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At Plastic Surgical Associates, Dr. Diane Duncan, board certified plastic surgeon, combines decades of surgical expertise with cutting-edge regenerative science to help patients achieve elegant, natural-looking results. An award-winning and internationally recognized plastic and reconstructive surgeon, Dr. Duncan is known for her innovative minimally invasive techniques that restore confidence while minimizing downtime. Through her thoughtful, patient-focused approach, she delivers customized surgical and nonsurgical treatments designed to help patients look refreshed, rejuvenated, and connected to their best selves.
Humans age in waves that last about 5 years, and occur at 3 different points in life.

Age 20: structural elements of the skin and underlying adipose frame work degrade at about 1% per year
Late 30s/early 40s: an accelerated wave of aging occurs. This includes loss of osteoblasts and muscle fibers—the beginning of osteosarcopenia as well as thinning of the skin. The dropoff can be fairly steep, or slow in early middle age with a more rapid decline in the late 50s-mid 60s.
During your late 70s, another wave of overall aging is seen, with significant changes in connective tissue aging.

Patient aged 40, above.
Patient aged 44, no intervention, below.

Note loss of bony volume of the mandible, change in skin quality, recession of the chin and development of skin and soft tissue laxity of the neck.
What can be achieved with a minimally invasive approach? For this patient, we used a combination of volume restoration using fat or adipose matrix filler plus skin surface reduction with a specialized laser. She now has a well defined jawline and significant improvement of the skin laxity.