The newest Juvederm product, Voluma has been FDA-approved for use in restoring volume in the cheek area. Voluma has been shown to last up to 2 years.
If you loved Juvederm, you will love Juvederm Voluma even more! Voluma is made of hyaluronic acid (HA), a naturally occurring sugar in the body. In large part, the longevity of HA fillers has been determined by the amount of "cross-linking" of the molecules, meaning essentially how densely they're packed together. Voluma is highly cross-linked, to the point where the density of the filler allows it to last up to two years. This added density has not detracted from the smooth, silky way it goes into the face, but (aside from the fact that there is 20% more product in each syringe than there was with Juvederm's former incarnations) Voluma is definitely creating more fullness just from the density alone.
As children, most of us have lips with a rosy cherubic color. As the decades pass, the lips tend to fade in color and the contrast between the border of the lips and the skin around the lips becomes less defined. With the loss of definition the border can become irregular and any asymmetries in the contour of the lip borders can appear exaggerated.
This is where lip liner comes in. A "lip-colored" lip liner allows you to restore that border, smoothing its contour and restoring the contrast between the rosiness of natural young lips and the skin outside of the lip line. Keep the lip liner close to your natural lip color or the lip color you're applying that day. Lip liner that is more than a shade darker than your lip color will look artificial and harsh. While you can "push" the border a little bit if you want the look of more volume, it's important to keep the lip liner from going onto the flat part of the lip outside the border.
If you feel that you've lost so much volume in the lips that enhancing them with lipstick or liner is an exercise in futility, I can restore the volume of the lips with a very long-lasting technique that will look beautifully natural. With all the overdone and "trout-mouth" lips that frighten people out of restoring lost volume, the fact remains that those results absolutely never need to happen. The difference between a disaster or even mediocrity and a beautifully restored lip requires:
1. An in-depth understanding of the anatomy and embryonic development of the lips and the area around them, 2. Impeccable technique, 3. Commitment, 4. Experience, 5. The correct product to restore the lips and 6. Artistic skill to sculpt a beautiful and natural-looking lip while correcting asymmetries.
"I was out to dinner with a few friends and they were talking about how awful those filled-up lips looked. They were saying they'd never have it done. Then one of my friends turned to me and said how lucky I was that I didn't need it. I just smiled."--As related to Dr. Barbour by an actual patient whose lips she had restored.
My father always said that getting older is much better than the alternative. To rephrase the sentiment, when my patients bemoan their advancing age (and this often starts in their thirties) I tell them that we all have a turn at being a particular age -- unless we don't, which is not a terrific option. One of my favorite axioms is from a good friend who opined that "old" is always 15 years older than your present age. Since my patients range in age from their mid-twenties to their mid-nineties, I can attest to the truth of that.
What most people are really concerned about are all the associations we have with aging, and usually that would be a slow decline into feebleness and drooling insensibility. The good news is that our whole paradigm around that picture has changed radically over the past few decades. There has been a shift even in the past 10 or 15 years. As I've often advised my patients, anyone who is a toddler right now may very well grow up thinking grandmothers can be a blast to spend time with -- not to mention, really hot-looking. I surely have a bunch of those in my practice and they are an inspiration to us all!
Here in Sarasota where people more often than not come to have a ball rather than to fade away as they get older, we have a perfect observatory for examining what is at work in aging fabulously versus not so fabulously. Let's start to take a look.
This is not a Pollyanna-ish thing, but acknowledging its importance is absolutely fundamental. On a physiologic level, things work a bit like this: If you routinely see the glass as half empty, not only are the endorphins ("happy" peptides that are secreted in the brain) not being secreted, but there's something else going on as well. Negative thoughts actually can place the body in a state of inflammation. This in turn causes aging of the cells in the body. Life is full of stressors for all of us. This can be anything from a careless remark that hurts to an entire range of family problems, a health issue or someone trying to destroy our life and/or our career. Remember that there are always things over which we have no control. We certainly have no control over what other people do. What we absolutely do have control over is how we respond to it. And this is where we have to be completely honest with ourselves and decide what that response is going to be. Given a perfectly normal period of anger or hurt, ultimately we have a choice between crawling under the bed and sucking our thumb, being mad at the world or dusting ourselves off and moving forward. Moving forward generally involves either attempting to rectify the situation or accepting it. Books are written on this, professionals are trained to help people with it and there is always at least someone who will be on your side. But ultimately, it's just really your call.
I remember during a particularly devastating time in my own life (I'm writing a book about it), I decided to take stock of it all. I bought one of those little journals with the blank pages. It had a muted pink linen cover with a beautiful botanical drawing on the front. This was to be my "grateful book". I began listing all the things for which I was grateful, even though I was feeling crushed by life at the time. Each entry was numbered: 1.I have a 3-digit IQ 2.I have the use of both arms 3.I have the use of both legs 4. There is a ceiling over my head 5.It is attached to a ceiling over a kitchen 6.In which there is a refrigerator 7.With food in it….You get the picture. Before I knew it, there were over a hundred items on that list. I just made it an exercise to review that list every morning. I pass this on because it was immensely helpful and so healing that it compelled one friend to say, "You're just like one of those Bozo the Clown toys. You get punched and then just pop up again." "Gee, Bozo the Clown," I replied, "I haven't had a compliment like that from a man in ages!"
That exercise was difficult at the time, but it was good medicine. More later.
As we age, our eyebrows often tend to rotate down and in a bit at their outer ends. They also may thin and start to turn gray just like the hair on our heads does. The process is so insidious that we often don’t realize what is happening and that our brows may be part of the reason we suddenly notice that we look “tired”. Here are just a few tips on keeping a youthful brow. Know that I’m speaking in generalities since every individual is unique.
One of the hallmarks of a youthful brow is contrast between the color of the brow and the skin. While we want to keep our look as soft as possible as we age (since Father Time wants us to look harder and even angry), the whole upper third of the face will look prettier if the brows are well-defined. They truly are a frame for your eyes. The conventional wisdom is that we should keep the brows close to or a bit lighter than the hair color. If your hair is very light brown, blonde or gray, this rule does not apply. If the brows look faded, try a slightly darker shade of brow color. Give yourself a good day for your eye to adjust to the new color as the immediate change may throw off your perception of how it really looks.
If the brows are thicker, they will generally look younger. Pull out an old photograph of yourself and see if your brows are thinner than they used to be. If so, thicken them up a bit with your brow color, and again give yourself some time for your eye to adjust before nixing the result.
Ideally, the outer ends of your brows should be at the top of your brow bone, not curving down over the most prominent part of the rim. If the outer ends are lower than the inner ends, try lifting your brow color toward the topmost brow hairs laterally to improve the balance.
Also ideally, the outermost tip of your brow should be along a line that extends from the nostril through the outer corner of your eye on each side. Hold a pencil along that line and see where it falls when it reaches your brow. Since the ends of the brow tend to thin as we age, they can actually look shorter than the best proportion for you if you don’t extend it a bit.
Whether it’s just a matter of improving your brows with cosmetics or a situation that may require my help, we are just a phone call away if you need me or my wonderful aesthetician, Jill.
To a certain extent – and within reason – that’s true. As you can well imagine, it’s certainly more likely that we’ll get a more youthful look with a more youthful patient. Regarding the longevity of the result, the more healthy the tissue on which we’re working, the more likely it is to retain the results of the surgery, and younger tissue often translates to more healthy tissue. Also, it has been shown that younger people generally tend to be happier with smaller levels of rejuvenation than older people are with even more dramatic levels of rejuvenation.
That being said, volume loss and sun-damaged skin are better treated with volume augmentation and lasers respectively than with a facelift. Both of these conditions tend to show up earlier than the conditions that are best treated with a facelift, those being the effects of gravity, accumulation of fat at the jowl areas, and stretching and shifting of connective tissues beneath the skin.
Remember too, that any invasive procedure will alter the anatomy somewhat. Structures are moved and stitched into a different position, and the nature of some of the operated tissue changes just by virtue of the natural healing process. So the fewer times someone has a lift over the course of their life, the lower the risk of complications.
Chronological age has less to do with age than individual genetics and lifestyle choices. I remember one day when I was operating, I had a 48 year old and a 64 year old back-to-back. The scrub nurse commented that even before the surgery, the 64 year old looked closer to 48 and the 48 year old looked closer to 64. The bottom line is that “how old” we look is becoming less and less a matter of numbers.
Lastly, make sure your doctor is someone whom you can trust to have your best interests in mind. A couple years ago I had a patient from out of town who had been told that she needed several things done including a facelift, and the fees came to well over $17,000. She was a beautiful, fit 36 year old with a slight genetic obliquity under her chin rather than the well-defined angle we associate with a young neck. She also had some early hooding at the upper lids and the beginning of some volume loss between her cheekbones and her nose. She had absolutely no indications for a facelift, much in keeping with most women that young. I gave her the contour she wanted at her neck, restored her upper lids and gave her some volume where she had lost it for way less than what she had been quoted and with much less invasiveness.
Thank you for the beautiful work on my neck lift and upper eyelids! I've had a double chin and turkey neck even as a teenager and now I look and feel beautiful!
- Julie A.
The Starflower Essentials skin care products are made right here in Sarasota, Florida, although the ingredients are sourced from all over the world. Cherylyn Van Kirk, the alchemist of Starflower, dedicates herself to finding the highest quality ingredients for her products and combining them for super-efficiency without the irritation that can occur with some organic products. Her ingredients are all food-grade, truly organic and cruelty-free. The products have an amazing ability to calm, hydrate and clear without any heaviness or greasiness at all. They are pristinely packaged in glass and have a shelf life of about 18 months in most cases, without any synthetic preservatives at all.
It’s been well over a decade now that we’ve come to appreciate the major role that volume loss plays in the appearance of facial aging. But prior to that, the best institutions, the textbooks and the journals were still teaching us that excess fat in the lids was a major culprit and that it needed to be rather enthusiastically removed. Aside from the foundational understanding that we tailor each procedure to the individual and that at least some minor amount of fat removal is a part of many upper and lower lid blepharoplasties, we are a lot smarter now than in decades past about preserving volume around the eyes and lids.
So the short answer to your question is “Yes”. However, we have certainly evolved in our techniques so that should no longer be an issue. Know however, that just having birthdays causes our eyes to sink somewhat. As I’ve discussed (probably ad nauseam to most of my patients), our skulls shrink significantly over time and we can see from imaging reconstructions that the body of the skull gets smaller and all the holes -- that would include the orbits (eye sockets) – get bigger. And that’s part of the reason why our eyes tend to sink back and down, even without any help from an old-fashioned blepharoplasty.
On the other hand, the “sags and bags” of aging lids can make us look and even feel tired or sad; and a well-done blepharoplasty can wake up the entire face and be immensely life-affirming.
Oculofacial Plastic Surgeon, Sarasota, Florida
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