With age comes wisdom and memories, but the signs of aging are also reflected on our faces. When wrinkles, fine lines, loose skin, and fat pockets cause patients to lose their youthful sparkle, they visit Boston plastic surgeon Dr. Mark Markarian in search of ways to restore the smooth, tight skin and volumized facial contour they once had.

Many treatments are available to rejuvenate the face, all with specific goals and techniques, customized to the individual based on their skin type, preferences, medical history, concerns, and goals. Choosing the best facial rejuvenation procedure for you may require a consultation with a board-certified plastic surgeon specializing in facial rejuvenation, such as Dr. Markarian. Having at least a basic understanding of what’s available before meeting with a doctor is helpful, as this will be useful for knowing which questions to ask.

What Surgical Options Are Available for Rejuvenating The Face?


As we age, our collagen and elastin production slows down, causing the skin on our face to sag, wrinkle, and fold. Although there are many topical skin care products and non-surgical solutions for anti-aging, there comes a time when surgery is the only option that will help us achieve our goal results.

The most popular surgical facial rejuvenation procedure is a facelift that targets a large portion of the aging face in one surgery by removing and tightening excess skin at the surface and tightening up and adjusting the underlying muscles for dramatic, long-lasting results.

The facelift reduces signs of aging in many ways, including:

  • Removing and tightening loose skin in the lower face
  • Removing jowls
  • Tightening the jawline
  • Lifting the cheek area

Dr. Markarian prefers the deep plane facelift over traditional SMAS techniques because it creates more natural-looking results that last. Other face-lifting procedures can give patients a “pulled” appearance, which can look unnatural. 

The deep plane facelift restores youthfulness to the face by releasing tension and tightening the deeper tissues. Dr. Markarian uses a specialized deep plane facelift technique that combines a modified deep plane rhytidectomy with a corset platysmaplasty to create consistency in the appearance of the mid-face down to the bottom of the neck. Mayo Clinic states that the neck lift is often done as part of a facelift as it reduces excess fat and sagging skin on the neck.


Although a facelift restores the face from the midface to the jawline, it doesn’t target the eyes. As our eyes are the first thing people look at when they see and speak to us and hold such a valuable role in exuding emotions and building relationships, it’s common for people to want to restore their bright, alert, and welcoming appearance when they start to look sad, tired, and mad.

There are variations of blepharoplasty techniques, each dedicated to improving patients’ specific concerns about the appearance of their eyes. From sagging skin in the upper eyelids to puffy fat pads and eye bags in the lower eyelids. In some cases, eyelid surgery is covered by insurance because it corrects the drooping in the upper eyelids reducing peripheral vision. It’s a widely chosen procedure for both appearance and functionality concerns. 

During upper eyelid blepharoplasty, excess skin and fat are removed with a thin stitch bringing the skin together, creating a youthful eyelid crease. If excess skin is causing drooping upper eyelids, or you have hooded upper eyelids causing you to age around your eyes more rapidly, upper eyelid surgery can rejuvenate your eyes so dramatically that your entire face appears refreshed.

During lower eyelid blepharoplasty, incisions are made under the eyes to reposition and remove excess fat, skin, and muscle. If you have excess skin and fat causing below your eyes to appear saggy or baggy, lower eyelid surgery can freshen up your face as a whole and help you feel confident in your eyes again. Lower eyelid surgery can also help those with eye bags or puffiness beneath the eyes from herniation of fat.

Eyelid surgery can address several concerns when it comes to aging eyes, including:

  • Droopy upper eyelids
  • Excess skin on the lower lids
  • Deficient peripheral vision
  • Puffiness under the eyes
  • Wrinkles around the lower lids

Eyes play an essential role in our social lives because eye contact can affect trustworthiness, and our eyes can show more emotions than our voices could ever speak. Unfortunately, our eyelids have the thinnest, most delicate skin on the entire human body and are the first to show our age. Fortunately, solutions are available just a call and consultation away.

Neck Lift

If you’re noticing that the upper part of your face is aging well, but you’re starting to develop a double chin, neck muscle banding, or sagging jowls, the neck lift can bring balance to your facial features, tighten up your neck, and redefine your jawline.

The neck lift, or lower rhytidectomy, promotes a slimmer neck with smoother skin and restores the contour of your neck, chin, and jawline.

Surgical neck lift techniques aim to target three main concerns:

  • Excess fat
  • Loose platysma muscles
  • Sagging skin

Although a neck lift may very well be done on its own for patients with no concerns over aging in their midface, when Dr. Markarian does neck lifts, it’s usually in combination with facelifts to create consistency in the tightness, smoothness, and youthful appearance of the midface down to the neck. As previously mentioned, he incorporates a corset platysmaplasty, a type of neck lift technique, in his preferred face-lifting procedure to tighten underlying neck muscles and rejuvenate the overall neck area while lifting and removing facial tissue.

Fat Grafting

Facial fat transfer is often combined with a facelift to restore youthful volume and contour while lifting and tightening. Transferring healthy fat from your inner thighs or love handles to restore lost volume in areas of the face such as the under eyes, cheeks, and temples. 

While fat grafting serves a similar purpose to dermal fillers, it is longer-lasting, promoting more natural, balanced results because it adds volume and smooths out wrinkles, and stimulates collagen production, over time creating new healthy, plump, glowing skin.

Facial fat transfer alone will restore volume and improve skin quality but is usually performed during a facelift procedure to achieve a more effective result.


Some people notice their chin receding with age and blending in with their necks. Genioplasty, or chin augmentation, can help enhance the appearance of the chin, jawline, and profile and create facial harmony. Chin augmentation can be done by adjusting bone placement, removing a part of the bone, or adding an implant.

Are There Non-surgical Ways To Look Younger?

According to the American Society of Plastic Surgeons, skin irregularities can be caused by the sun, aging, skin disorders, and genetics, and there are multiple non-surgical modalities available to help improve upon different signs of skin damage.

Eventually, surgery is necessary to address facial aging when it reaches the point of drooping, jowling, and banding. Still, fillers and injectables are excellent non-surgical solutions for preventing facial aging and restoring volume for as long as possible.


Botox (botulinum toxin) and other neuromodulators, such as Dysport and Xeomin, reduce the appearance of fine lines and wrinkles and temporarily halt muscle movement at the injection site. By paralyzing the facial muscles that are used often and cause the most noticeable lines, Botox prevents future fine lines and wrinkles from forming and reduces the appearance of existing ones.

Cleveland Clinic says that while Botox results usually last about 3-4 months, your muscles may train themselves to contract less, so your injector will decide how often you need maintenance treatments based on your unique needs.

Botox has a wide variety of both FDA-approved and off-label uses for rejuvenating the face, but we’re usually using it to address the following:

  • “11” lines or worry lines between the eyebrows
  • Crow’s feet lines around the outer portion of the eyes
  • Horizontal forehead lines
  • Neck bands
  • Nasolabial folds
  • Marionette lines

Dermal Fillers

If your main concern with the appearance of your face is volume loss, dermal fillers such as Juvederm®, Restylane®, Belotero®, and Radiesse® may be the perfect option for you. A wide variety of dermal filler brands and families are available to address some concerns outside of volume loss, including smoothing out fine lines, improving contour, lifting the appearance of the cheeks, reshaping the nose, and more.

Dr. Markarian is richly trained in surgical procedures such as face and neck lifts but also in injectables, allowing him to help patients who prefer not to undergo surgery feel more confident in their appearance. This combination of talents enables him to combine surgical techniques with non-surgical treatments, creating well-rounded results. For example, while eyelid surgery reduces and tightens excess skin and fat in the eyelids, it doesn’t necessarily address the crow’s feet around the eyes. Dr. Markarian can combine blepharoplasty with fillers to remove and tighten excess skin and smooth fine lines.

Ready To Rejuvenate Your Face?

If any of these facial rejuvenation options address your concerns, there’s no better time than the present to turn back the clocks. Schedule a consultation with Boston plastic surgeon Dr. Mark Markarian to discuss your goals and develop a treatment plan tailored to you.