"Aging Gracefully"
One definition of the word subtle by Oxford Dictionary is “a change so delicate or precise as to be difficult to analyze.” Subtle is the focus of my cosmetic treatments. The goal is never to make you look overdone or like someone else, rather to enhance your natural born features and turn back the pages of time on the face. In my opinion, if you can tell someone has had work done, it wasn’t done correctly.
I often hear people say that they “want to age gracefully.” That can have many meanings, but in general, my opinion of aging gracefully is living your best life and embracing who you are with confidence at all stages of your life. For some, this might mean feeling good about letting the gray grow out and avoiding ever stepping foot in a plastic surgeon’s office. For others, it might mean just the opposite. Some want to focus on maintenance and being able to hold on to a more youthful appearance for as long as they reasonably can. Both approaches are ok, it’s more about what makes you feel happy and confident.
One of the first places that we see visible signs of aging on the face is around the eyes. Many of these lines and wrinkles are caused by the muscles involved in facial expression; scowling, squinting, raising the brows. Lines caused by muscle contractions are known as "dynamic" wrinkles. Over time and with repeated creasing, these lines can remain at rest and are also now static lines or wrinkles.
BOTOX® Cosmetic and DYSPORT® are two very common injectable treatments known as neuromodulators. They are not “wrinkle fillers”, rather they are medicines injected in the muscles to relax the muscle and minimize “dynamic wrinkles.”
It is always very important to me that my patients have a clear understanding of not only the procedure(s) that they are considering, but also the reasons behind why I am suggesting a particular treatment plan. I spend my time during a consultation to ensure that all questions are answered, that my patient is comfortable with the treatment plan, and that they have realistic expectations of the treatment outcome. You can grab a handheld mirror as you read this article, and I will walk you through part of a consultation with me!
If you look in the mirror and make a scowl, you will see the area commonly known as the “11’s”. For many, you will see two vertical lines form between the brows when you scowl, hence the common term “11’s”. For others you might just make one vertical line and some might see three vertical lines between the brows. These lines are caused by the medial brow depressor muscles working together to pull inward and downward. Now put your finger on the outer edge of your lateral brow, and squeeze your eyes closed really tight. Do you feel the downward pull of the muscle? This muscle is the lateral brow depressor, and is also responsible for the “crow’s feet” when you smile. Since both of these muscle groups are brow depressors, injecting them with a neuromodulator can release the downward pull and help open the eye area and slightly elevate the brows.
Now if you look in the mirror and raise your brows up like you are surprised. You will see the horizontal forehead lines. These are caused by an elevator muscle or a muscle contraction that raises the brows.
A common misconception is that injecting the forehead raises the brows. It is actually just the opposite. If a muscle usually raises up and you relax it, it relaxes down and visa versa.
The only time you get a lift when injecting the forehead is if you just treat the top half of the muscle. In this instance, the bottom portion of the muscle works overtime to lift the brows and you often get that overdone “Spock” look. That is not usually a desired cosmetic outcome.
The muscles around the eyes interdigitate or interlock. It is important to go to a cosmetic injector that is highly knowledgeable with facial anatomy so that careful consideration is taken when treating a particular muscle group as to how that will affect other muscle groups. I do not have a “cookie cutter” approach to cosmetic injections. I look at each individual’s existing anatomy to carefully determine the dosing and treatment areas, so that I can achieve an optimal aesthetic outcome.
Consultations are complimentary. I take the time to listen to what concerns you have and we discuss treatment options. There is no pressure during a consultation. I always tell patients that my job is to make them feel happy and confident. In the end, cosmetic injectables are not medically necessary. So, it is important for you to feel very comfortable with your decision, and to wait until the time is right for you. I have said it many times, but there has never been a person that has sat in my treatment chair that I couldn't find a very beautiful feature to their face. So if you end up doing nothing, you are still beautiful!
Written By: Trisha Kennedy Roman, MSN, FNP-BC, NP-C
Trisha Kennedy Roman, MSN, FNP-BC, NP-C has almost 15 years of experience in cosmetic injectables, combined in both dermatology and plastic surgery. For over a decade, she has been highly sought after across the nation for cosmetic injectable training and lectures. Trisha is best known for her conservative approach to cosmetic injectables, delivering very natural appearing results. She has many repeat patients traveling from out of state to her Peachtree City location, and her reputation for outstanding cosmetic outcomes has garnered her celebrity clientele from television personalities to award winning recording artists.