A Classification of the Aging Face
and Its Relationship to Remedies
(Journal of Clinical Dermatology, Cosmetic
Dermatology, Summer of 1998 Issue – Douglas G. Hamilton, MD from the Department of
Dermatology at the UCLA School of Medicine in Los Angeles, CA)
Abstract: Appropriate therapy
requires meaningful and accurate diagnosis. Nowhere is that more the case than with the
changes found in the face as it ages. A classification for these changes is presented
based upon tissue location, clinical morphology, clinical location, and etiology.
Appropriate procedural remedies are then presented for each type of change.
Condensed Version of Article Follows:
| Table 1. Changes
in facial contours occurring with age |
Type of
Change |
Tissue Location |
Clinical Morphology |
Clinical
Location |
Etiology |
A |
Muscular |
Laxity (sag) |
Cheek (may intensify
nasolabial fold), neck and eyelids (bags) |
Genetic (intrinsic)
loss of tone; bone shift; gravity |
B |
Musculo-cutaneous |
Furrows |
Forehead lines
(horizontal); frown line (vertical); smile lines, upper lip (deep) |
Repeated facial
expression |
C |
Cutaneous |
Wrinkles |
Cheeks, crow’s
feet, perioral, forehead lines (superficial) |
Photoaging, intrinsic
aging of skin |
D |
|
Combination |
|
|
Type A |
Type B |
Type C |
Type D |
| Table 2.
Appropriate Treatments |
Type
of Change |
Optimal
Treatment |
A |
Rhytidectomy (with or
without implants); Blepharoplasty |
B |
Filler Substances:
Injectables/Implants – Alloderm, Artecoll, Autologen, BOTOX, Dermalogen, Fat,
Gore-Tex, Isologen, Soft-Form, Zyderm/Zyplast Collagen |
C |
Resurfacing: Laser,
Chemical Peel |
D |
Combined Approach |
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