For this reason, skin tightening alone with procedures such as a facelift, eyelid lift or brow lift may not be enough to restore a youthful appearance.

“The original thought was that skin goes through changes, such as a loss of elasticity and fat, so the primary approach to facial rejuvenation was skin tightening procedures,” study co-author Dr. Robert Shaw Jr. told HealthDay News.

“But a lot of faces never looked like they did when they were younger. Patients bring in pictures and say they want to go back to that look, but they can never really go back to that look just by tightening their skin alone. If there are changes to those underlying structures it’s going to change the appearance of how the skin looks.”

According to the study, which is published in the January issue of Plastic and Reconstructive Surgery, bone loss and recession is most pronounced in women over 40 and men over 65. Study authors performed CT scans on 120 Caucasian patients (60 men and 60 women) split into three age categories—20-40 years, 41-64 years and 65 years and older.

“We saw changes around the eye, and then in the cheek area and in the jaw,” study co-author Dr. Howard Langstein told NPR. “And if you think about it, it kind of makes sense. When people age, the eyes appear hollow, deep-set. And, in fact, that’s what we found. The cheek bones right beneath the eye socket descend somewhat and come back in. As a result, they don’t give as much support to the lower eyelid.”

Langstein also said that chin recession and thinning of the jawbone were also major contributors to facial aging, explaining the slack-jawed appearance of some of the study’s oldest participants.

To combat the effects of bone loss on facial aging, Dr. Shaw suggest combining skin tightening with other cosmetic procedures designed to restore the facial structure, such as fat grafting, injections with fillers like Radiesse or Sculptra and facial implants for the chin, cheeks and jaw.

“It’s not ever possible to bring someone back to how they looked when they were 20 years old, but adding volume back to the face can improve results for some patients,” says Dr. Shaw.

Since bones makeup the underlying structure of the skin and provide a sort of scaffold to support facial tissues, the study results are no surprise to cosmetic surgeons.

“It’s one of those things that, in retrospect, you sort of say, ‘Duh, I should have known that!’” says Dr. Langstein. “Nothing stays the same on the body. Everything ages.”

And while there already a small number of cosmetic surgeons performing the procedure in the country, many surgeons and researchers say there is no evidence to prove it is effective.

Dr. J. Peter Rubin, co-director of the Adipose Stem Cell Center at the University of Pittsburgh, says that while he’s excited about the potential of stem cells for cosmetic uses, there are many unanswered questions about them. “Claims are being made that are not supported by the evidence,” he says.

While Rubin think it’s possible that injected stem cells could create new collagen and blood vessels, as they’ve been shown to do in animals studies, such results haven’t been proven in humans.

Researchers in Asia, Italy and elsewhere are reporting satisfactory cosmetic results with injections of stem cell-enriched fat, but Rubin says that nobody really knows how the stem cells themselves are behaving. Fat injections alone can improve a person’s appearance—without stem cells—he also points out.

Plastic surgeon Michael McGuire, MD, thinks that stem cell facelifts could offer real advances in cosmetic medicine in the future, but that it is still at least ten years away. “Stem cells have incredible potential. But nobody knows exactly what they do. So they’re marketed to do everything,” he says.

Dr. Edds performs facelift surgery and weekend facelifts, which combine tumescent liposculpture and CO2 laser to sculpt and redefine the neck and lower face through a minimal one inch incision, creating some of the effect of a facelift with a procedure that is much less invasive.

Although many studies have been conducted to evaluate short-term face lift patient satisfaction, this study is the first to evaluate long-term satisfaction in face lift patients.

Study participants included 89 patients of study senior author Dr. John Owsley, who performed a superficial musculoaponeurotic system–platysma facelift, or SMAS facelift, on each patient between January 1, 1994 and January 1, 1999.

When patients were surveyed one year after surgery, 98 percent reported that their results were “very good or beyond expectations.”  Each facelift patient was surveyed again 10-15 years after surgery, and 68 percent reported not only that their results continued to be “very good or beyond expectations,” but also that they looked 10 years younger.

Only 31 percent of patients who participated in the study indicated that they were disappointed by some aspect of their long-term face lift outcome, which suggests a majority of facelift patients experience a high degree of satisfaction with facelift results in the long term.

It is important to note that the results of a SMAS facelift are typically longer lasting than those of a subcutaneous, or skin-only, facelift, and improvement of sagging skin and jowls is an expected outcome.  An extended SMAS facelift offers the same benefits as a SMAS facelift, plus correction of nasolabial folds.

Variations of the SMAS facelift technique exist, but all SMAS facelift techniques involve repositioning and tightening the SMAS, which is a sheet of muscle and connective tissue on the cheek that contributes to facial expression.

If you’re considering face lift surgery, don’t trust your face to just anyone.  Avoid marketing hype and seek a highly experienced Owensboro facelift surgeon who can customize your facelift procedure to meet your unique facial rejuvenation goals.

Now according to the Pittsburgh Tribune-Review, doctors and plastic surgeons at the University of Pittsburgh Medical Center are seeking approval to perform a similar operation.

The surgeons evidently have experience with hand transplants — procedures that require advanced techniques to reconnect tissues, veins and blood vessels.  A face transplant however, would have different cosmetic goals and could require donation of organs that are difficult to procure.

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