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One of the first things you will find when you see an aesthetic doctor is they will ask you what is bothering you about your face – usually they will hand you a mirror at the same time. This is a really important thing to think about beforehand as different things trouble different people. Are you looking to be generally more refreshed and relaxed or is it more specific? You may love the laughter lines around your eyes but be really concerned with the downturning at the corners of your mouth – it’s about what you see when you look in the mirror. Your doctor will listen and, if they are experienced and thoughtful, will let you figure things out as to the real issues bothering you before offering their own opinions and advice. If you have had a chance to really think this through before your appointment you won’t feel so flustered when asked.

So, as we learned earlier in the book the face ages in a variety of ways and these processes are what lead to the concerns we develop with our appearance. Lots of things combine together to cause this overall ‘older’ face including:

● Wrinkles and deep lines- These can be when you are actively using the muscles of facial expression (i.e. smiling, frowning, etc) but over time these temporary active lines stay there even when relaxed causing ‘static’ or permanent lines.
● Pigmentation – age spots, freckles, sun damage and broken veins, etc
● Skin becomes more loose and less elastic due to lack of collagen and elastin
● Fat pads shrink and move south causing hollows and folds
● Bone is reabsorbed especially around the eye sockets and jawline
● Skin texture becomes drier and rougher – leads to a ‘dull’ look

The combination of these all produce the typical facial ageing that we all see. In women, this starts around age 35 years but men tend to have a better time of it and things start in earnest around age 60.

Once you have figured out exactly what it is that is bothering you the next thing to consider is how much you want to change it. Are you looking for a drastic and dramatic alteration in a short period of time, or are you wanting a subtle improvement that is slowly built up? The trend nowadays is more for the gradual, subtle improvement with most people as they don’t want it to look too obvious to their friends and family, but some do want to have that instant ‘wow’ factor.
If there is only one thing that bothers you and you love the rest of the character of your face then that is great – concentrate on that and you will be happy. It’s easy to be caught up in what can be done, especially in a clinic that might be a bit more pushy on the commercial side, and not focus on what should be done. Saying that, if there are several concerns then discuss that with your doctor – figure out where is the most beneficial to start and what order is best to proceed.