Facial Rejuvenation: A Multidimensional and Multimodal Perspective

Fred G. Fedok, MD, FACS

As I have become increasingly aware, rejuvenation of the aging face requires a multimodality or a multidimensional approach. To achieve superior outcomes, one must have at their disposal a variety of surgical techniques, laser, light, and energy-based devices, a knowledge of advanced skin care and other modalities, including minimally invasive modalities, that is, injectables and biologicals. The visible changes of aging manifest themselves at the surface of the skin as well as in deeper tissues—the surgeon must then have at their disposal modalities that treat both the surface of the skin and deeper tissues. The practitioner should have command of interventional elements that reverse actual biological aspects of aging as well as induce processes that will continue to improve the patient's soft tissues and appearance. Hence, the term “multidimensional” is apropos in facial rejuvenation. “Rejuvenation” ideally impacts aging that has already happened, but also aging processes that will continue to worsen unless addressed. Technologies and techniques must be used that not only produce immediate changes but induce favorable changes that occur over time.

The experienced surgeon is able to individualize the pallet for each patient. They must reposition tissues and remove associated laxity that has occurred through skin and soft tissue aging. They must correct undesirable changes that are the result of sun exposure and unfavorable life habits. The practitioner at times must make changes in anatomic deficiencies that may have been present during most of the patient's lifetime.

In assembling this panel of authors, my purpose was not only to report on the technical aspects of facial rejuvenation but also to demonstrate that the contemporary facial plastic surgeon expertly embraces every tool at their disposal while engaging facial rejuvenation. Several internationally respected authors were recruited to present a key component of their approach to facial rejuvenation and demonstrate it within a presentation of a case or cases where that key technique or technology was used within the constellation of other modalities in the comprehensive management of (a) patient(s) desiring to look and feel rejuvenated. As you read ahead, you will enjoy a glimpse at the current state of art of facial rejuvenation. Thank you to all the authors for their time in sharing their perspective and experience.

Publication History

Article published online:
12 April 2021