I wish I could tell you that the number of hours I spend on zoom/teams has improved this summer, but I cannot. As most of us know, there has never been so much personal face time as we all have today. Prior to March of 2020, I looked in the mirror about once a day and that was it. Sure, I bet my appearance and specifically my hair would have benefited from some attention, but it seldom got it. Today, it is unavoidable. We all stare into the screen and start our own critical self-assessment, often without solutions. The simple solution is to turn off my camera but video conferencing etiquette frowns on that so I offer to you the 5 things that I wish were different about my video image and what I should do about it!
1) Static and Dynamic lines of the forehead
I don’t know why but I have always disliked my forehead lines. I am an expressive individual, and these tend to be exaggerated and deep. They are responsive to botulinum toxin but require a higher dose given the strength of my muscles. It is a bit of a balancing act in that stronger muscles require more toxin which may in turn drop one’s brows. To attempt to avoid this complication, we have to be a bit more conservative injecting primarily in the top half of the forehead, accepting a bit more mobility and lines so the brows do not drop.
Should one have very deep lines, noticeable both with animation and when relaxed, often a filler can be added (used in combination with toxin) to “fill and plump out” the lines. This works very nicely.
2) Low Brow
The appearance of a low set brow can create a tired appearance and may impact one’s visual acuity, particularly when looking upward and outward. In both men and women, there can be a falling of the brow most often seen in the outside portion or tail of the brow. This creates a tired appearance and increases the heaviness of the upper eyelid area. One of the telltale signs of plastic surgery is an overly exaggerated brow (following treatment) creating a startled appearance. This is even more noticeable in males, as they tend to have lower brows to begin with. So, any changes made to the brow must be done conservatively.
Often the easiest way to create some mild elevation is with botulinum toxin. Injection of the “brow depressors” will elevate the brow a few millimeters helping to open the eye up. Some patients may benefit from the addition of adding a filling agent in this area. This helps create a more youthful appearance and simulates brow elevation. In patients looking for a more definitive procedure, a surgical browlift can be performed. Fortunately, things have evolved from the days of extensive incisions to accomplish this goal. This frequently can be achieved through small, localized incisions to help elevate the brow to a more normal position.
3) Hollow Lower Eyelid
Our face undergoes many changes during the aging process. In my mid 30’s I began to notice a gradual loss of volume or fat in the middle part of my face underneath my eyes. This creates an illusion of a “lengthening” of the eyelid and a tired appearance. Once can also see this in patients who lose weight. In some cases, weight loss can have a dramatic impact on the facial appearance, creating a deflated appearance. Hyaluronic Acid fillers are products we can use to help restore some of the volume loss we experience with aging or weight loss. Injected in this specific area, we can see improvements for 9-12 months. It involves a simple procedure done in the office under a topical anesthetic and ice. There typically is minimal downtime associated with the procedure. The results create a more rested appearance which is youthful!
Not many people 57 are happy with their necks. There are many factors that contribute to having an aging neck.
Excess skin requires surgical excision in most cases . This can be done using traditional facelifting techniques or may be accomplished with a direct neck excision. In some cases, where a patient may be a bit younger and good quality skin, a skin tightening procedure may be performed such as FaceTite, Morpheus, Profound or Ulthera.
Visible edges of the muscle can be tightened and repaired at the surgical procedure. I do not feel some of the office-based procedure work very well for the muscle. Even Botulinim Toxin is a bit unpredictable in this area.
Fat is best treated by liposuction which can be performed in the office under a local anesthetic. The results can be dramatic and impact the skin in the area which tightens in response to the procedure.
In some patients, salivary glands can give the appearance of a full neck. For many, that is just who they are they simply live with that appearance. In others, it is problematic, and they chose treatment. Botulinum toxin can help “shrink” the gland temporarily. Others chose to remove a portion of the gland during facelift or neck procedures. I do not perform this procedure but appreciate that some patients would benefit from it.
Pigment in our skin makes us look older. One of the many goals we have for our patients is to make the skin look more even and homogeneous. This can be accomplished in a number of different ways including skin care, light treatments, peels, and lasers.
We are very excited to bring in a brand new device that will be more effective, particularly for stubborn pigment. The mJoule has two treatment modules:
- HERO – This takes the intense pulse light device we have had for nearly 20 years and makes it faster and more effective decreasing discomfort and the number of treatments required. The continuous application of energy allows for a more uniform treatment.
- MOXI – This new laser seems ideal to treat stubborn pigment more successfully than many of the other treatments attempted in the past. Of course, this will require a good skin care program with our aestheticians and diligence with sun protection. We hope to have this up and going by mid-July.
Check out before and after photos of real patients with some of the same concerns!
I hope that by me sharing with you some of the concerns I have looking at myself on zoom that you will appreciate that there are some relatively simple, office-based procedures that can be done to help improve the signs of aging and sun damage. I have not done all of these, but my time is coming! Our team is geared up to help you work through your zoom-phobias! I shared mine, what are yours?
Did you know? We have clinics in Dallas and Frisco- contact us here for your consultation with Dr. Kenkel!