Many of us want to restore a youthful appearance. Looking in the mirror may feel overwhelming as the years go by, seemingly in the blink of an eye. However shallow some may see it, feeling good about your reflection in the mirror boosts self confidence and puts a smile on your face. 

What causes a tired, aging appearance?

As we age, the quality of our skin, volume and structure of our face declines. As collagen, elastin and oil production diminishes, the texture and quality of skin declines and is further compromised by sunspots arising from sunlight damage over the years. 

The volume and fullness in our face is affected by loss of subcutaneous fat, especially in the midface areas, bringing the muscles closer to the surface, creating and accentuating the formation of lines and wrinkles and producing a hollowed appearance. 

The structure of our face is obscured by sagging skin because at some point, gravity wins.  

Restoring a youthful appearance requires three steps:

Step 1. Improving skin quality: Medical-grade skin care is the first step to healthy skin, and incorporating non-surgical treatments can have a profound effect on signs of aging. Advanced medical grade skin care can help restore, protect and correct signs of aging with replenishment of lost nutrients, protection from sun, free radicals and intrinsic factors of aging and brightening skin from dyspigmentation. Fine lines, wrinkles, and brow position (chemical browlift) are markedly improved with Botox, Dysport, and Xeomin when injected properly. Skin peels, hydrafacials, microneedling, lasers, and intense pulsed light (IPL) accelerate correcting signs of aging and can be tailored to the individual and their budget. 

Step 2. Volume restoration: Dermal fillers are the most modern addition to the plastic surgeon’s toolbox. These fillers add volume and fullness to the face to improve and strengthen its structure. Dermal filler brands vary in their composition, qualities, areas of injection, requirement for treatments, and duration of efficacy. 

Using dermal fillers to restore a youthful appearance may delay the need for surgical intervention for some time, such as with a “liquid facelift.” 

Dermal fillers bring fullness to the cheeks, plump lips and improve dark circles under the eyes, soften lines around the mouth, strengthen the jaw line and can improve hollowing in the temples while elevating the lateral brow.

Step 3. Enhancing structure: The most effective way to restore a youthful structure to the face with a strong jawline, youthful brow and alert appearance is achieved through surgical intervention. A facelift elevates and repositions skin in the midface, improves the appearance of the jawline, and re-creates a firm neck. Browlift re-establishes the natural eyebrow shape and placement at a height just slightly above the bony rim of the eyes. 

Eyelid or blepharoplasty is possibly the biggest bang for the buck in plastic surgery with minimal operative and recovery time. A modern eyelift reliably restores youthfulness of 10 years or greater, especially when combined with lower eyelid lift and facelift. 

Mathew T. Epps MD, MS, DABS is a triple fellowship trained aesthetic plastic surgeon specializing in facial, eyelid, and breast surgery. or