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Why the Face Ages and What Can Be Done About It E-mail
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According to Dermatologist Melvin Elson, M.D., of Nashville, Tenn., there are five basic types of aging that occur on the face, and for each of these aging processes modern dermatology has an answer that can turn back father time.

How Dermatologists  Can Restore Your Youthful Look

Dermatologic treatments can improve the skin's texture and return its youthful glow. "Dermatologists evaluate a patient with aging facial skin for many different factors, including how well the face is aging overall; is there obvious damage to the skin's surface; what does this damage look like; and how deep does it go," stated Dr. Elson. "Once we have a picture of what has occurred on the face over time, dermatologists can identify the steps necessary to reverse the damage - whether that be through a single treatment or a combination of several treatments."

Factors that Act Together to Age the Face

Intrinsic Aging

Intrinsic aging is the natural process of aging that begins late in life and is characterized by a loss of substance to the skin and the underlying fat resulting in a gaunt, thin look with hollowed cheeks and eye sockets. The treatment options for this type of aging are aimed at replacement of the lost tissue, such as solid implants, which are surgically placed under the skin, or fat transfer, where fat and tissue from other parts of the patients' body are used to fill in deeper wrinkles and contour the "hills and valleys" associated with aging.


No one is immune to the effects of gravity on their body. For the face, this means that as soon as we stand, everything moves downwards - the eyelids fall, the jowls form, the nose tip points downward, the upper lip disappears while the lower lip pouts and even the ears get longer. These facial changes related to gravity become more pronounced as we age.

"No amount of facial exercises or ‘good genes' can offset the pull of gravity," stated Dr. Elson. "Dermatologic treatments for the everyday effects of gravity remain surgical, such as a blepharoplasty, a surgical procedure to correct the "droopy" look of eyelids. Because surgical procedures are invasive and require extensive downtime, it's important to discuss with your dermatologist the option that is right for your lifestyle." 


More than 80 percent of the damage on an aging face is from photodamage which occurs from overexposure to the elements, including the sun and the wind. Individuals with fair skin, light eyes and a history of long-term sun exposure are more susceptible to photodamage, which is represented by blotchy pigmentation, wrinkling and scaling.

Dermatologists have a variety of innovative techniques which can improve the appearance of photodamaged skin, including laser resurfacing, a treatment option where heat or light pulses from a laser are used to rejuvenate the skin's tone and texture and minimize fine lines. Depending on the type of laser used, moderate to advanced fine lines and deeper wrinkles can be treated with very little downtime.

An alternative to lasers are chemical peels which remove levels of the skin to stimulate rapid rejuvenation. The strength of chemical peels can vary from very superficial to deep, and this strength determines the benefit to the skin and the downtime following this procedure.

Sleep Lines

Much as a napkin gets a crease when it is folded in a drawer too long, sleep lines etch the surface of the skin and occur from putting the face into the same position on the pillow every night. "Even though these lines may seem to diminish or disappear once a patient is no longer lying in bed, if the patient assumes the same sleeping posture every evening, these lines will return creating more damage," said Dr. Elson. Due to different sleep patterns, women tend to see these types of lines on their chin and cheeks, while men notice them on their foreheads.

Since changing sleep positions is challenging for some patients, dermatologists recommend the use of botulinum (botox) rejuvenation to hold the skin taut. Botulinum rejuvenation is an increasingly popular cosmetic procedure where dermatologists carefully inject a low dose of botulinum toxin into a patient's facial muscles, causing temporary relaxation of the injected muscles. The procedure is non-invasive, features practically no recovery time and can safely and effectively reduce the appearance of facial lines, crow's feet and wrinkles when performed by a qualified physician.

Expression Lines

Every smile, frown and laugh affects the face, especially the collagen fibers beneath it. Expression lines are commonly referred to as "laugh lines" and are most noticeable around the large muscles of the eyes and the mouth. While most people do not find these types of lines funny, there is no way to change the way the face reacts to emotion.

One of a dermatologist's most effective treatments for softening or removing these lines is the use of botulinum rejuvenation. Another treatment option is soft-tissue augmentation and a dermatologist can assist patients in selecting from the variety of Food and Drug Administration-approved wrinkle fillers which produce immediate, yet temporary, results to improve the appearance of lines.

Anti Aging Options Increasing

"Aging skin is a fact of life, but patients today need to know that dermatologists can offer them more options than ever before," said Dr. Elson. "It is important that anyone considering a cosmetic procedure for the treatment of the aging face consult with a dermatologist to discuss their expectations and select the best treatment available."

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