Aging can be divided into two primary categories known as "photoaging," and "chronoaging."
Photoaging is the result of skin damage from exposure to the sun and elements. While prevention is the best way to deal with this problem, corrective measures are available. Fine wrinkling may respond to chemical "peels" of the skin or to dermabrasion (mechanical "sanding" of the surface). In other instances "laser resurfacing" of the skin will yield the best outcome. Deeper wrinkles can be improved by the use of injectable filling agents such as "collagen" or the patient's own fat.
Chronoaging is the time and age-related loss of facial muscle tone and skin elasticity. It is corrected primarily through surgical intervention. This surgery may be comprehensive when the aging process has become advanced, or may be more limited and focused when the process is intercepted early.
Restorative facial surgery (facelift) dates from the early 20th century when American and European surgeons began to explore the possibility of correcting age change and the wrinkling of skin. Early operations involved the use of incisions around the ear and in the hairline to allow undermining of the facial skin and upward-backward traction on the sagging countenance. These simple procedures produced some improvement, but sometimes produced an overly taught, mask-like appearance and tell-tale alterations in the hairline.
In recent years, facelift techniques have undergone major improvement, allowing for natural, and more enduring correction. Better understanding of the aging sequence and of the deep facial anatomy have been critical to our surgical progress, as has been the combination of this knowledge with the new technologies of superficial liposculpture and endoscopic surgery.
For patients presenting in the fifties and sixties, full "facelift" procedures may be appropriate. Today's techniques are myriad in nature, and will often involve correction of the deep, inelastic facial structures and fat, along with the skin. Although it is often better to "intercept" aging changes early and perform more limited procedures for correction, the full facelift can produce a dramatic and gratifying return to more youthful appearance.
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