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Update on treatment rationale and options for the ageing face

Dulguerov, Nicolasa; D'Souza, Alwynb

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2011 - Volume 19 - Issue 4 - p 269–275
doi: 10.1097/MOO.0b013e328348c1cb
Facial plastic surgery: Edited by Julian M. Rowe-Jones

Purpose of review Techniques for rejuvenation of the ageing face continue to evolve rapidly as we gain further understanding of the ageing face. This article reviews various noninvasive, nonsurgical and surgical options in light of the recent clinical research and provides some pointers for management.

Recent findings The ageing of facial structures depends on genetic, anatomic, chronologic, and environmental factors. For optimal rejuvenation various anatomical structures should be treated in combination using appropriate modalities. This involves management of the skin envelope, subcutaneous tissues including facial fat compartments, muscles and bony skeleton. Treatment outcome may be measured using a validated, objective, quantitative facial grading scale.

Summary A brief overview of the facial ageing process is presented, based on which a treatment plan is suggested in order to target specific anatomic structures. Recent literature pertaining to cosmoceuticals, injectables, lasers and surgical options is briefly discussed. It should be stressed that a thorough analysis of the ageing face is mandatory for planning appropriate treatment, monitoring, achieving optimal outcome, and furthering our knowledge.

aSt Mary's & University Hospital Lewisham

bUniversity Hospital Lewisham, London, UK

Correspondence to Mr Alwyn D'Souza, University Hospital Lewisham, Lewisham High Street, London SE13 6LH, UKTel: +44 208 297 4774; fax: +44 208 297 4775; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.