We have written about the excellent results that plastic surgeons can get by rejuvenating your drooping and wrinkled face. You can look ten or fifteen years younger -- if you let us use every artistic trick we know. Gaunting is where our fatty padding thins out and our faces develop more valleys as time goes by. For most faces it shows up late in life — not until our sixties or seventies. "My face used to have baby fat, but now it has no padding at all. It's all angles!", said Mary, 70. "What can you do about it"?

Facial Rejuvenation: Smoothing the Hills and Valleys

Well, as plastic surgeons, we can do quite a lot to improve gaunting. We can't correct it quite as well as we can for the younger types of aging — drooping and wrinkling — but even if you have a lot of gaunting, we can still have you look terrific for your age.

Actually, some of your gaunting gets taken care of when we correct your droops and wrinkles. We can also perform some finesse procedures, designed specially to lower your hills and fill in the valleys.

We can lower the hills by smoothing down the jutting bony eyebrows or reducing the now-too-big-and-droopy nose. We can often use your own extra tissue to fill in hollow temples, fill in hollow cheeks and make thin lips fuller.

We can also fill in the deep corners alongside the nose, and we have been getting good results filling in the hollows under the eyes. Sometimes we can partially fill in the hollow above deepset eyes to make them look younger and brighter.

And there you have it … three types of facial aging … drooping, wrinkling, and smoothing and filling-in for gaunting.

The Candles on Your Birthday Cake

In a previous column, we said "rejuvenating the aging face is like creating a beautiful birthday cake." The three layers of the cake are: the face lift, the brow lift and eyelid procedures. The frosting is resurfacing the wrinkled skin to smooth it.

To top off your cake, the candles are the tricks of finesse.

• The corners of the mouth turn down with age, creating an unhappy or bitter look. A corner lift can make the mouth look pleasant again.
• The upper lip gets long, concealing the upper teeth. We can shorten it with a lip lift.
• The outer corners of the eyebrows droop, adding to the "drooping christmas tree look" of aging. We can lift them up with a virtually invisible scar. We call this the temple lift.
• The chin narrows with age. We can widen it with small implants.
• The lips turn in and get skinny. We have several tricks to make them fuller…
• As the skin begins to age, it gets a little rough and the pigmentation gets blotchy. We can improve it with a freshening peel.
• Later in life our skin gets raised moles, cysts, rough spots, red spots and brown spots. We often heat-wipe these away. "Hey, all my barnacles are gone." said one of our patients.
• The nose droops and the tip widens. There are several young-nose techniques we can use to shorten it and narrow the tip without having to have a complete nose job.

The Face: From Old to Young

She was animated and glowing. Beautiful hair. Lovely make-up. We were in the office looking at her "before" photos. Now the tired look was gone and she looked ten years younger. She took my hand and solemnly shook it. She chuckled and said, "I am so glad to have met you… back when I was older."

Cosmetic surgery may be for anyone who wants to look as good as they can. "I don't feel older, just more grounded and wiser. But these droops and wrinkles tell me… and the world… that I'm over the hill. I don't mind getting older. I just don't want to look it." Cosmetic surgery can get rid of the mask of age and create a harmony between our inner and outer selves. Then we can say, "I look like me again." And stride newly out into the world. Younger.

Harvey W. Austin, MD
Box 1470
Berlin MD 21811
email: h.austin@mchsi.com