Face or Body?

Face or Body?

Many of us like to maintain a healthy lifestyle which includes eating well and exercising. It’s important to take care of your body from the inside out…which shows on your skin and on your face.

However, as we age, we begin to lose fat and volume from the face, and also start to show signs of sun damage such as brown sports and wrinkles from working out, outdoor sports, and the aging process.

The important question becomes…Face or Body?? Do I need to gain that extra 10 pounds in order for my face to be fuller and rounder? Or do I work out, train hard, and have no fat on my face?

If you are in your late 30’s to early 40’s and are reading this, you know exactly what I mean. Many patients come in for consultations because they work out frequently and want to maintain a fit, trim shape, yet they are noticing that when their weight is at a desirable level, the face looks thin.

This is very common among women who exercise competitively, who train several times a week, runners, bikers, swimmers, etc.

Also, in the land of Hollywood, there are many actresses and television personalities who want to be thin and to look good on camera but want to maintain youthful looking faces, which need volume and fullness. There is a fine line between maintaining the body and the face, and fortunately, there are some options so that your face can be full, plump, and healthy and your body can be slim and trim at the same time.

First, let’s ask: Where do you lose volume and fullness? Starting at the top of the face, the temples around the eyes can start to thin out, indent, and become concave. This can make your eyes look tired. The under-eye area can lose fat and results in a sunken or hollow area under the eyes.

The midface, or cheeks and naso-labial folds, or laugh lines can become noticeably deflated and start to drop or develop creases. The lips also get thinner as we age, along with the upper lip which becomes longer.

The jowls and jawline can also either lose volume or start to drop as well as around the chin and directly under the lower lip. The chin can become very angular looking. Marionette lines, or vertical lines on either side of the chin can also begin to appear, making the face look square shaped, rather than heart shaped which is the most desirable look.

The neck, which should always be addressed with the face, can also start to show signs of aging. The skin is thinner, and the first thing we notice are sagging bands which are called the platysmal bands. Also, loose skin directly under the chin which is also called the “waddle” can be a combination of fat and loose skin.

So how do we maintain volume in the face while wanting to stay in great shape?

Non-Surgical Options: These are options that have no downtime, however are not permanent:

If there is a small loss of volume you can start with fillers such as Restylane, Juvederm, or Perlane. They are made of Hyaluronic acid and can be injected anywhere in the face…temples, eyes, cheeks, lips, nasolabial folds, marionette lines. The result is immediate and it can last up to 6 months. Voluma was recently FDA approved for cheek augmentation. Another great option is Radiesse.

Some people who exercise a lot and have high metabolisms may notice that the product might diminish faster, and you might need a touch up after 3 months. Voluma lasts longer, and is said to last up to two years in some patients.

Radiesse is a calcium based filler that works really well in restoring volume to the temples, cheeks, and deeper lines in the face. It remains in your body for a longer period of time (about a year). It also works great when injected into the tops of the hands to replace lost fat there.

Sculptra is a volumizer that is injected into the face that stimulates your own collagen production. The results are not immediate, and you do need an allergy test first. It takes about 6 weeks to see results, and are gradual but they can last for up to 2 years. Usually about 3 to 6 treatments are done about 3 weeks apart to get optimal results.

Surgical options:

Fat transfer is probably the most popular and easiest surgical option that there is. Fat is removed from one part of your body and transferred to any part of your face. Even the thinnest people will have an area of fat that can be used to transfer. It does require anesthesia which usually is a General Anesthetic, but if it is a small area sometimes the surgeon can do it under sedation. Usually patients who do fat transfer have tried and used the fillers mentioned above and like the results, but now just want to move to something more permanent.  Fat transfer can last for 1 to 3 years, sometimes more, but may need to be repeated.

Including PRP on its own or with fat transfer is another option. The down time is only a day or two…there is some bruising that might happen which can be covered up by a good concealer… i.e. Dermablend or Joe Blasco. It creates a softer contour and looks great especially around the eyes and temples.

Cheek implants and facial implants sometimes have a less than desirable reputation that goes along with them…however if they are done correctly and are done by someone who does this frequently it can be a great option. They are permanent, but, if for some reason you do not like them, they can be removed.

Chin implants as well are very popular and can balance the face nicely. The downtime is about a week as there is some swelling and maybe bruising after the procedure.

What about brown spots and sun spots on the face and chest?

It is essential to always wear sunscreen on your face, chest, and hands when outdoors. Sun damage really does not start to show until you are in your late thirties, and then it’s too late, and the damage is done. You can, however reverse some of the damage!

IPL (Intense Pulsed Light) lasers will treat brown spots and discolorations on the face, chest and hands.

Fraxel laser and fractionated lasers such as E-Matrix Sublative laser will resurface the skin and tighten pores. There is minimal downtime…some redness that resembles a sunburn can be expected.

Skin care is also essential!

Exfoliate once a week, and use a retinoid product. Do not neglect your neck and chest. Also, a skin crème with a mild bleaching agent will help to lighten brown spots.

Eye crème is very important. Use it twice a day and even in during the day if you can.

Wear sunglasses when outdoors.  Squinting from being in the sun (especially those who do outdoor sports) will add small dynamic wrinkles around your eyes. Make sure the lenses are high quality to block out all the damaging rays.

Drink plenty of water at all times, but especially when travelling and exercising! Do not wait until you feel thirsty, that means that your body is already dehydrated. Water is essential to all the cells in your body, especially your face.

In the quest to stay fit and in shape, the term “Face or Body” comes up a lot with patients and their Doctors. He or she can help you in deciding what you want to address, and what avenues and choices there are for you based on your budget, time, etc.

If you look at many celebrities in their early 40’s who work out frequently, you will notice that their faces look fuller now than they did 5 or 7 years ago. Jennifer Aniston, Courtney Cox, and Sandra Bullock are some great examples of what a small amount of filler or fat can do.

These are some of the secrets of how to maintain you face and your body and look and feel fabulous all the time. Again, always do your research and choose what the best is for you and your lifestyle. We are all different and everyone has their own vision of what is beautiful, which is something to remember!

Sylvia Silvestri, R.N.