A foundational guide to the science of facial aging — and how today’s surgical and non-surgical treatments can help Manhattan patients restore a naturally refreshed appearance.
Aging is inevitable — but understanding it is the first step toward addressing it on your own terms. Many patients who come to 740 Park Plastic Surgery in Manhattan have noticed gradual changes in their face and want to understand what is actually happening beneath the surface. Why does skin loosen? Why does the face appear hollower with age? Why do lines form where they do?
The answer is not simply that skin gets older. Facial aging is a multidimensional process that involves structural changes to the skin, the underlying fat compartments, the muscles, and even the bones. When these changes are understood in full, it becomes clear why a comprehensive approach — tailored specifically to each patient — yields the most natural-looking results.
Below, Dr. Stafford Broumand provides a clinical overview of how time shapes the face, and how the treatments available at 740 Park Plastic Surgery can address each layer of change.
The Skin: Loss of Elasticity and Surface Changes
The most visible signs of facial aging begin at the skin’s surface, but their origins lie deeper — in the dermis, where collagen and elastin fibers provide the structural scaffolding that keeps skin firm, smooth, and resilient.
From the mid-20s onward, the body produces progressively less collagen. By the time most patients reach their 40s and 50s, this decline has become clinically apparent: skin that was once taut begins to crease, fine lines deepen into wrinkles, and surface texture changes with a loss of natural luminosity. Sun exposure, lifestyle factors, and genetics can accelerate this process significantly.
Key dermal changes associated with aging include:
- Decreased collagen production, reducing skin firmness
- Reduced elastin, limiting the skin’s ability to rebound after movement
- Thinning of the epidermis, which can lead to a crepey texture
- Decreased sebaceous activity, resulting in drier, less supple skin
- Uneven pigmentation and changes in skin tone from cumulative sun damage
Addressing Skin-Level Aging
For patients in New York City seeking to improve skin quality without surgery, 740 Park Plastic Surgery offers several clinically proven non-surgical treatments administered by Tamara Spaide, RN, MLA:
Morpheus8® combines radiofrequency energy with microneedling to stimulate collagen remodeling at targeted depths within the dermis. It is effective in treating skin laxity, textural irregularities, and fine lines across the face and neck.
SkinPen® Microneedling uses controlled micro-injuries to trigger the skin’s natural healing cascade, promoting the production of new collagen and elastin. It is well-suited for patients with mild-to-moderate textural changes or early signs of aging.
AquaGold® Fine Touch delivers customized microinfusions of active ingredients — including neuromodulators and hyaluronic acid — directly into the skin, enhancing surface quality and radiance.
Facial Fat and Volume: The Architecture of a Youthful Face
A youthful face is not simply a tight face — it is a full face. Volume plays a central role in the appearance of youth, and its redistribution and loss over time is one of the most significant contributors to an aged appearance.
The face is composed of multiple discrete fat compartments arranged in both superficial and deep layers. In youth, these compartments are well-supported and evenly distributed, creating the smooth contours and gentle convexities associated with a young face. As the decades pass, these compartments lose volume at different rates and begin to descend, disrupting the balanced architecture of the face.
The clinical consequences are predictable and recognizable:
- Hollowing of the temples and periorbital area
- Flattening of the midface and loss of cheek projection
- Deepening of the nasolabial folds as midface volume descends
- Formation of tear troughs beneath the lower eyelids
- Loss of lip volume and definition of the vermilion border
Addressing Volume Loss
Dermal fillers, administered by Tamara Spaide, RN, MLA, are among the most precise tools available for restoring facial volume. Injectable hyaluronic acid fillers can be used to replenish volume in the cheeks, temples, tear troughs, lips, and along the jawline. Results are immediate and, depending on the product used, can last from one to two years or more.
For patients pursuing surgical correction, Dr. Broumand’s facelift techniques incorporate volume management as a central component — repositioning descended fat compartments and, where appropriate, using fat grafting to restore structural support.
The Muscular Layer: Dynamic Lines and SMAS Changes
Beneath the skin and subcutaneous fat lies the muscular architecture of the face — a complex network of expressive muscles responsible for the full range of human facial movement. This layer, and the connective tissue that envelops it (the superficial musculoaponeurotic system, or SMAS), plays a critical role in both the creation of dynamic wrinkles and the descent of facial structures over time.
Every expression made over a lifetime — a smile, a squint, a furrowed brow — involves repetitive contraction of the underlying muscles. Over time, these repeated movements etch lines into the skin above them. These are known as dynamic wrinkles, and they are distinctly different in character from the static lines and folds caused by volume loss or skin laxity.
The most common sites of dynamic line formation include:
- Horizontal forehead lines from frontalis muscle activity
- Glabellar lines (“11s”) from corrugator and procerus muscle contraction
- Crow’s feet from orbicularis oculi activity around the eyes
- Perioral lines and neck bands from platysma changes
The SMAS, meanwhile, provides structural support to the overlying soft tissues. With age, the SMAS weakens and relaxes, allowing the facial soft tissues to descend along predictable vectors — contributing to jowling, deepened labial folds, and loss of a defined jawline.
Addressing the Muscular Layer
Botox® Cosmetic (botulinum toxin type A), administered by Tamara Spaide, RN, MLA, works by temporarily reducing the contractile activity of targeted facial muscles. When precisely placed, Botox can soften dynamic lines, smooth the forehead, open the brow, and reduce the appearance of crow’s feet — with results typically lasting three to four months.
Surgical correction at the SMAS level is a defining feature of Dr. Broumand’s facelift technique. Rather than simply tightening the overlying skin — an approach that can produce unnatural results — Dr. Broumand addresses laxity and descent within the SMAS itself, repositioning the facial soft tissues and restoring the structural integrity of the deeper facial layers. This approach allows for lasting, natural-looking outcomes.
The Foundation: Skeletal Changes and Bony Support
The least visible — but equally consequential — component of facial aging occurs at the level of the underlying bony skeleton. Research has demonstrated that the facial bones undergo measurable remodeling with age, including resorption at the orbital rims, the pyriform aperture (the bony frame of the nose), and the jaw and chin.
As bony support diminishes, the overlying soft tissues lose their structural foundation. This contributes to:
- Recession of the orbital rim, which can accentuate the appearance of deep-set or sunken eyes
- Reduction in chin projection, altering the balance of the lower face
- Widening of the pyriform aperture, contributing to changes in nasal appearance over time
Addressing the Skeletal Foundation
For patients in whom skeletal changes are a contributing factor to their aged appearance, Dr. Broumand may discuss chin augmentation as part of a comprehensive facial rejuvenation plan. A well-defined chin is foundational to facial balance — enhancing projection in this area can meaningfully improve the proportions of the jaw and lower face and is often performed in conjunction with facelift or other facial procedures.
A Comprehensive Approach to Facial Rejuvenation in Manhattan
Understanding facial aging in its full complexity — across the skin, the fat compartments, the muscular layer, and the bony skeleton — underscores why no single treatment addresses all aspects of the aging process. The most effective outcomes are achieved through a carefully individualized approach that accounts for each patient’s unique anatomy, degree of change, and aesthetic goals.
At 740 Park Plastic Surgery, Dr. Broumand offers Manhattan and New York City patients a full spectrum of facial rejuvenation procedures, including:
- Facelift addresses descent of the SMAS and soft tissues, jowling, and loss of jawline definition
- Brow Lift corrects brow descent and forehead laxity for a more open, rested appearance
- Eyelid Surgery (Blepharoplasty) removes excess skin and addresses fat prolapse in the upper and lower eyelids
- Chin Augmentation restores lower facial balance and projection
- Botox Cosmetic softens dynamic lines through targeted muscle relaxation
- Dermal Fillers restore volume to hollowed areas and softens static folds
- Morpheus8 stimulates deep dermal collagen remodeling with radiofrequency microneedling
- SkinPen Microneedling and AquaGold Fine Touch enhance skin texture, tone, and overall quality
Every consultation with Dr. Broumand begins with a thorough assessment of the patient’s facial anatomy and an honest conversation about goals and expectations. Non-surgical treatments administered by Tamara Spaide, RN, MLA, are often used as standalone options for patients seeking subtler refinement, or as adjuncts to surgical care to maintain and extend results.
Schedule a Consultation at 740 Park Plastic Surgery
If you are considering facial rejuvenation and would like a personalized assessment of your anatomy and options in NYC, we invite you to schedule a consultation with Dr. Stafford Broumand at 740 Park Plastic Surgery in Manhattan. Consultations are available for both surgical and non-surgical facial rejuvenation.