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Gregory Branham, MD


Dr. Gregory Branham treat patients at the
Washington University Facial Plastic Surgery Center
605 Old Ballas Road
Creve Coeur, MO 63141
Phone: 314-432-7760

Question: I’m looking tired all the time. My eyes look swollen no matter how much sleep I get. I know I’m getting older but what exactly is happening to my face and what can I do about it?

Answer:  There are two basic patterns of aging that occur in the face and neck. The first, an involutional pattern, can be thought of as a grape turning into a raisin as it dries in the sun. This is primarily a problem of volume loss in both the soft tissues and the bones of the face. The second pattern is basically a sagging or gravitational change that occurs.

Although not always the case, most people will exhibit some combination of both of these processes. Often, by observing how your parents have aged, you can predict what gradual changes to expect in your facial features.

As we get older, the collagen and elastin in our skin breaks down from ultraviolet exposure and cumulative damage, causing the skin to be thinner and less elastic, and allowing the facial muscles to etch fine lines. Sagging changes result from a loss of muscle and ligament support that attach skin and soft tissue to the facial skeleton.

Treatment really depends on what type of aging patterns you are exhibiting and to what degree. Volume loss can be treated permanently with facial implants or temporarily
with injectable fillers. Implants are the treatment of choice for areas requiring large volume augmentation such as cheeks, chin and jaw line.

Injectables work best in the lips where a smaller volume and a softer feel are desired. For fine lines and texture changes, laser treatments are preferable to repeated injections.
Laser procedures stimulate your skin to make its own new collagen – which then functions as a natural filler. Sagging changes are treated with procedures that lift the soft tissues back to a more normal, youthful position, such as a facelift, neck lift, and brow or forehead lift.

Each person is unique and has a distinct pattern of aging that must be considered when developing a treatment plan. Only by considering these individual differences can we successfully rejuvenate the face and neck.
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Copyright 2009 Washington University School of Medicine
Copyright 2009 Washington University School of Medicine