It happens to all of us: We get older and our aging shows on our face, skin and hair. Here are some common concerns and potential ways to address them.

Signs of aging:

• Skin – age spots, wrinkles, large pores, loss of elasticity, sagging, and loss of clarity.

• Hair – thinning or receding hair line in both men and women.

• 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.

• Sagging brow – brows sag with age, particularly the outer brow. There should be an arch between the middle and outer 1/3 of the brow. 

• Upper eyelids – excess skin and even fat occurs with age causing a “tired” appearance. Sometimes excess skin covers the lashes.

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

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

• 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.

• Jowls – these develop from loss of volume and elasticity.

• Neck – excess skin and/or fat develop. Platysma muscle bands may occur.

Treatment for aging features:

• Good skin care. We prefer New Youth Cosmeceuticals combined with resurfacing with lasers, e.g.  CO2 or less-invasive lasers (Cool Peel Laser) or a Hetter Peel is very effective.

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

• 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.

• Brow lift – under local or general anesthesia according to the extent of the procedure

• Upper lid lift – usually local anesthesia. Very rewarding for more youthful appearance.

• Lower lid lift to remove skin, fat pads or both. Laser resurfacing or Hetter peel can be done at the same time to remove fine lines.

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

• Fillers in lips 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” lift.

• Jowls – facelift is usually indicated. Improvement can also be achieved non-surgically with fillers on each side of the jowl along the mandible and with micro-liposuction of the jowl.

• Sagging neck, a mini- or full facelift is sometimes best. When the problem is only fat, liposuction with Renuvion (to reduce loose skin) works very well.  Excess neck skin can also be removed with a direct vertical excision.

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