1. Skin: age spots, wrinkles, large pores, loss of elasticity, sagging and clarity.
  2. Hair: thinning or receding hair line 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 might 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 thin, and the distance between the nose and upper lip elongates. The corners of the mouth may 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.

Treatment of aging features

  1. Good skin care. We prefer New Youth Cosmeceuticals. Resurfacing with lasers, e.g., Fraxel, or less invasive lasers like the Laser Genesis.
  2. Hair transplant with 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, etc., can be used, 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 lid lift. Usually under local anesthesia. Very rewarding for more youthful appearance.
  6. Lower lid 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 can add volume and 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. For 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. For sagging neck, a mini- or full facelift is usually best. Sometimes when the problem is only fat, liposuction (with ThermiTight, if skin also needs tightening), works very well. Often, men want the excess skin to be removed with a direct vertical excision. Recovery time is minimal and scarring inconspicuous.

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