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  William J. Binder, M.D., F.A.C.S.
  120 S. Spalding Drive, Suite 340
  Beverly Hills, CA 90212
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  310 858-6749
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Facial Aging

The aging process is a complex one that is not completely understood. However, for this discussion, we will limit our focus on the outward changes to the appearance of the face and neck, their basic underlying causes and what can be done to minimize or reverse them.

Volume Loss

In general, the appearance of facial aging is largely due to the loss of deep and superficial adipose (fat) tissue that have the following effects:

arrow image  A decrease in thickness and elasticity causing the skin to relax and sag.
arrow image  Soft tissues caving in causes depressions to occur in the face
arrow image  Volume loss of the lips. The lips become thinner and shorter (in both the vertical and horizontal dimension)
arrow image  Increased depth of the facial folds and wrinkling of the skin.

This volume loss of fat tissue has a significant impact on how youthful someone appears. One analogy used is an inflated beach ball compared to the older beach ball that gradually deflates over time. Even aging athletes such as marathon runners and weight lifters experience significant loss of fatty tissue of the face that produces a gauntness or a hollowing out of the cheeks and midface, causing them to look much older than their real age.

Weakening Facial Muscles

Other signs of aging produced by weakening and sagging of the facial muscles are formation of jowls along the mid-jaw, skin hanging under the chin (turkey gobbler deformity) and the formation and deepening of the nasolabial folds and marionette grooves.

Modern Facelift Surgery

Contemporary facelift surgery differs vastly from the old stretch-and-tighten facelift procedure. Today, revolutionary facelift techniques focus on creating dramatic, yet solid, long-lasting changes that are natural in appearance. They correct underlying skeletal structural deficiencies and effectively reposition and contour the underlying muscle layer and skin. For these reasons, the surgeon must have the necessary training to understand and effectively deal with the anatomy and underlying structures of the face.

Individualized Approach

As the skin begins to sag and fatty tissue layers are lost, imperfections in the contour of the face become very noticeable. Additional procedures can be performed to support or augment both the bony and soft tissue structures of the face. Implants can improve the flattening that occurs over the midface and cheekbones or enhance the contour of the chin and neckline.

Facelift surgery is performed on both men and women, and corrective procedures vary from person to person. While one individual may need a complete face and neck lift, another may only require elevation of sagging eyebrows or fat removal from the lower eyelids. Another may need only correction of an early double chin. A person whose facial appearance is very weather-beaten may also require a chemical peel or laser resurfacing. Occasionally a patient may require all of these procedures to maximize the outcome of the facial rejuvenation process. This is the basis for the multi-level approach to facial rejuvenation.

William J. Binder, M.D., F.A.C.S.
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Dr. Binder pioneered the "facial contouring" approach to facelift surgery that utilizes a 3-dimensional perspective to balance facial contours and underlying structure.
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