I recently had a little girl and noticed that she looks like a little old lady. But why is this? The primary reason is that both very young and very old people have too much skin for the bone underneath. As children get older and become adolescents and then young adults, the facial skeleton grows more than the skin around it, such that in our mid-20’s we achieve a “sweet spot” when the facial skeleton stretches our skin nice and tight and gives our eyes, nose, chin and neck nice definition with no visible wrinkling. As we enter our 30’s and then after, we begin losing bone again and our skin gets more stretchy so it doesn’t suck down onto the bone as well as it does in our 20’s. Eventually, we end up looking like little babies again with folds around our mouth, jowls, and extra skin above our eyes.
Esthetic procedures target this imbalance between facial skin and bone. A facelift or eyelid lift (blepharoplasty) removes the extra skin and tightens the skin that is left behind. Facial fillers like Juvederm, Sculptra or fat grafting give volume back to the face, which is like making the facial skeleton a littler larger. This creates a more youthful bone to skin ratio, and makes a person look younger. Skin treatments like peels, skin pen or photorejuvenation (IPL) are literally the icing on the cake, evening skin pigment and texture to make a person look even younger. I use the mnemonic LFS to remind me to think about Lifting (surgery), Filling, and Skin during an esthetic consultation to make sure I achieve the very best improvement for the patient.