Dr. Ernst N. Kaplan
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FACIAL COSMETIC SURGERY

What is facial aging?

There are actually four forms of facial aging. Each of these is caused by a different mechanism and respond best to different kinds of treatments The four general causes of facial aging are: Muscle wrinkles, Gravitational folds, Volume depletion, Surface damage

Muscles Wrinkles

Your face is animated by many small muscles that create emotional expression and open and close the eyes and lips. These muscles are attached to the skin so that when the muscles contracts, they compress and bend the skin causing wrinkles. Repeated bending of the skin damages the skin collagen and creates permanent wrinkles. Muscle wrinkles are located horizontally on the forehead, vertically between the brows (“frown lines”), at the corners of the eyes ("crow's feet"), along the cheek-lip junction (“smile line”), and radially around the lips (pucker or smokers lines). These wrinkles can be treated non-surgically or surgically.

After (top)
Before (bottom)


Gravitational Folds

Gravity pulls down the heavy loose skin with underlying fat or muscle. These folds are seen as smile lines or puppet lines to the side around the mouth, the jowl lines of the jaw, and the folds under the chin and neck. This type of aging is best treated by surgery.

Volume depletion/Skin inelasticity

Aging and/or weight loss causes a reduced volume of the fat, muscles and bone and the skin. Also, the skin loses its elasticity and cannot shrink to compensate for the loss of volume. This combination of volume depletion and skin inelasticity results in skin folds and drooping of the neck, jowls and cheeks.

Before & After

Before & After


Surface damage

Youthful skin is smooth, even colored and extremely well hydrated with waters and oils. Damage of the skin surface and dermal collagen and elastic layers is caused by natural aging, reduction of hormones, cigarette smoking and the sun’s ultraviolet rays. The skin becomes, leathery and inelastic. In addition, the surface develops brown patches, dilated blood vessels and has a crepe-paper-like texture. This is best treated with a variety of crèmes, skin peels, lasers.

Before & After