User login
Tomorrow's approach to the aging face is all about restoring volume and moving away from filling in lines and wrinkles, according to Dr. W. Philip Werschler.
Advances in nonsurgical options such as fillers, toxins, lasers, peels, and topical products make it possible to address the volume loss and change in facial shape that comes with aging. Volume loss is cumulative through the decades and consists of several components including dermal and muscle atrophy, shifts in fat deposits, and skeletal thinning and remodeling including flattening of the maxilla, expansion of the occipital orbit, and shrinking of the mandible, he said at the seminar.
The heart shaped or trianglular appearance of a youthful face, which peaks in the mid-twenties, inverts to the pyramid of age with volumetric loss and alteration, said Dr. Werschler, an assistant clinical professor of dermatology at the University of Washington in Seattle. In women, this occurs earlier, typically in the late 40s and 50s, than in men, in the 60s and 70s. The bottom of the face appears heavier, often jowly, there is loss of the mandibular sweep, and the nose, instead of the chin, serves as the apex of the inverted triangle. Ultimately, as we age, we take on facial proportions that make us look more like infants than adults, he said.
To address wrinkles only is to address only half of the problem, Dr. Werschler said. For example, laser resurfacing can produce smooth skin in an aging patient, but they will still have a flat face, lacking in contour and dimension. If, however, nasolabial folds are tackled by volumizing the cheeks, it will lift the face and fill in the nasolabial folds, resulting in a more youthful, balanced, and natural appearance. Similarly, botulinum toxin A can be used to change the shape of the orbital opening, thus affecting crow's feet and softening eyebrows.
It is helpful to divide the face into three facial treatment zones when planning a nonsurgical total facial rejuvenation (NSYFR)--upper, mid and lower. Facial treatment zones are useful terms in patient education because they are easy to remember and easy to comprehend.
When analyzing the treatment zones, look for changes in balance, proportion, and symmetry, and consider what the patient hopes to achieve. There are many approaches to NSTFR. However, they don't exsist in isolation, and frequently the combination of NSTFR and surgery is best, according to Dr. Werschler. A good example of this is a brow lift along with laser or filler on the lips or lower part of the face. That may mean referring or collaborating with a surgeon in your practice, but the patient will thank you for the result, he said.
Photo Courtesy Dr. W. Philip Werschler
Dr. Werschler is a speaker, consultant, and clinical investigator for Allergan and Medicis, and has relationships with numerous other pharmaceutical companies. SDEF and this news organization are owned by Elsevier.
Tomorrow's approach to the aging face is all about restoring volume and moving away from filling in lines and wrinkles, according to Dr. W. Philip Werschler.
Advances in nonsurgical options such as fillers, toxins, lasers, peels, and topical products make it possible to address the volume loss and change in facial shape that comes with aging. Volume loss is cumulative through the decades and consists of several components including dermal and muscle atrophy, shifts in fat deposits, and skeletal thinning and remodeling including flattening of the maxilla, expansion of the occipital orbit, and shrinking of the mandible, he said at the seminar.
The heart shaped or trianglular appearance of a youthful face, which peaks in the mid-twenties, inverts to the pyramid of age with volumetric loss and alteration, said Dr. Werschler, an assistant clinical professor of dermatology at the University of Washington in Seattle. In women, this occurs earlier, typically in the late 40s and 50s, than in men, in the 60s and 70s. The bottom of the face appears heavier, often jowly, there is loss of the mandibular sweep, and the nose, instead of the chin, serves as the apex of the inverted triangle. Ultimately, as we age, we take on facial proportions that make us look more like infants than adults, he said.
To address wrinkles only is to address only half of the problem, Dr. Werschler said. For example, laser resurfacing can produce smooth skin in an aging patient, but they will still have a flat face, lacking in contour and dimension. If, however, nasolabial folds are tackled by volumizing the cheeks, it will lift the face and fill in the nasolabial folds, resulting in a more youthful, balanced, and natural appearance. Similarly, botulinum toxin A can be used to change the shape of the orbital opening, thus affecting crow's feet and softening eyebrows.
It is helpful to divide the face into three facial treatment zones when planning a nonsurgical total facial rejuvenation (NSYFR)--upper, mid and lower. Facial treatment zones are useful terms in patient education because they are easy to remember and easy to comprehend.
When analyzing the treatment zones, look for changes in balance, proportion, and symmetry, and consider what the patient hopes to achieve. There are many approaches to NSTFR. However, they don't exsist in isolation, and frequently the combination of NSTFR and surgery is best, according to Dr. Werschler. A good example of this is a brow lift along with laser or filler on the lips or lower part of the face. That may mean referring or collaborating with a surgeon in your practice, but the patient will thank you for the result, he said.
Photo Courtesy Dr. W. Philip Werschler
Dr. Werschler is a speaker, consultant, and clinical investigator for Allergan and Medicis, and has relationships with numerous other pharmaceutical companies. SDEF and this news organization are owned by Elsevier.
Tomorrow's approach to the aging face is all about restoring volume and moving away from filling in lines and wrinkles, according to Dr. W. Philip Werschler.
Advances in nonsurgical options such as fillers, toxins, lasers, peels, and topical products make it possible to address the volume loss and change in facial shape that comes with aging. Volume loss is cumulative through the decades and consists of several components including dermal and muscle atrophy, shifts in fat deposits, and skeletal thinning and remodeling including flattening of the maxilla, expansion of the occipital orbit, and shrinking of the mandible, he said at the seminar.
The heart shaped or trianglular appearance of a youthful face, which peaks in the mid-twenties, inverts to the pyramid of age with volumetric loss and alteration, said Dr. Werschler, an assistant clinical professor of dermatology at the University of Washington in Seattle. In women, this occurs earlier, typically in the late 40s and 50s, than in men, in the 60s and 70s. The bottom of the face appears heavier, often jowly, there is loss of the mandibular sweep, and the nose, instead of the chin, serves as the apex of the inverted triangle. Ultimately, as we age, we take on facial proportions that make us look more like infants than adults, he said.
To address wrinkles only is to address only half of the problem, Dr. Werschler said. For example, laser resurfacing can produce smooth skin in an aging patient, but they will still have a flat face, lacking in contour and dimension. If, however, nasolabial folds are tackled by volumizing the cheeks, it will lift the face and fill in the nasolabial folds, resulting in a more youthful, balanced, and natural appearance. Similarly, botulinum toxin A can be used to change the shape of the orbital opening, thus affecting crow's feet and softening eyebrows.
It is helpful to divide the face into three facial treatment zones when planning a nonsurgical total facial rejuvenation (NSYFR)--upper, mid and lower. Facial treatment zones are useful terms in patient education because they are easy to remember and easy to comprehend.
When analyzing the treatment zones, look for changes in balance, proportion, and symmetry, and consider what the patient hopes to achieve. There are many approaches to NSTFR. However, they don't exsist in isolation, and frequently the combination of NSTFR and surgery is best, according to Dr. Werschler. A good example of this is a brow lift along with laser or filler on the lips or lower part of the face. That may mean referring or collaborating with a surgeon in your practice, but the patient will thank you for the result, he said.
Photo Courtesy Dr. W. Philip Werschler
Dr. Werschler is a speaker, consultant, and clinical investigator for Allergan and Medicis, and has relationships with numerous other pharmaceutical companies. SDEF and this news organization are owned by Elsevier.