Three fundamental changes in the face occur during aging:
Due to gravity, the tissues sag downwards. This effect is more pronounced on thick skin. Eyebrows, upper eyelids, cheeks and neck are the structures most affected by gravity. As we age, our eyebrows and upper lids pile downwards, the cheeks hang downwards, and the lines descending from the nose to the lips deepen. On the edge of the jawbone, piles begin, the neck skin relaxes, and the tickle becomes pronounced.
There is a loss of soft tissue on the face. Due to the loss of subcutaneous tissue, the skin becomes thinner, the cheeks lose their fullness, the eyes escape into the pit, under-eye bags become pronounced, the mid-face area becomes flattened. While the mid-face loses its fullness, the facial skin is piled up on the edges of the chin. The face, which was oval when young, becomes round over time, then takes on a rectangular shape. Skin aging begins. The skin becomes thinner, loses its elasticity. Especially due to the sun, spots on the face and skin lesions that may turn into cancer in the future are formed. Mimic lines are formed with the effect of mimic muscles. These occur most often in the form of crow’s feet at the edges of the eyes, vertical lines between the eyebrows due to frowning, and horizontal lines on the forehead due to raising the eyebrows. Wrinkles are more common in thin-skinned people.
Perhaps the most important factor determining aging is genetics. The person who has a good genetic structure ages late, even if the environmental conditions are bad. Apart from this, racial characteristics are important. While more gravity-related sagging is observed in the Mediterranean race with thick skin, wrinkles are more pronounced in thin-skinned blonde Northern Europeans. The factors that we can control about aging are: sleeping regularly, eating well, staying away from the sun, consuming plenty of fluids, not smoking, not consuming too much alcohol, staying away from tension and sadness, living in a clean environment, avoiding excess makeup, using regular moisturizers and skin care products.
We divide facial rejuvenation surgeries into three types:
Upper face rejuvenation: forehead area, temples, eyebrows and upper eyelids. In this region, more lifting operations are carried out for sagging creatures caused by gravity. These include forehead lift procedures, temple lifting, eyebrow lifting, eyebrow straps, upper eyelid surgery (upper blepharoplasty) and botox applications. Mid-face rejuvenation: Lower eyelids, cheeks and cheekbones. In this region, the aim is to correct the deteriorated lower eyelid-cheek relationship, to move the sagging cheek up and to replace the soft tissue loss that has occurred. These procedures include lower eyelid surgery (lower blepharoplasty), mid-face lift, mid-face slings, fat injections and fillers.
Lower face and neck rejuvenation: Jaw edges, lower lips and neck. The purpose of this region is to lift the face up and down with the effect of gravity, to correct the skin accumulations on the jaw bone, to remove the excess fat in the neck and to stretch the neck. These procedures include face and neck lift surgeries, longitudinal liposuction procedures.
Non-surgical rejuvenation procedures include suspension procedures, skin peeling procedures, botox and filling applications. With the closed method and hangers made with special stitches, eyebrows, mid-face area and neck can be suspended. They act on mild sagging and their effect is temporary. However, it is the appropriate method in patients who are thought to be too early for surgery and in patients who do not want surgery. They are administered under local anesthesia and the postoperative recovery process is very short.
The purpose of skin peeling procedures is to remove the stained, damaged and wrinkled top layer of the skin and replace it with a new and fresh skin. This process is carried out either by mechanical sanding of the skin (dermabrasion), by burning it with various acids (chemical peeling, chemical peeling), or by peeling it with the help of laser beams. Lasers and other light applications stimulate the production of collagen under the skin as well as peeling the skin, allowing the skin to thicken and refresh.
The aim of Botox applications is to prevent the formation of mimic lines by neutralizing the mimic muscles and to delay their deepening. Botox is mostly applied around the eyes. It is very effective on crow’s feet at the edges of the eyes, vertical lines between the eyebrows and horizontal lines on the forehead.
Various fillers are used to fill the deep wrinkles on the face, to replace the volume loss in the middle face, to clarify the facial contours, to plump the lips. In large areas, fat tissue taken from the patient himself is preferred, while ready-made fillers are applied for smaller areas. Among these, the most commonly used is the substance called Hyaluronic acid, which is found in the connective tissue between cells in the body.
