Baby Boomer Plastic Surgery

The Aging Process

From about the ages of 35 to 50 the aging process happens slowly and almost insidiously. Patients are also focused on careers and raising a family. Women is this age group are focused on cosmetic treatments that enhance and correct the undesired effects of pregnancy and breast feeding.


All in all, these are great but busy years and the aging process is active but more gradual. During these years, routine maintenance is the key to maintaining a youthful appearance. Options are Botox, Fillers, skin rejuvenation, lasers, chemical peels, etc.





Explore some of our most popular treatments for women here:

Breast Augmentation with Implants

Breast Augmentation with Fat

Mommy Makeover

Liposuction

The "Nifty" Fifties

It's around age 50 that the aging process accelerates and gravity begins to take it’s toll. Traditional maintenance treatments are less effective and filler fatigue and filler face become issues that create unnatural-looking outcomes. Gravitational aging of the face and neck become more obvious, as evidenced by:

-sagging brows

-hollowing at the temples

-excess skin and fat in the eyelids

-loss and descent of facial fat

-deep nasolabial folds and marionette lines

-jowling

-neck fat

- a loss of contour in the neck


All this adds up to an older and more tired-looking face. For some, when marked lines and volume loss sets in, nonverbal expression can communicate signs of frustration that mature patients are unaware of. (Cue resting boomer face).

It's usually about this time that women and men schedule a cosmetic consultation to review longer-lasting and results-driven procedures.

Addressing Boomer Aging In The O.R.

In my practice, here are the most common areas of concern and how I address them.

Brows

In females, the lateral brow should be positioned so that the lateral third arches 1.0cm above the brow bone. Females' brows should be slightly arched, while male brows are more straight. Brow lifts can be done via an open or coronal approach OR an endoscopic method with smaller scars. In most cases, I'll recommend the endoscopic brow lift because it's less invasive with smaller scars, preserves hair growth, and has less downtime than the coronal approach.

Eyes

Aging eyelids are characterized by both excess skin and fat. As the upper eyelid ages, the upper eyelid crease becomes less visible as excess skin folds over the crease. Removing the excess skin is done with a small ellipse of skin leaving the scar in the eyelid crease. If necessary some fat can be removed from the upper eyelid so that the lids appear less puffy. In the lower lid, the incision is placed just below the lash line and excess skin is trimmed. Fat is removed from the lower eyelid to eliminate eyelid bags. A canthopexy can be used to tighten the skin at the lower eyelid, eliminating lower eyelid sag.

Face

A facelift uses an inconspicuous incision hidden around the ear and behind the ear to BOTH remove excess skin and tighten the internal layer called the SMAS or DEEP PLANE. The goals of a facelift are to produce a natural result, lift the cheek fat, improve the nasolabial fold and marionette lines around the mouth, and eliminating jowling to give a sharp jawline. A facelift is often combined with facial fat grafting where fat is harvested, purified and carefully injected to provide youthful volume to the temples, tear trough area, cheeks/midface, nasolabial folds, marionette lines, and for subtle volume restoration to the lips.

Explore more on facelifts here:

Mini Facelift
Standard Facelift
Lift & Fill Facelift

Neck

Loss of neck contour is one of the first tell-tale signs of aging. Loss of the crisp 90-degree angle of the neck can make a person look much older and heavier. The neck has 3 components: skin, fat, and muscle. First, fat is removed with VASER ultrasound liposuction.  Next, the neck muscle can be tightened in the midline by sewing the platysma bands together. This is called a corset platysmaplasty and gives a sharper contour to the neck, eliminating the rope-like neck bands called platysma bands. Finally, excess skin is removed using discreetly placed incisions behind the ears.

Additional Enhancements To Consider

Once the major contributors to facial aging have been addressed, we can really polish the results for each patient by addressing secondary and tertiary issues that factor into aging like dull skin, volume loss, and more.

Here are some of our more popular procedures that effectively address specific concerns. We'll sometimes refer to this as "the frosting on the cake." 

Skin Resurfacing

Skin is the canvas of the face. A great facelift with poor skin tone, texture, color, and clarity is not a great outcome. Laser resurfacing is ideal to rejuvenate the skin improving the skin and eliminating fine lines and wrinkles. The most commonly treated area is the fine lines and wrinkles around the mouth called “smoker’s lines.” These lines can’t be eliminated with a facelift as the skin around the mouth can’t be “pulled tight.” Peri-oral laser resurfacing is a component of most facelifts I do because every person has varying degrees of dynamic wrinkles that should be softened.

Fat Grafting

 As we age, we lose volume which is why most older patients develop thin, gaunt faces. Adding fat restores youthful volume, which is known as the “lift and fill” technique when done with a facelift. Common areas for fat grafting are the temples, tear trough area, mid-face/cheeks, nasolabial folds, marionette lines, and sometimes the lips. Fat is carefully processed to match a specific location. More dense natural fat is used for deep augmentation in the cheeks whereas filtered fat called micro or nano fat is used more superficially in the eyelids and lips.

Buccal Fat Removal

For some patients the opposite holds true. Patients with round or cherub-shaped faces can benefit from fat removal to give a slimmer and more angular look. Buccal or cheek fat can be removed through a small incision inside the mouth to create a slimmer appearance, highlighting the cheeks and jawline, which many people desire.


Watch the video here for a demonstration of buccal fat removal.

Lip Lift

As we age, the upper lip elongates and hides the upper teeth; central incisors. In repose the upper lip should cover all but 2mm of the upper teeth. When the lip elongates it will hide the teeth and give an older appearance to the mouth. A lip lift involves removing a small amount of upper lip skin using an incision carefully placed around the base of the nose. This lifts the lip and rolls it outward to give a more youthful upper lip without over-correcting in a way that appears unnatural.

Lateral Brow Lift

When the lateral aspect (sides) of the brow is droopy, the endoscopic or open full brow lift might not be necessary. A much simpler technique can be used where the incision is hidden in the hairline and just a small amount of hair-bearing scar can be removed to lift the lateral brow. This rejuvenates the brow and upper eyelid by eliminating hooding most often seen in the lateral aspect of the upper eyelid and brow

The Takeaway

Regardless, it is important to remember that breast implants are NOT permanent medical devices and were never intended as such. Like everything we value, implants should be cared for and monitored.

At the appropriate time, implants can be changed for a new pair, and any desired changes made at the same time. As a patient, you deserve to have all of the information you need so that you can make informed decisions around your short-term and long-term plan for your breasts and that communication is clear with your plastic surgeon.

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