While our faces are all different, there are basic aging principles that apply to all of us – Muscle motion, weight changes, and genetic predisposition, all influence the our loss of facial volume or fullness. The cheekbones serve as an upper support for the skin that drapes below. The upper jaw helps to support the skin that drapes beneath it. In the middle, is the “sub malar” area, just below the cheekbone. When this area loses volume there is atrophy, or a look of ‘hollowness’ in the face.
The mouth has a circular muscle surrounding it that enables talking, eating, kissing, and laughing. That’s a lot of function for one muscle group and it’s the reason why the first signs of aging are frequently around the mouth. Loss of lip volume, vertical lip creases, and deepened smile lines are what usually drive us to seek treatment.The problem occurs when the natural anatomy is not examined and the filler is injected “textbook” style instead of tailoring the treatment to your unique anatomy. A poor result happens when filler is forced into an area that didn’t have significant volume in the first place. Lips that were never full cannot not suddenly become full when we are older. If there was no space for genetically determined volume to be present, the tissue will stretch in an unnatural way to accommodate the filler.
The over-averted, stretched look is known as “duck lips”. This “over the top” look is exaggerated when the volume loss under the cheekbone is not treated. When you have too much fullness or over correction in the lower face, and a hollowed depression in the mid face, it is known as the “muzzle effect”. For the most natural result, the natural anatomy of the entire face should be evaluated and balance restored. The transition from one plane of tissue to the next should be smooth in the entire face, and sometimes this can only be accomplished by placing filler in the cheekbone, or just below, providing a lifting effect for the lower face. (Imagine raising a tent) Variations of this procedure are known as the “Filler Facelift”.
I know that sounds like a lot more expense if additional syringes are needed. It is more expensive, but so is healthy eating. And there is no worse emotional expense than a poor result. As more than has one patient put it: “I feel like a fool!” It is really a wonderful time to age! Look at your own face with an artistic eye and make a list of questions and concerns about how your face is aging. Hold your practitioner accountable to educate you. Check credentials and get referrals. And, when you have a great result and get those compliments, share with your friends. Believe me, they’ll know it’s not all genetics and you’ll look even more beautiful for sharing!
