Question: I hear a lot about the importance of facial analysis. What is analyzed and why is it important?
We now know that multiple tissues of the face are involved in aging, including bone, fat, muscle, and skin. We also know that these tissues seem to age independently and each influences the aging of proximal tissues. Although the sequence of age-related changes is predictable, the pace of those changes varies. It is crucial to bear this in mind when developing a facial rejuvenation plan for a patient.
For example, the most commonly treated area when a patient walks into a cosmetic clinic is the nasolabial fold; however, in a lot of 50-year-old women who are going through perimenopausal bone loss, the lower third of the face looks 5-10 years older than the mid face or the upper face. So if you make the mid face look even younger by filling the nasolabial fold, you have taken the face out of perspective. I think that this practice creates a face that isn't harmonious, that doesn't seem to go together, and the final effect is that the patient looks "filled" or "done."
Facial analysis is a process. It is a read, not a recipe. It isn't a checklist that the physician goes through, looking for glabellar lines, tear troughs, nasolabial folds, and marionette lines, and then fixing what needs to be fixed. We know that some changes that physicians note clinically and that patients say bother them are the end stage of a longstanding, underlying global process. We are constantly gaining new insights into what changes and where it changes as the face ages. This knowledge allows us to address the underlying process and achieve much more natural-looking results.
In conclusion, facial analysis is important because it allows us to focus our attention on rejuvenating the particular facial tissue and the particular region that seem to be aging the face we are treating, thus creating harmonious results.
-Rebecca Fitzgerald, MD (Clinical Instructor; UCLA - Los Angeles, CA)
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