NEW YORK — Assessment of facial aging should include all structural layers as well as the patient's aesthetic goals, according to an educational program presented at Facial Aesthetics New York.
“Facial aging is more than skin deep and almost everything you see on the outside is indicative of what’s going on on the inside,” Lee A. Gibstein, MD, of Miami Beach, Florida, said in his presentation.
Lee A. Gibstein
Gibstein first addressed the aspects recognized as a youthful face and sometimes known as the “triangle of youth.” These factors include a convex form to the face with high cheeks, well-defined features, soft contours, and a defined jawline. Additionally, youthful skin is found to be supple, hydrated, toned, and smooth.
The opposing “inverted triangle of aging,” however, is represented by skin laxity, midface deflation, a sagging jawline, and a double chin, while the skin is dry, has a loss of elastin and collagen, and has a rough texture.
Aesthetic assessment of facial aging, according to Gibstein, should be a multidimensional approach that encompasses all structural layers of the face: skin, superficial subcutaneous layers, the deep compartments, as well as the foundational bone structure. By defining a patient’s structural changes and volume loss, as well as a consultation with the patient regarding their aesthetic goals, an optimal, comprehensive plan can be achieved.
Key features of facial aging include shortening of the vertical dimension (low heavy brow), widening of the horizontal dimension (fullness in the lower face), volume depletion (loss of projection), sagging skin (loss of jawline contouring), static and dynamic rhytids, and submental fat.
Gibstein advised in his conclusion to avoid what he refers to as “line chasing.” Lines are natural and help to define the face. The misconception that a youthful face is synonymous with no lines or wrinkles can diminish results. Instead, correction of sagging skin with laxity will result in a better restoration of the face. – by Talitha Bennett
Lee reports he is an advisor for Allergan and Galderma.
Gibstein LA. Facial Aging. Presented at: Facial Aesthetics New York; Nov. 3, 2016; New York.