Facial features are continuously changing throughout one’s life. Here are some of the most common:

1. Skin: age spots, wrinkles, large pores, loss of elasticity, sagging, and loss of clarity.

2. Hair: thinning or receding hairline in both men and women

3. Loss of facial volume: Youthful faces are full and convex. Aging causes loss of volume in skin, fat and even bone, causing shadows and hollows.

4. Sagging brow: Brows sag with age, particularly the outer brow. There should be an arch between the middle and outer third of the brow. 

5. Upper eyelids: Excess skin, and even fat, occurs with age, causing a “tired” appearance. Sometimes excess skin covers the lashes.

6. Lower eyelids. Bags and/or excess skin may develop. Dark circles are usually shadows from volume loss and/or protruding fat pads.

7. Crow’s feet: wrinkles lateral to the eyelids, usually from sun damage and animation. Also, frown lines and forehead furrows.

8. Lips: Aging lips get thinner, and the distance between the nose and upper lip elongates. The corners of the mouth might turn down, giving a “sad” appearance.

9. Jowls: These develop from loss of volume and elasticity.

10. Neck: Excess skin and/or fat develop. Platysma muscle bands might occur.

The good news is that options are available to treat the signs of aging. Common treatments include:

1. Good skin care treatment: Cosmeceuticals work best combined with resurfacing with lasers, e.g.  Fraxel; or less invasive lasers like the Laser Genesis or a Hetter Peel are very effective.

2. Hair transplant: micro grafts, preferably FUE (follicular unit extraction) with Neograft, or strip excision technology called FUT.

3. Fillers: such as Restylane products (e.g. Lyft), Juvederm products (e.g. Voluma), Sculptra, and Bellafill, the longest-lasting filler, can be used, and often in combinations for the best overall results.

4. Brow lift: under local or general anesthesia according to the extent of the procedure

5. Upper eyelid lift: Usually done under local anesthesia. Very rewarding for a more youthful appearance.

6. Lower eyelid lift: to remove skin, fat pads or both. Laser resurfacing can be done at the same time to remove fine lines.

7. Botox or Dysport: for crow’s feet, frown lines, forehead furrows, and even elevation of the corners of the mouth and diminishing mouth wrinkles.

8. Fillers in lips: These can add volume and/or reduce wrinkles. A minor lip lift procedure can also be done with inconspicuous scarring under the nose – an excellent procedure when indicated, called a “buckhorn” excision.

9. Jowls: A facelift is usually indicated. Some improvement can be achieved non-surgically with fillers on each side of the jowl along the mandible and with micro-liposuction of the jowl.

10: Mini- or full facelift: For sagging neck, when the problem is only fat, liposuction with Renuvion to tighten saggy skin is needed. Often men want the excess neck skin to be removed with a direct vertical excision. Recovery time is minimal and scarring inconspicuous and it effectively removes the extra skin.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com