Facial rejuvenation procedures should be customized for each patient

The term "facial rejuvenation" can be applied to many popular procedures, and it's important to understand which procedure is right for you and your goals. When it comes to your face, "one size fits all" is not the right way to approach these procedures. Every face is unique, and your treatment plan should be customized to your needs and anatomy.

Prior to your consultation with a board-certified plastic surgeon, be sure to write down your concerns about your facial appearance and questions you would like to ask. New patients frequently ask, "What do I need, doctor?" I always respond by saying, "You don't need cosmetic plastic surgery; however, what bothers or concerns you about your appearance?" Even when a patient informs me that it is their jowls or cheeks that are the issue, I always perform a complete facial assessment from the forehead down through the neck region. It is important to realize that every component of the face is connected and we need to look at the big picture.

Volume loss vs bony foundation

When assessing a patient, I always determine the issues concerning their underlying bone architecture in comparison to their soft tissue, skin and muscles. Addressing one concern may not necessarily fix the other. When augmenting the cheeks, there will be some natural lifting of the midface. Likewise, a chin augmentation will similarly tighten the neck. While these two are modest changes, neither will correct excessive laxity of the skin, significant volume losses or facial muscle atrophy/laxity.

Surgical vs nonsurgical procedures

There are many nonsurgical and minimally invasive treatments for an aging face. I try to approach facial rejuvenation with a conservative philosophy. Neuromodulators such as botulinum toxin are still used regularly to treat wrinkles, frown lines and crow's feet. I use these treatments as a way of determining if the forehead wrinkles are significantly bothersome to the patient. The patient may need a brow lift to fully address their concerns or it may be possible that their concerns can be managed conservatively with minimally invasive treatments.

Dermal fillers allow patients to view themselves with a fuller appearance while treating just the areas of concern. As I explain to patients at the time of their consultation, the good news is if you don't like the way you look with dermal fillers, then the results will go away. The bad news is, if you like the way you look with dermal fillers, the results will go away. In the case of both botulinum toxin and dermal fillers, there is no downtime, no incisions and you can always get more if you like the results.

If a patient requires tightening of the face and/or neck or treatment of the underlying soft tissue foundation, then they will most likely require a surgical procedure, such as a facelift and/or neck lift. In several cases, patients can receive significant improvement with a combination of bony augmentation with either cheek augmentation and/or chin implants, along with botulinum toxin and dermal fillers. I frequently perform lower facial liposuction of the neck and jowls at the time of the bony augmentation and use the retrieved fat for fat grafting to the face, if needed.

Achieving your cosmetic goals

Do your homework prior to a facial rejuvenation consultation, and make sure your consultation is with a board-certified plastic surgeon. When it comes to your face and health, be sure you've researched the procedure and never cut any corners. All patients do not require, nor should they have the same facial rejuvenation procedures. Every patient is individual and unique – and their treatment should be too.