As we age, our facial structure changes. Sometimes we know what’s changed, aren’t certain how or why this is occurring or, more importantly, what may be done to address the concerns. One of the main issues for our patients is a loss of facial volume due to thinning of the skin. When this happens, not only do we lose volume, but the skin we do have shifts which then affects the structure and shape of the face. We also lose muscle and skeletal mass as bone gets reabsorbed by the body. The face becomes elongated and the heart shape or upside down triangular shape of a more youthful face becomes the opposite.

We often hear that the eyes are the windows to the soul, and women often complain that their eyes are testimony to the aging process. We’d like to suggest that it isn’t the windows that have necessarily changed but the frame of the windows. The “frame” being the mid-face. A young face appears rounded with soft contours. Whereas, the aging face displays a more angular appearance where there is more defined borders and hollow areas.

restylane los angeles before and after photoslos angeles restylane before and after photosBecause of gravity and age facial muscles begin to contract which leads to a downward and inward pull. This is represented by drooping of the eyelids combined with a constant contraction of the frown lines (between eyes) and crow’s feet (sides of the eyes). The mouth begins to contract in a purse string effect. This then leads to the fine lines so annoyingly known as “smoker’s lines.”

As the volume of tissue in our faces change, jowls along the jaw line appear and pockets of volume loss below the corners of the mouth also known as marionette lines show. The mouth may become thin with a loss of definition and fullness. We begin to see a flattening and enlarging the surface area between the bottom of the nose and the upper lip. In contrast, consider the youthful mouth that has a defined border and full body to the lips.

What are the options for those interested in slowing down the aging process with Botox and injectable fillers? Or, more importantly, how can we look like we used to without an unnatural appearance? The traditional face lift may not be the most appropriate solution because of the loss of volume. If we understand that the factors involved in aging are volume loss as much as gravity, the ideal treatment is to restore the volume before deciding if surgical intervention will be beneficial. This is where Botox and cosmetic dermal fillers such as Restylane, Juvederm and Perlane play a valuable role.

By relaxing hyperactive facial muscles with FDA-approved Botox Cosmetic and adding volume with FDA-approved cosmetic fillers (Restylane, Juvederm, Perlane), we can restore a more refreshed appearance – a natural, more youthful and appealing look. The many techniques and products offered in accomplishing this goal is considered “shaping” of the face, and there is an artistry involved in these injectable treatments. Be certain to choose a practitioner that has an aesthetic eye and appreciates the individual canvas that they see before them.

Facial Shaping Techniques

Wrinkle Removal

Restylane injections before and after-pictures


Lori Haney, RN, MEP-C

Certified Medical Laser Safety Officer

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