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Alexander J. Stratigos, MD; Kenneth A. Arndt, MD; Jeffrey S. Dover, MD, FRCPC

JAMA. 1998;280:1397-1398.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

THE PHYSICAL APPEARANCE of aged skin derives from a combination of intrinsic and extrinsic factors. Intrinsic changes are largely genetically determined and include the effects of gravity (sagging), expression lines, and atrophy of the dermis and subcutaneous tissue. Extrinsic aging is related to environmental influences with sunlight being the most important, followed by smoking and chemical exposure. The effects of long-term sun exposure on skin (photoaging) are characterized by a recognizable progression of textural, vascular, and pigmentary changes. Dyschromia, lentigines (brown macules), and telangiectasias appear gradually, and the skin loses its tautness and smoothness and develops fine and coarse rhytides (wrinkles), keratoses, and, possibly, skin cancers. The aesthetic relationships of the aged face are also altered by a decrease in the volume of the facial skeleton, loss of suspension of overlying structures, and reconforming of the skin . . . [Full Text of this Article]

Laser Resurfacing

Relaxation of Expression Lines

Soft Tissue Augmentation

Liposuction

From the Department of Dermatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. Dr Arndt is a member of the JAMA Editorial Board and Editor of Archives of Dermatology.