"I love you, Dr. Bock"

That is how I was greeted last week by a long time patient. She had undergone a number of noninvasive procedures in the past few years, but two weeks before I saw her I had, for the first time, injected filler in her cheeks. The aging of the mid-face has, with the development of better and linger fillers, become recognized as one of the primary events that makes a person look aged. The young face is full, with smooth, convex surfaces, while the aging face becomes concave, with the loss of deep tissue and other structures. This produces depressions such as the "tear trough", a groove that extends downward and sideways from the inner (medial) part of the eye. It was this area that was filled in my patient. She was smiling as she reported that even her teenage son, without knowing that anything had been done, told her that she looked good.

Loss of tissue in the cheeks also produces bags under the eyes, which, in most cases, is best treated with filler rather than surgery. Also, most people have less prominence of the "apple" of their cheeks, than they did when they were young. Restoring this can produce a subtle change that results in a considerably younger appearance.

"Facial sculpting", which is our name for this, is a very operator dependent procedure. It is the most artistic procedure that we perform. Fortunately, I have now learned how to perform this on myself. It is routine for at least oe patient a week to comment that I look better now, than I did when they saw me a few years ago. Unfortunately the possibility of facial sculpting is relatively unknown. There is no company behind it, paying for media coverage. There is no catchy name that has become common. Many patients don't know that it exists. However, the patients who have had the treatment are very appreciative and return for further treatment when their filler disappears. Today we had a woman come in whose eye bags we had treated 3 years ago. Circumstances had prevented her from returning sooner, but she still looked better than she did in her original pre-treatment photos.

Gerald N. Bock MD

California Skin & Laser Center

Stockton & Lodi, CA