Beauty and Aging

Abstract

The face does not age as one homogeneous object, but as a result of several dynamic components. Changes that occur with facial aging involve a complex interaction among the bone, skin, soft tissue, support ligaments, and septa. Facial aging is a multifactorial process. To properly restore the youthful facial appearance, it is essential to understand the facial morphological changes over time. A balanced approach to facial rejuvenation between bone and fat volume augmentation and soft tissue envelope repositioning will avoid the distortions of either approach in isolation. Skeletal resorption can be improved with calcium hydroxyapatite injections or implants. The loss of volume in fat compartments can be restored with fillers or fat grafting in specific deflated fat compartments. The SMAS, the retaining ligaments, and the lid structures can be modified with surgery. Botulinum toxin is useful to reduce the increased muscular resting tone present in aging. Skin rejuvenation can be performed with retinoids, laser resurfacing, and peels. To achieve an integral rejuvenation, we should individualize the treatments and perform them step by step.