There are a number of factors that combine to make our faces look older with time, but the two most important factors are changes in the quality of the skin and the loss of volume. The skin quality changes that are markedly worsened by factors such as sun exposure and smoking have long been recognized but the changes due to volume loss have come to be appreciated only recently.
Physicians used to believe that loose skin was due to the gradual stretching effect of gravity, but now we understand that much of this is due to the loss of deeper tissues. As we age we lose facial fat and connective tissue. Our facial bones get thinner and our teeth get ground down. All of these factors combine to produce a hollow appearance where the skin that was once supported by these deeper tissues now sags and droops. There have been examples where patients have had large volumes of filler injected, and have had tightening of the loose skin on the lower face and jowls, comparable to that produced by a surgical procedure. Unfortunately the amount of filler required currently makes this approach not economically feasible for the vast majority of people.
One area where filling is a very practical solution is restoring the mid-face, the youthful contour of the cheeks, and improving the appearance of the bags under the eyes. We now understand that, in many cases, bags under the eyes are not the result of excess or protruding tissue, but are due to the loss of the deeper tissue in the upper cheek, which makes the normal tissue around the eye visible as a bag. Surgically removing this normal tissue results in what has been called "hollow eye" while replacement of the tissue lost with filler results in a more youthful and attractive appearance.
If you’re interested in restoring a more youthful look with a filler, call us at Holzapfel + Lied Plastic Surgery for a consultation at (513) 984-FACE in Cincinnati, (859) 331-9600 in Northern Kentucky.
