Support for The Structure

Dermascope – March – April, 1992

William Binder, M.D., has more than a decade of research and patient care experience in facial plastic and reconstructive surgery. He helped create a new vista in plastic surgery known as facial contouring.

Today, he uses computer technology to perfect the implant design. Efforts to keep men and women looking younger through facial rejuvenation have been around for decades. People who could afford to do so have asked surgeons to make strategic nips and tucks or dramatic face lifts to compensate for the effects of aging, to correct facial deficiencies, or to recover from injuries.

Face lift surgery has been the most popular request of plastic surgeons over the years. It is designed primarily to lift and tighten loose or sagging skin and is particularly helpful in removing jowls and the redundancy of skin and muscle found in the aging neck. In analyzing the effects of face lift surgery over the past 15 years, studies have shown that face lift techniques alone may not be enough to restore the vibrancy that people identify with youth and beauty. In fact, in some instances, the consequences of face lift surgery alone may prove to be just the opposite of what is desired. In some individuals, if the skin is over-stretched against the underlying bone, the patient may appear taut, drawn, or “mask-like,” making the patient look less healthy or natural. The effects of aging or damage from disease or injury are not shown only in excess skin, but in the loss of underlying facial support, whether in soft tissue or bone. Looking at photos of an individual over a lifetime reveals that soft tissue, starting with the fullness of a baby’s face, gradually lessens over time. A somewhat leaner appearance emerges in early adulthood, and for some, spare or even hollow lines of maturity come later. Over time, the thick supporting tissues gradually thin out and fail to maintain the skin at the levels of elasticity which characterize the faces of youth. This natural process of atrophy or gradual loss of soft tissue results in the underlying bone structure becoming more apparent over time. People with “great cheekbones” or similar attributes are not as affected by the aging process-others find previously unnoticed features, such as asymmetrical structure, to appear more noticeable.