Youthful facial structure contains soft tissues that are firm and smooth with little mobility. The skin fits snugly over the muscle and bone with few facial lines. A rather firm fatty tissue lining just under the skin fills the contours leaving an overall smooth appearance.

With age the fatty tissue shrinks. The skin stretches. This change causes the skin to fit loosely. The remaining fatty tissue gravitates to the jowls and neck (turkey wattle). In addition, various linear marks become evident where the facial muscles attach to the under surface of the skin. These skin folds become more prominent as a result of gravity and muscular action.

The most profound changes in appearance due to aging occur:

• under the chin and on the upper neck
• along the outer most part of the eyebrows and upper lids
• where the skin folds at the corner of the mouth
• along the border of the jaw
• where underlying muscles attach to the skin and cause lines
• on the forehead, upper & lower lids, upper lip & Crow s feet

The nose also undergoes changes with aging. It becomes slightly larger in the tip and longer. Dental ridge shrinkage and sag in the point of the chin exaggerate these changes. Cartilage imperfections in the nose become more noticeable as the overlying soft tissues thin with age.

Many factors have a direct bearing upon the rate and degree of the aging process. Genetic characteristics can forecast potential developments: fair-skinned people with dry thin skin have more profound signs of aging which occur at a younger age. Other important factors include exposure to sun light and tobacco smoke. Both will cause the elastic fibers to degenerate faster and cause premature, or more severe wrinkling.

Fortunately, although getting older is inevitable and unpreventable, looking and feeling older is not.

Body Structure

Skin stretches, thins, wrinkles and sags. Bone thins, compresses and height decreases while cartilage continues to grow (nose, ears & rib cartilages). Body fat distribution changes and gravitates. Muscle shrinks. You eat less and gain more -- fat! Your hair line recedes and your hair thins. There is a silent but relentless plugging of the arteries with arterio-sclerotic plaques, until eventually memory decreases, sexual performance decreases, immune function decreases, cardiac & pulmonary function decreases, VO2 decreases, vital organs shrink and then you turn 40!

Yes, this all begins in the 20's and continues relentlessly until death. The good news is, most of it is not only preventable but reversible!

Anti-Aging Medicine

The Tahoe Clinic Phase II Project endeavors to make you feel as young as you look. Global hormone replacement therapy (melatonin, pregnenolone, DHEA, thyroid, testosterone, estrogen, progesterone & Human Growth Hormone) can return your metabolism to that of a 25 year old. Click here to go to Tahoe Clinics' Anti-Aging Web site.

Cosmetic Surgery

Each year, the number of individuals who undergo cosmetic surgery increases at an incredible rate. Age no longer is a barrier. Everyone faces the challenge of maintaining a positive attitude about themselves, especially with the social and economic influences of today.

It is well accepted that cosmetic surgery can satisfy a variety of needs, for instance, improving ones appearance will provide an extra measure of inner confidence, which then leads to improved career performance.

The final decision to undergo any elective surgical procedure must be made by you alone. Don t be encouraged or discouraged about it solely by the suggestions of others. It is a personal decision. You will find support from those who are truly concerned about your well-being.

More minimally invasive procedures are available now than ever before. That means you get bigger and better results with smaller and smaller incisions, or in some cases, no incisions at all (such as the laser face-lift). Only highly experienced plastic surgeons (we have over 50 years of combined experience) who are skilled in all available techniques can offer you the full range of available procedures, explain the various benefits and enable you to make an informed choice. We have each performed not thousands, but tens of thousands of plastic surgery operations of all types.