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Treating the Aging Face
By MSP Staff | Published 07/2/2007 | Business Trends |
MSP Staff
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Treating the Aging Face
Over time, the face begins to show the effects of sun exposure and gravity. Fine lines and wrinkles start to appear. The skin can become drier and less supple and elastic. Underlying fat pads shrink, giving the cheeks a more sunken or hollow appearance.

One of the treatments for reducing the visible signs of facial aging is a facelift (rhytidectomy). There are several different ways to perform the procedure. In general, doctors make an incision following hairline to conceal the cut. The skin is separated from the fat and tissue. Sometimes the underlying tissue is tightened or enhanced. The skin is pulled up and back. Excess skin is cut way and the remainder is sutured in place. The procedure may also be used to remove excess skin around the jowls or neck.

According to the American Society for Aesthetic Plastic Surgery, about 138,245 facelifts were performed in 2006. Patients are usually back to work within 10 to 14 days. Bruising can last for two or more weeks.

Cosmetic Fillers Injectable fillers have become very popular over the last several years. Last year, more than 1.97 million injections of soft tissue fillers were given in the U.S. Fillers can be made from natural or man-made materials. They are injected under the skin to fill in depressions (like fine lines and wrinkles), provide fullness to some areas of the face and restore a smooth, youthful appearance. Here's a rundown on some of the soft tissue fillers approved in the U.S.


Fat injections are prepared using fat obtained from another area of the patient's own body (like the thighs, buttocks or abdomen). The results can last from a few months to years.


Collagen has been used as a filler for more than 20 years. It can be prepared from human tissue or cow tissue (bovine collagen). An injection lasts about six months.

Hyaluronic acid

Hyaluronic acid is a laboratory made version of a natural component of connective tissue in humans. It's sold in the U.S. under the names Hylaform®®, Restylane® and Juvederm™. The results last about four months to one year.

Calcium hydroxyl-lapatite

Calcium hydroxyl-lapatite is a man-made form of the natural material found in bones and teeth. It's available under the names Radiesse® and Radiance®. The results last much longer than other filler products, generally two years or longer.

Poly-L-lactic acid

Poly-L-lactic acid is a synthetic material used in the medical industry to make dissolvable sutures and some types of medical implants. It's sold in the U.S. under the name Sculptra®. Sculptra is only indicated for correction of severe facial fat loss in patients with HIV. However, some physicians are using it off-label for wrinkles. An injection lasts about two years.


ArteFill is the first permanent filler to be approved in the U.S. It contains bovine collagen and particles of a material used to make medical implants, called polymethyl-methacrylate.


Perlane is the most recently approved soft tissue filler (approved May 7). It is made of hyaluronic acid, but contains larger gel particles than those in Restylane. Thus, it can be used to fill in moderate to severe wrinkles. An injection lasts about six months.

All-filler Facelift Facial Plastic Surgeon, Allan Wulc, M.D., is using soft tissue fillers for patients who are not quite "ready" to have a facelift. He uses Restylane to provide volume for wrinkles and reduce the visibility of acne scars. It can be injected in layers to add more volume and fullness and provide a better contour for the face. Wulc compares the needle to an artist's brush. Doctors should be experienced with the use of fillers to provide just the right amount at the right depth.

Since a large number of injections are needed to perform the all-filler facelift, patients are given a numbing topical cream. A dental block may also be given to numb the area around the mouth. Patients may initially experience a significant amount of swelling and bruising.

Wulc says the only limit on the amount of Restylane that can be used is how much money a client is willing to spend. Each syringe of Restylane costs from $450 to $800. Most patients are spending between $2,500 and $5,200. While the treatment isn't considered to be permanent, patients usually only need a touch-up after about nine months, rather than a full treatment.

For general information on injectable fillers:The American Society for Aesthetic Plastic Surgery,

American Society of Plastic Surgeons,

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