As we age, our faces age as well. Since we present our faces to the world every day, it is normal that we are most concerned with these unwanted changes in our faces — other areas we can simply cover up. Traditionally, we have attributed these changes to the effects of gravity and environmental factors, such as sunlight exposure. However, we also are aware that there are genetic factors which affect aging, in addition to the effects of stress. For evidence of the effects of stress, look how much the presidents appear to age in just four short years.

In the face, we notice sagging in the cheeks and jowls, as well as in the neck, which is affected the most. Also, we acquire “circles” under the eyes, the flattening of the cheek-bone area, and increased puffiness and lose skin around the eyelids. Since these are the most typical signs of aging, traditional remedies have revolved around the “nip and tuck” procedures, such as face lifts and eye lid surgery. These are still important procedures in the correction of the aging face and remain the first line of defense in this ongoing battle.

However, in recent years, studies have shown that we also tend to losefat, muscle, and bone mass with time. If you look at a “young” face you will notice certain common features. A young face, in fact, looks “fatter”. This is not an insult, it’s actually the principal characteristic of a youthful face. Pick up any magazine and have a look. You’ll notice that in younger individuals the cheeks are fuller, and the “cheek-bones” flow gracefully into the lower eyelids and into the temple areas. Also the jawbone areas look fuller, and flow smoothly toward the chin without interruption. This is because critical “volume loss” of fat in the face has not begun.

With these observations in mind, we now consider the “aging face” in a different light. We have long known that we must eliminate the loose and sagging tissues with traditional techniques. But we now recognize that, in order to capture the essence of youth, we must also recontour the face. Some newer procedures such as midface lifts are a step in that direction. We also however can see the importance of facial contouring with the “fat transfer” technique. This is taking fat from elsewhere in the body (which, I am sorry to say, most of us have in more-than-sufficient quantities) and placing it in those areas described above that need “volumizing”.

The combination of this kind of fat transfer with traditional procedures and more-recent surgical techniques is a thrilling new development which I call “Total Facial Rejuvenation”.