21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

There comes a point in the aging process, and it’s different for everyone, where your reflection in the mirror no longer syncs up with how you actually feel. This dichotomy is probably the number one reason why an over 40 patient comes in to see me. Many younger patients today start their skincare journey much earlier. Thanks to the internet, they understand the importance of “prejuvenation”. This is a term I use to describe treatments that will slow down or delay the aging process. Regardless of age, one of the first conversations that I have with any new patient is how to age gracefully.

The aging process is different for everyone.

What Causes Facial Aging?

In order to understand how to age gracefully, I find it helpful to discuss the underlying causes of facial aging. To start, aging is never about just one thing. Instead, it is multi-factorial. This is why everyone ages at his or her own rate. Some of the factors that affect the aging process are:

  • Genetics
  • Healthful diet
  • Consistent exercise regime
  • Proper hydration
  • Getting enough sleep
  • Skincare regime
  • Time spent in the sun
  • Smoking
  • Hormones
  • Living in or near a big city

During your initial consultation, I will listen closely to what bothers you about your appearance as well as what makes you feel most attractive. I will ask you specific questions about your lifestyle choices and skin goals. I will then perform a thorough assessment of your skin tone and texture. My purpose is to help you uncover what aging gracefully means to you.

View more Dermal Fillers before and after pictures

Individualized Treatment Plan

In order for a treatment plan to be successful, it must be tailored to your individual needs. Not only is every patient’s anatomy unique, but what bothers your best friend or sister about her face may not be an issue for you. Some patients come in hyper-focused on:

  • Skin texture
  • Fine lines & wrinkles

Others don’t really care about a wrinkle or two, yet are completely bummed out by skin discoloration such as:

  • Brown spots
  • Hyperpigmentation
  • Redness
  • Broken blood vessels

Defining what facial aging means to you is the first step of your rejuvenation journey.

Slow Down the Aging Process

Delivering a natural look is the foundation of my practice philosophy. This is why, for me, aging gracefully is about slowing down the aging process not stopping it in its tracks. Lasers and energy based devices are the key to naturally turning-back-the-clock. The right one is going to depend on your goals. As a laser expert, I have a deep understanding of the pros and cons of each. I will typically use one or more of the following to improve skin texture issues, discoloration, and mild sagging:

For patients with a more moderate to severe degree of skin laxity, I will often recommend Profound RF which combines micro-needling with radiofrequency energy.

Lasers or Fillers?

Injectables, which is the overall term for neurotoxins and fillers, is probably the most recognizable aesthetic procedure on the market. The problem with its popularity is that most patients don’t really understand what an injectable procedure does, and think it’s a panacea for everything. I can’t tell you how often a patient will often come in asking for filler to address his or her “jowling”. Drooping skin around the mouth/lower face is a common problem area.  However, trying to “lift” sagging skin with filler will only wind up making you look like an overstuffed monkey.

Skin laxity is due to a loss of elasticity. At around 25, your body’s production of collagen and elastin declines. One of the many reasons that I love lasers is that they induce your own body to ramp up its production of both. Since collagen and elastin are the two building blocks of plump, lifted skin, a laser or energy based treatment can deliver an improved look to your jowls.

Fillers for Volume Loss

Fillers definitely have their place. I generally use them to replace lost volume, and improve the appearance of:

  • Fine lines and wrinkles
  • Deflated or disproportional lips
  • Under eye hollows
  • Prominent veins on the back of the hands

As with lasers, the key is choosing the right filler for the job. A heavier weight filler is good for the mid-face/cheek area while a lighter weight filler is better for those fine lip lines. This is why it is so important to see a board-certified cosmetic dermatologist such as myself who is trained in all of the skin rejuvenation modalities. Aging gracefully is about doing only what needs to be done to keep you looking and feeling refreshed. I want people to tell you that you look great, not ask what you did.

To find out more about lasers and fillers at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.

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