Beneath the surface the very way the facial muscles attach themselves to your bones is under the process of re-modeling. This will lead to bone re-absorption and loss of structure beneath the skin. The most obvious region is the chin, where the area beneath the bottom lip and chin become hollowed out both from restructuring and loss of volume.

Although it is inevitable that these changes in our face will occur over time, there are a number of non-surgical ways to give your lower face a helping hand.

The Lips and Mouth

Signs of Ageing As we age the lips thin and retreat from the vermillion boarder that naturally outlines the lip and defines their shape. The most feminising aspect of a female mouth - the philtrim or the delicate lines from the base of the nose to the cupid bow of the lip - elongate and also lose their youthful look.

Treatment
To define and plump the lips once again, lip augmentation can be used - this is a very popular walk in walk out procedure. Lip augmentation is a treatment whereby dermal fillers, such as Juvéderm® are carefully injected into the lips to re-volumise them.

Balance is the key. To get the best results from this technique it is important that you seek a doctor with a good aesthetic eye. Ask to see some real patient's 'before and after' pictures -this will avoid the greatest fear of the first time lip augmentation "trout pout", often created when too much volume is added to the upper lip.

To further soften the "pull down" effect of active muscles, a small injection of BOTOX® into the lower jaw will relax the muscle enough to lift the edges of the mouth, and can sometimes create a small curl in the mouth corners - a popular technique amongst celebrities.

The Naso-labial folds

Signs of Ageing

The collagen change and bone remodeling is leading to a slippage of the cheek apple and the development of a more prominent naso-labial fold. These folds are not always offensive (think Angelina Jolie) however over time they can become quite deep in some individuals. A prominent and high cheek bone is a sexual signal and anthropologically it is associated with high fertility and youthfulness, and hence the reasons why we seek to re-create this look either with surgery, fillers or blush.

Treatment
Youthfulness is associated with a round face with a firm jaw line. By using a technique referred to as "facial rebuilding", Juvéderm® is used to replace the slipped cheek apple and plump up the cheek flats leading to a natural softening of the naso-labial folds and a redefining of the cheek bone.

As a strategy I offer patients a two step procedure. First we use Juvéderm® to create a look they are happy with, and then insert another product Sculptura to help stimulate their own "plumpness". Over time the patient experiences a natural fullness and progression to youthfulness without the need for invasive surgery.

This two step procedure is ideal for those patients for whom surgery is not an option and for those who have a thinned, almost gaunt face. The most important aspect of this combined technique is flexibility, ability to add to the procedure, and a maintenance regime to maintain the very natural looking results.

For those who feel they do not require a facial rebuild technique, direct injection into the naso-lablial folds can remediate this area immediately. This involves injecting directly into the line of the fold and then placing struts of Juvéderm® to provide structure to the area which results in a slightly longer lasting and more satisfying result.

The Chin

Signs of Ageing

The chin is often forgotten when considering the beauty of a woman's face, however bone remodeling and sun damage along with collagen change and acne scarring can leave one of the most prominent parts of the face highly exposed.

A hollow can develop between the lower lip and corners of the mouth heading towards the jaw. Again this area is not often thought about when we look in the mirror but it contributes highly to the strength and visual impression of the jaw.

Treatment
In this region, Juvéderm® can be injected to fill the hollow. This technique is also useful for those who suffer acne scarring. The right technique also helps with the visual presentation of jowls, leading to a firm outline to the face. Creating a natural face Creating a natural face requires an analysis as to what changes are taking place, as well as an assessment as to where the problem is occurring - is the jaw line or hooding the main problem, or are you experiencing loss of volume in the cheeks and slippage of the cheek apple? A well designed treatment program leads to a satisfying and natural look where the face is in balance.

Dr Gabrielle Caswell (BSc, BSc, MB;BS, BA) is a Cosmetic Physician with four clinics in rural NSW and the Gold Coast operating under the Eyra brand, named after the Viking goddess of medicine and beauty. Special interests include injectable cosmetic medicine, laser technology and other tools modern medicine uses for the remediation of sun-damaged skin. More recently, Dr Caswell developed the Caswell and Marcells product range designed for Beauty Therapist use. Visit www.eyramedical.com.au for more information.