had cosmetic surgery done." We really want you to be able to fool people into thinking that you really are younger than you are. There's no reason we shouldn't be able to achieve those goals when we address facial rejuvenation through this technique.

Facial Rejuvenation to Improve Volume Loss

Dr. Edward Buckingham discusses the key factors in aging and how to rejuvenate your facial features without surgery.