Understanding facial ageing

Written by: Ms Monica Fawzy
Published:
Edited by: Kate Forristal

As we journey through life, our faces undergo a myriad of transformations. From the subtle changes in skin texture to the more pronounced shifts in facial structure, ageing leaves its indelible mark on our appearance. But what exactly causes these changes, and how can we address them? In her latest online article, Ms Monica Fawzy gives us her insights.

The science of facial ageing:

The ageing process affects both the superficial and deep layers of our skin, leading to a multitude of changes. Skin becomes thinner, loses elasticity, and develops uneven pigmentation over time. However, perhaps the most noticeable alterations occur in the underlying facial structure. One significant change is the reversal of the 'triangle of youth,' where facial tissue gradually descends, centering along the jawline rather than the midface. This is primarily due to the loss of volume, including fat pads and even bone, as well as the sagging of the SMAS (superficial musculoaponeurotic system) muscle layer and overlying skin.

 

Understanding facial rejuvenation techniques:

Facial rejuvenation techniques, particularly facelifts and neck lifts, aim to counteract the effects of ageing by restoring lost volume, reducing excess tissue, and lifting sagging structures.

 

Facelift:

A facelift involves several techniques that target different anatomical layers of the face, such as the SMAS and periosteum (the thin layer covering facial bones). The procedure typically begins with an incision in front of the ears, varying in length based on individual needs and chosen technique. Less invasive techniques, like SMAS plication, focus on tightening the superficial aspect of the SMAS layer and are suitable for early to moderate facial ageing. On the other hand, more invasive approaches, like deep plane facelifts, involve dissection under the fibrous layer for a more extensive lift but may require a longer recovery period.

 

Neck lift:

A neck lift addresses sagging skin and muscles in the neck region, often performed in conjunction with a facelift due to the continuity of the SMAS layer between the face and neck. Techniques may include lateral platysmaplasty and anterior corset platysmaplasty, which lift and tighten the superficial muscle layer. Excess fat and glands under the chin can also be addressed during a neck lift, with procedures such as submandibular gland reduction and digastric muscle thinning.

 

Combining procedures:

Many patients opt to combine facelift and neck lift procedures to comprehensively address ageing concerns. However, some individuals, particularly those with short hair or men concerned about visible scars, may choose an anterior neck lift alone.

 

Ms Monica Fawzy is an esteemed plastic surgeon. You can schedule an appointment with Ms Fawzy on her Top Doctors profile.

By Ms Monica Fawzy
Plastic surgery

Ms Monica Fawzy is a renowned consultant plastic surgeon with a private practice based in central London. She specialises in facial rejuvenation procedures (such as face/necklift, facial fat transfer, blepharoplasty, lip lift) and facial reanimation for facial paralysis.  

Her professional journey includes teaching anatomy at the University of Oxford and Guys Hospital, as well as training in various surgical specialties. She became a member of the Royal College of Surgeons in 2006 and pursued specialised training in Plastic Surgery in the East of England. This was complemented by fellowships in craniofacial and aesthetic surgery in Paris, followed by microsurgery in Cambridge. After completing formal training in 2015 and joining the GMC Specialist Register in Plastic Surgery, she expanded her expertise through visits to centres in Europe and the USA.

Monica currently practices reconstructive surgery within the NHS, focusing on head and neck microsurgical reconstruction and facial palsy. She has held leadership roles in patient safety and governance, serving as deputy program director and educational director of the post-graduate training scheme for plastic surgeons in the East of England. Additionally, she authored a popular textbook for trainee plastic surgeons and joined the national team of examiners for the final plastic surgery FRCS (Plast) exam.

Passionate about extending training opportunities globally, Monica has collaborated with surgical charities. She has been actively involved in the leadership team of organisations such as the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), the British Association of Aesthetic Plastic Surgeons (BAAPS), and the American Society of Plastic Surgeons (ASPS). 

In her private practice, Monica primarily focuses on facial rejuvenation surgery and facial palsy reanimation. Offering a comprehensive range of procedures, she tailors surgical plans to achieve natural results, considering each patient's unique facial identity. Her approach involves thorough consultations, during which she listens to concerns and assesses medical, personal, and work circumstances. Surgery is recommended only when she is certain that the patient is a suitable candidate, both physically and psychologically, ensuring they are fully informed about the associated benefits and risks. This commitment to personalised care underscores her dedication to preserving each individual's distinct facial identity.
 

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