Gravity is Over-Rated in Facial Aging

At a recent plastic surgery conference in Paris, most physicians admitted that we have been wrong.  Gravity is not the primary cause of facial aging.

Surely, as the face ages, muscles and ligaments do grow more lax.  Therefore, the skin is definitely subjected to the vicissitudes of gravity.

• As we age, the eyebrows do tend to descend--by a few millimeters.
• 3% of aging patients have a downward movement of the corners of the mouth--by 1-2 millimeters.
• In many patients, the upper lip does tend to lengthen.

"Just a few millimeters?  And just 3%?!  Then, why do I look so old?" you might be thinking.

Here are the real reasons why the face ages:

1. volume loss (wasting of fat and osteoporosis of bone)

2. repeated contractions of facial muscles (muscle hyperactivity)

3. skin damage (especially from sun and tobacco)

While the eyes of an observer may perceive significant downward movement in facial structures, objective measurements do not support these common assumptions.  What we are seeing is a combination of cutaneous aging and structural aging that gives the illusion of descent.

Since gravity is not a primary cause of facial aging, should you cancel your lift?  Not necessarily.  Sometimes, a surgical lift does give a great result, even if it is not addressing the issue of aging entirely appropriately.  Plastic surgery is, in truth, as much art as science, and sometimes art does trump science!

However, with this new information, I am going to recommend to my patients in Ventura that they consider...

1. more fillers (especially Sculptra) to increase the facial volume
2. more muscle relaxants (like Botox and Dysport) for over-active muscles
3. more skin care and lasers to minimize skin damage