As a facial plastic surgeon, a deep understanding of the aging process is important. With this knowledge we can diagnose unique problems with each of our patients, and then provide the best advice for correction. Doctors Prabhat Bhama, Alyn Kim and I are just about to publish a chapter on principles of facial aging in a book edited by Dr. Mack Cheney of Harvard University. I thought a few insights from our introduction might be interesting to know and, so, a précis!
The search for a “fountain of youth” dates back centuries, being depicted in paintings and literature from ancient times. All of this indicates our perpetual fascination with youth and beauty. We also know that our feelings about youth and beauty are intertwined – one begets the other – and that this is true in all cultures. Studies between Western and native cultures consistently reveal that all humans rate “attractiveness” and “beauty” similarly. And the characteristics they define as such…? They are those that are exaggerated markers of youthfulness. The face is a genetic “health certificate” indicating one’s youthfulness and reproductive capacity. It reflects that our primary goal as humans is to increase the numbers of our species to ensure our survival.
As we age, many of us feel that our loss of a youthful look defies our inner sense of youth, and therefore belies the real person inside. In fact, a recent American study showed the average 50-year-old really felt they were about age 40 and a 65-year-old age 50! And so it is easy to understand why so many people consider facial rejuvenation surgery to create an outer appearance reflecting their inner sense of self.
The earliest record of the facial “peel” was 3,500 years ago, and the first documented facelift was done in 1901 in Germany. Although many books dating back centuries have presented reconstructive facial plastic surgery, the first book on purely aesthetic surgery is credited to Miller in 1906. Botulinum toxin has become the most studied of all drugs in the last 15 years, and constant improvements in the variety of facial fillers have expanded the numbers of people who are considering rejuvenation procedures.
Being developed and refined now are significant potential surgical and non-surgical treatments to be refined. Think lasers, ultrasound, growth factors for healing, stem cell transplants and face transplantation, amongst others. Of course, most of us hope that anti-aging therapies such as diet, vitamins, minerals, physical fitness and emotional centering will preclude our need for more significant interventions. Only time will tell what the future will bring. But what we do know is that the search for the “fountain of youth” will continue. It is our biological imperative.