22 Jan 2026
One of the interesting things about facial aging is that patients will often come in for an appointment and bemoan the fact that whatever is bothering them seemed to spring up overnight. Even in an area like the neck, which has become a “hot spot” thanks to the fact that we all stare at ourselves all day on screens, patients may be more conscious about the signs of aging in the lower face/neck, but many still feel as if one minute, things were ok and then — BOOM, everything headed south.
Obviously, this is not actually the case. There are early signs of facial aging that patients don’t notice, but surgeons do. Does this mean that you should schedule a facial rejuvenation consultation with a Board-Certified Facial Plastic Surgeon, such as myself, at the first sign of a wrinkle? I don’t ever think it’s a bad idea to get assessed early so that we have a baseline for aging, but it’s always going to be a personal decision. However, if you do decide to come in to the office, here are some of the things that I’m looking at.
Facial Aging Consultation
The thing about facial aging is that it is multi-factorial. Your crow’s feet may be what brought you in, but there are multiple forces at play that are creating these annoying lines. During our meeting, I will listen to what it is that you don’t like about your appearance. I’ll ask a lot of questions about your medical history, family history and any prior procedures you may have had. I will then perform a physical exam to assess:
- Skin tone & texture
- Fine lines & wrinkles
- Areas and degree of volume loss
- Sagging skin
- “Jowling”
- Delineation at chin/neck juncture
- Muscle laxity, if any
Together, we’ll discuss treatment options that could address your concerns. Younger patients may be ideal candidates for non-surgical treatments to improve skin texture and induce the body to produce more collagen and elastin which may improve a mild to moderate degree of skin laxity.
What Are the Early Signs of Facial Aging that Patients Don’t Notice, but Surgeons Do?
So, what are the early signs of facial aging that I notice, but maybe you don’t? Here are the most common ones in my Boston area practices:
- Subtle mid-face volume loss
- Early descent of the cheek fat pads
- Softening of the jawline
- Neck changes before face changes
- Loss of skin elasticity even without visible wrinkles
- Changes around the eyes
As mentioned, there are effective non-surgical options for dealing with many of the above. These include:
- Botox®
- Dermal fillers
- Lasers
- Micro-needling with or without radiofrequency (RF)
- Chemical Peel
At Boston Center for Plastic Surgery (BCPS), we have a well-deserved reputation for delivering non-surgical facelift results by layering the appropriate selection of procedures for addressing the underlying causes of your facial aging. As mentioned, this can be a nice choice for younger patients who still have good skin elasticity. But what if the sagging in your skin and tissues is more severe?
Facelift is the Gold Standard for Sagging Skin in Boston
A facelift has been and remains the gold standard for lifting and repositioning a moderate to severe amount of sagging skin and tissue. It gives me the most access to restore definition to your chin/neck juncture, lift loose tissues in the lower face and neck, and address muscle laxity in the neck, if needed. A facelift can be a stand-alone procedure, but I will often combine it with dermal fillers or fat grafting to restore volume in the mid-face/cheeks. All of this will be discussed with you in detail during your initial consultation. As a double board-certified facial plastic surgeon, I am adept in all facelift techniques, including the cutting-edge Deep Plane Facelift. The right option for you is always going to depend on your individual anatomy, goals and lifestyle.
To find out more about a deep plane facelift, or any other surgical or non-surgical procedure with Dr. Akshay Sanan at the Boston Center for Plastic Surgery, contact us today or call (617) 402-2768 to schedule a consultation.
