Many changes occur in our skin as we age: Our skin thins, we develop fine lines and skin coloration becomes abnormal, with dark spots scattered about. The aging face typically moves from a heart shape ― the youthful, plump cheek mounds ― to more of a rectangular shape as fat shifts and drops underneath the skin. Changes in the skin, the subcutaneous fat and muscle, and the underlying bone, lead to changes in our external appearance.

Improving facial appearance depends on the person and the condition of his or her skin. There are many options to achieve younger-looking skin, and some do not involve surgery.

Standard daily skin care is incredibly important.

Washing your face every day is simply not enough. Everyone over 25 should establish a daily skin care regimen that works for their skin type, in combination with sun protection of at least SPF 30 — the sun is one of the biggest agers. One of the most effective ways to delay the effects of aging is with a skin care routine that includes products with tretinoin. This is the one ingredient proven in large clinical trials to actually smooth fine lines and wrinkles, thicken the skin, and diminish uneven coloration.

Fight the signs of aging with periodic resurfacing.

Resurfacing is an anti-aging treatment that can be done with chemical peels, laser treatments or dermabrasion. These procedures “sand off” or exfoliate the upper layer of the skin in varying levels to remove dead skin cells and allow new skin to resurface. These treatments can help reduce the appearance of fine lines, acne scars, blemishes and hyperpigmentation caused by sun damage to a greater extent than the routine skin care described above.

The type of resurfacing will depend on your skin’s type and condition. Treatments go from light to moderate to more aggressive, dramatically softening wrinkles and erasing fine lines. Your skin probably will be bright red or raw after a resurfacing session, and the recovery time will depend on the depth of the procedure. For example, after moderate resurfacing, your skin can take up to three weeks to recover.

Restore volume with fillers.

Another approach to facial rejuvenation is to restore or “fill in” the volume that has been lost beneath the skin. This can be done by transferring fat from an area in the body to the face. Fat can be injected into the cheeks, nasal folds, lips or wherever needed. Since it is your own tissue, the possibility of complications is minimal, but there is no way of predicting how long the results will last — it varies from patient to patient.

Another way to restore volume in the face is with synthetic injectable fillers. There are several to choose from. Among the most popular ones is hyaluronic acid, a natural component that makes up our native skin, which means the risk of rejection or reaction is low. When injected, hyaluronic acid serves as a cushion, plumping and restoring suppleness to the face. The effects of hyaluronic acid fillers can last for about a year.

Smooth out lines with Botox.

Botox is a purified version of botulinum toxin. When injected in strategic places in the face, it relaxes the muscles, reducing the appearance of wrinkles. It is especially effective for smoothing the creases between the eyebrows and in the forehead, and the crow’s feet that form when we smile. The only downside is the effect is temporary ― for most patients, it lasts about three to four months.


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Content courtesy of Lisa E. Ishii, M.D., associate professor of otolaryngology–head and neck surgery at the Johns Hopkins University School of Medicine. The content was reproduced with permission of the Office of Marketing and Communications for Johns Hopkins Medicine International. Additional reuse and reprinting is not allowed. The information aims to educate readers and is not a substitute for consultation with a physician.