Perimenopause: Facial Plastic Surgery with @DrDianaPonsky

Facial aging involves skin laxity, facial volume loss, jaw shortening and masculinization, brow flattening (loss of arch), and gravitational descent of fat.

Within 5 years around menopause, 30% of collagen depletes, followed by 2% annual loss thereafter.

Twin studies show that lifestyle habits (smoking, drinking, sun exposure) can make identical twins look 10 years different in age after sufficient time.

Estrogen receptors are present throughout the body, especially in skin, and circulating estrogen changes drive skin, mucosal, and hair changes during menopause.

Starting hormone replacement therapy earlier is a game changer for maintaining muscle mass and preventing fat redistribution from face to midsection.

Repeated motions from straw use contribute to lip line formation.

Smoking cessation is required for 4 weeks before and 4 weeks after facial surgery to enable optimal healing.

Fillers volumize rather than lift; volumizing enough can create the illusion of lifting but does not actually lift tissues.

Hyaluronic acid fillers can infiltrate into muscle fibers, restricting adequate room for movement and distorting smiles.

Collagen supplements provide building blocks but do not directly translate to collagen production in the body; there is no proven direct correlation or direct science supporting supplement claims.

Blonde, blue-eyed individuals age faster from a skin standpoint but have better bony health than Asian individuals.

Osteoporosis occurs in facial bones (jaw, around nose) in addition to long bones.

In Asian patients, jaw and chin recede faster due to bony changes than soft tissue changes, while fair-skinned patients develop etched lines faster even with sunscreen use.

30-40% of women's lives are now spent after menopause, a period without circulating estrogen.

Subtherapeutic minoxidil can be used prophylactically to curb hair loss anticipated during menopause.

Better muscle girth from resistance training helps patients recover faster from injuries such as bone fractures.