• Cosmetic Services
• Blepharoplasty
• Facelift Surgery
• Endoscopic Forehead Lift
• Midface Lift
• Facial Fat Transfer
• Fraxel re:pair
• Threadlift
• Rhinoplasty
• Sculptra®
• Otoplasty
• Peels/Laser/Dermabrasion
• Lip Enhancement
• Frown Lines
• Chin/Cheek Augmentation
• BOTOX®
• Dysport
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• Radiesse®
• Restylane®
• Perlane®
• Juvederm®
• Acne Scarirng
• Scar Repair
• PCA Skin®
• Rhinophyma
• Facial Spider Veins
• Rosacea & Brown Spots
• Reconstructive Services
• Skin Cancer
• Trauma
• Birthmarks

Dr. Buckingham:
Hi. What I'd like to talk to you today is a little bit about our philosophy related to facial aging and therefore facial rejuvenation procedures.

When you look in the mirror at someone when they're thirty and compare that to say when they're fifty or sixty, you're going to see several key features related to how their faces aged. You're going to see things that have been affected by gravity, such as jowling as it develops along the jaw line where the fat pad of the face has descended and is now interrupted the contour of the jaw line. You are going to see the brow that has perhaps descended and is now causing hooding or covering up part of the eyelid. The other thing you're going to see is facial volume loss.

We think that this is an unbelievably important part of facial aging, but many people who do a smattering of facial plastic surgery really miss out on and don't rejuvenate. In fact, people who go in and have three and four facelifts - they're just missing the boat. People don't really need to have three or four facelifts to create that unnatural appearance. What they're really missing is facial volume. And what I mean by that is as you age, especially the area under the eye and in the cheek, you lose volume. You develop a double convexity, as we call it, of the lower eyelid where you have a slight pouching of the orbital fat, or the fat within the eyelid, and then a groove underneath the eyelid with a deflated cheek.

So I challenge you to look at a picture of yourself in youth and really see what that lower eyelid cheek contour looks like. I think what you'll notice is that the eyelid appears short, or in other words, the cheek is built up and forms a nice convexity as it flows into the lower eyelid which appears very short. Older surgical techniques, mainly blepharoplasty of the lower eyelid, that just removed fat from this region really just converted a convex lower eyelid to a concave lower eyelid, but it still has a long appearance and the face still appears deflated and doesn't have the youthful volume that it needs. The third aspect of facial aging is really the skin itself. And that is that it relates to wrinkles, brown spots commonly known as dyschromia, red spots, other features that are just effecting the skin and its appearance and not making it look uniform - primarily related to time and sun damage.

The skin is treated through a variety of methods that start with good skin care. We feel strongly about our skin care regimen which is known as PCA. It's a physician only skin care line and it really does wonderful things to tone the skin and prepare it for perhaps some other more aggressive procedures such as Fraxel laser or skin resurfacing with chemicals that will really give you a boost to rejuvenate and decrease the amount of wrinkling and brown spots on your skin. So as you come into our office and we ask you to tell us what your concerns are we're really going to go through the areas of your face starting with the upper face, which consists of the brow and the upper eyelids, and then the middle face, which is the lower eyelid and cheek, and then the lower face, which is the jaw line and neck. And we'll listen to your concerns about which one of these areas are affecting your desire to look in the mirror and look a little bit more youthful. Related to each one of those areas then we can talk about gravity, how volume has changed and what procedures we can do affect those areas. The gravitational changes are typically corrected with things like blepharoplasty, browlifts and lower facelifts.

Volume is corrected usually by using your own adipocytes or fat cells from another part of your body which we harvest through a very small incision and implant into the deep structures of the face using small hollow tubes known as cannulas.This really rejuvenates and restores the lost volume of the face and it brings back that nice convexity extending into the upper cheeks and lower eyelid. And then we may look at some sort of surgical procedure to address the skin changes that have occurred. So, all of those things will happen during your consultation. That's our philosophy on facial rejuvenation - both gravity, volume changes and skin related issues. And throughout the rest of our website, there are other videos and informative areas that can talk about the individual procedures and there's many before and after pictures of patients who've had these procedures done. And I think if you look at those, you'll see that we really strive to achieve youthful, natural results - turning back the clock. We don't want anyone to be able to look at our patients and say "Gosh, that person had cosmetic surgery done."

We really want you to able to fool people into thinking that you really are younger than you are. There's no reason we shouldn't be able to achieve those goals when we address facial rejuvenation through this technique.

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