UT Southwestern doctors rework theories on facial aging

by John P. Meyer

If you've been noticing that your eyes are developing unsightly bags while the skin of your forehead remains supple and youthful-looking, you may be living proof that 1) the research being conducted by Dr. Joel Pessa, assistant professor of plastic surgery at UT Southwestern Medical Center, is valid, or 2) you should stop wearing those magnifier glasses while sunbathing. Or both.

Dr. Pessa and his research colleagues have been spending their time between surgeries injecting various sorts of dye into the facial cavities of cadavers and observing the results. (Haven't they heard of bowling?) While none of the cadavers have yet complained of this treatment, after 24 hours or so the dye was shown to have settled into only isolated sectors of the cadaverous face, confirming that the facial cavity is not an homogeneous mass but is segmented into individual compartments which are bounded by fibrous tissue. (At least in the case of cadavers.)

Thus demonstrating (in somewhat morbid fashion) that currently-employed practices of facial rejuvenation can be improved upon by exercising increased precision in the selection of injection sites, rather than just falling back on the old "fill 'er up!" approach.

According to Dr. Pessa, the face can be thought of as a three-dimensional puzzle, with fat acting somewhat like the creme filling in a Hostess Twinkie (not Dr. Pessa's metaphor), giving substance to distinct facial units around the forehead, eyes, cheeks and mouth. The various Twinkies comprising the face, it seems, can retain or lose fat at differing rates over the course of one's life, leading to the sorts of imbalances experienced by some individuals.

The results achieved by Dr. Pessa and his team were published in a recent issue of Plastic and Reconstructive Surgery, which I must have missed last time I was browsing the newsstand, so it's fortunate that the study was brought to my attention by a UT Southwestern press release.