The Beauty in the Face of a Child

Paul Van Camp MD
"Within every beautiful woman, is the face of a child."

Dr. Fournier of Marseille France is considered one of the greatest contributors to the refinement of facial cosmetic surgery. We were fortunate to have him attend the last World Congress on Liposuction and Body Contouring held near Denver Colorado.

Dr. Fournier presented a lecture on how beauty is achieved and recognized in a woman’s face. One principle stood out: "Within every beautiful woman is, the face of a child."

We all know that wondrous reaction that all people have to the face of a healthy happy child: innocence, openness, roundness, receptive, and smooth. It does not require any thought or interpretation. Our response is immediate: we feel a gentle attraction. We want to protect the child and nurture it. It is part of our biology. It is wired into our DNA.

The face of a healthy infant or child has a generous amount of fat. The face is full and oval or round. There are no hollow areas such as below the eyes or beneath the corners of the mouth. In an infant those might suggest less rigorous health or poor nutrition. The lips of a healthy child are full and thick. There are no depressions or deep creases in the skin. So do you want to know a truly timeless beauty secret? Keep your face like that of a child.

Unfortunately, it is easier said than done. Removing wrinkles and blemishes and restoring a clear smooth skin have been the topic of previous articles. There are excellent technologies available for this. But what about the change in contours and shape that occur with normal aging?

Over the years, it is normal (if not desirable) to gain fat and fullness in certain areas. Likewise, we also lose fat and fullness in other areas of the body. This is particularly noticeable in the face. Fat is lost from beneath the eyes making them slightly more hollow. Fat is often lost from beneath the corners of the mouth (the region Dr. Fournier calls "the pillars of the mouth"). This occurs even as fat may accumulate beneath the cheeks forming "jowls". This interrupts the youthful single smooth curve of the jawline from beneath the ear to the chin. Some develop hollowness beneath their cheekbones.

Each of these changes takes us a bit further away from that "face of a child". Perhaps the strongest element of a youthful, even sensuous face is the fullness of the lips. Over the years our lips get thinner, and the loss of volume allows deeper wrinkles to appear.

Excess deposits of fat can be readily and permanently removed through liposuction/liposculpture with very gratifying results. What about restoring volume to hollow areas or to thinned out lips? The most widely used method in past years has been through collagen injections. Zyplast and Zyderm are the bovine collagen products that have set the standard for many years. Unfortunately these products fall short of perfect. Since the collagen is of bovine origin there is the possibility of being allergic to it. So a two phase skin test is required before starting collagen treatments. Even with a normal skin test there is a small risk of becoming allergic later. These collagen products do produce excellent cosmetic improvement in the majority of patients. My staff refers to it as "instant gratification" because of the immediate improvement in the appearance of thin lips that have been restored to their youthful fullness. It is similarly good for hollowness beneath the corners of the mouth (called "marionette lines"), the deep folds between the cheeks and jaws (naso-labial folds), and depressed areas from scars. The main disappointment from injectable collagen is that it does not last long enough: most patients need to have it replenished every six months in order to maintain the cosmetic improvement. The only permanent products available are synthetic materials such as Artecol containing plastic micro-beads, and Gore-Tex materials such as SoftForm. Each of these has its own problems and limitations.

There are two new offerings becoming available which will retain the simplicity of the Zyderm and Zyplast collagens while overcoming some of their limitations. The first of these is CosmoDerm and Cosmoplast. These are collagen injections completely similar to the older products (and made by the same company) with one important difference: They contain actual Human collagen grown in tissue cultures and are not animal collagen. This means that the risks of collagen allergy are eliminated and no skin test is required. This is a big step forward. These products have recently been FDA approved and are available for use.

The other new products are Perlane (and also Restylane). These contain no collagen at all. Instead they are made of hyaluronic acid complex. This is the non-protein structural component of our skin and connective tissues. Because there is no protein they are similarly free of the allergic potential of collagen and no skin test is needed. However, most importantly: Perlane products seem to last twice as long as collagen. This means that there is still good cosmetic improvement retained after six months in the majority of patients. Touch-up treatments are thus expected to be less frequent, perhaps only once a year for some people. Restylane and its related product Perlane have been used in Europe for many years with a good track record for safety and patient satisfaction. Two recent North American studies have confirmed this: one done in the United States at six centers, and one in Vancouver Canada. The main side effects noted were discomfort during injections, and some temporary bruising and swelling which might be expected. The FDA has not yet given final approval for Restylane in the USA. However, this is expected by the end of the year.

Finally, lot us not forget that while having beautiful skin and healthy youthful facial contours is nice. It is far more important to cultivate and maintain a youthful healthy attitude towards life. Curiosity, a sense of wonder, kindness towards others, a forgiving heart, a sense of humor and the spirit of adventure. For these are the hallmarks of a beautiful human being.

The above information is presented for educational purposes and not to recommend treatment for any individual or condition. Dr. Paul Van Camp is a physician and surgeon and is medical director of Aesthetics MD. Further information is available at www.aesthetics-md.com/ or by calling 330-6160. References to original publication of these studies is available upon request.