Facial rejuvenation is a cosmetic treatment (or series of cosmetic treatments), which aims to restore a youthful appearance to the human face. Facial rejuvenation can be achieved through either surgical and/or non-surgical options. Procedures can vary in invasiveness and depth of treatment. Surgical procedures can restore facial symmetry through targeted procedures and facial restructuring and skin alterations. Non-surgical procedures can target specific depths of facial structures and treat localized facial concerns such as wrinkles, skin laxity, hyperpigmentation and scars.
Surgical (invasive) facial rejuvenation procedures can include a brow lift (forehead lift), eye lift (blepharoplasty), facelift (rhytidectomy), chin lift and neck lift. Non-surgical (non-invasive) facial rejuvenation treatments can include chemical peels, neuromodulator (such as botox), dermal fillers, laser resurfacing, photorejuvenation, radiofrequency and Ultrasound.
Human visual perception is notable for its sensitivity and accuracy in estimating our perceived age by instant pattern recognition of facial features. Often, human faces with no measurable difference in facial geometry and appearance are perceived as having different ages. This mechanism is not yet entirely understood, but there may be a relation to the subtle changes in facial bone structure related below. [1]
Facial symmetry has a direct relationship to perceived beauty. A guiding approach to facial rejuvenation and balancing facial symmetry is through an application of the golden ratio. [2] Artists and architects have been using this ratio to create works that are pleasing to the eye for centuries. [3] Aesthetic medicine and facial rejuvenation techniques has adopted this mathematical approach to facial restoration and enhancement. [4]
More recent research has pointed out the influence of changes in the facial skeleton with age on the appearance of aging, especially in the mid-face area and the lower part of the orbits around the nose. Quantitative study with CAT scans of the faces of men and women in several age brackets has revealed that there is an appreciable amount of bone tissue loss in these regions with age, leading to changes in angles, lengths and volumes, and also decreasing the distance between the eyes. [5] It has been hypothesized that skin sagging and wrinkles may occur not only because of loss of soft tissue and fat, but also because bone retraction creates an excess of skin which is no longer flexible. Many of the facial manifestations of aging reflect the combined effects of gravity, progressive bone resorption, decreased tissue elasticity, and redistribution of subcutaneous fullness. [6] Future facial rejuvenation techniques may take into account these findings and restore bone lost by aging processes. [7]
According to the American Society of Plastic Surgeons, more than 133,000 facelifts and nearly 216,000 eyelid surgeries were performed in the US in 2013, a six per cent increase from 2012. Facial rejuvenation procedures experienced the most growth, as 2013 marked the highest number of botulinum toxin type A injections to date, with 6.3 million injections. [8] A significant upward trend on the number of facial rejuvenation procedures is predicted, [9] and could be due to the following factors:
However, while surgical procedures are still preferred to achieve a more dramatic improvement, the current trend is towards less invasive procedures, such as injectables (Botox, fillers) and laser skin treatments. While these treatments achieve temporary results, they tend to be preferred because of their reduced cost and less intensive recovery period. [10]
Facial rejuvenation procedures can include (but are not limited to):
Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims to improve the appearance of it. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.
Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.
Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and requires due care before, during, and after a surgical procedure to minimize or prevent further damage. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. It continues to be a widely practiced class of surgery, with various techniques having been developed for treating eye problems.
Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.
A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are multiple surgical techniques and exercise routines. Surgery usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. Exercise routines tone underlying facial muscles without surgery. Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.
Chin augmentation using surgical implants alter the underlying structure of the face, intended to balance the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants. Altering the facial balance is commonly performed by modifying the chin using an implant inserted through the mouth. The intent is to provide a suitable projection of the chin as well as the correct height of the chin which is in balance with the other facial features.
The depressor supercilii is an eye muscle of the human body. The nature of this muscle is in some dispute. Few printed anatomies include it and many authorities consider it to be part of the orbicularis oculi muscle.
Facial toning, or facial exercise, is a type of cosmetic procedure or physical therapy tool which alters facial contours by means of increasing muscle tone and facial volume by promoting muscular hypertrophy, and preventing muscle loss due to aging or facial paralysis. Facial toning and exercise is therefore in part a technique to achieve facial rejuvenation by reducing wrinkles, sagging, and expression marks on the face and skin. As a physical therapy, facial toning is used for victims of stroke and forms of facial paralysis such as Bell’s palsy. Facial toning achieves this by performing facial muscle exercising. There are two types of facial toning exercises: active and passive face exercises.
Cheek augmentation is a cosmetic surgical procedure that is intended to emphasize the cheeks on a person's face. To augment the cheeks, a plastic surgeon may place a solid implant over the cheekbone. Injections with the patients' own fat or a soft tissue filler, like Restylane, are also popular. Rarely, various cuts to the zygomatic bone (cheekbone) may be performed. Cheek augmentation is commonly combined with other procedures, such as a face lift or chin augmentation.
The buccal fat pad is one of several encapsulated fat masses in the cheek. It is a deep fat pad located on either side of the face between the buccinator muscle and several more superficial muscles. The inferior portion of the buccal fat pad is contained within the buccal space. It should not be confused with the malar fat pad, which is directly below the skin of the cheek. It should also not be confused with jowl fat pads. It is implicated in the formation of hollow cheeks and the nasolabial fold, but not in the formation of jowls.
The nasolabial folds, commonly known as "smile lines" or "laugh lines", are facial features. They are the two skin folds that run from each side of the nose to the corners of the mouth. They are defined by facial structures that support the buccal fat pad. They separate the cheeks from the upper lip. The term derives from Latin nasus for "nose" and labium for "lip".
Jaw reduction or mandible angle reduction is a type of surgery to narrow the lower one-third of the face—particularly the contribution from the mandible and its muscular attachments. There are several techniques for treatment—including surgical and non-surgical methods. A square lower jaw can be considered a masculine trait, especially in Asian countries. As a result, whereas square lower jaws are often considered a positive trait in men, a wide mandible can be perceived as discordant or masculine on women, or sometimes in certain men, particularly when there is asymmetry.
Aesthetic medicine is a branch of modern medicine that focuses on altering cosmetic appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider veins. Traditionally, it includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery, surgical procedures, non-surgical procedures, and a combination of both. Aesthetic medicine procedures are usually elective. There is a long history of aesthetic medicine procedures, dating back to many notable cases in the 19th century, though techniques have developed much since then.
A lip lift is a plastic surgery procedure that modifies the cosmetic appearance of the lips by reshaping them to increase the prominence of the vermilion border; and to enhance the facial area above the lips into a more aesthetically pleasing shape. In corrective praxis, a lip lift procedure is distinguished from lip enhancement, the augmentation of the lips, which can be effected with a non-surgical procedure.
Babak Azizzadeh, MD, FACS is an American facial plastic and reconstructive surgeon. He is the founder and president of the FPBPF, a non-profit organization committed to the treatment of individuals with facial nerve paralysis and Bell's palsy.
New York Plastic Surgical Group (NYPS Group) was founded in April 1948 and is the oldest and largest private academic plastic surgery practice in the United States. The group currently has 10+ offices within the New York Metropolitan area, including Garden City, East Hills, Babylon, Huntington, Manhattan, Flushing, Astoria, Brooklyn, White Plains, and Connecticut. The practice operates with over 20 plastic and reconstructive surgeons who were trained at institutions including Memorial Sloan–Kettering Cancer Center, Cleveland Clinic and Massachusetts General Hospital. NYPS Group is composed of nine Centers of Excellence: Breast Reconstruction Surgery and Microsurgery; Burns and Complex Wound Management; Cosmetic Surgery of the Face, Breast, and Body; Facial Reanimation Treatment; Hand Surgery and Peripheral Nerve Repair; Non-Invasive Cosmetic Procedures; Pediatric Plastic and Craniofacial Surgery; Post-Weight Loss Cosmetic and Reconstructive Surgery; and Skin Care and Age Management.
Injectable filler is a soft tissue filler injected into the skin at different depths to help fill in facial wrinkles, provide facial volume, and augment facial features: restoring a smoother appearance. Most of these wrinkle fillers are temporary because they are eventually absorbed by the body. Most dermal fillers today consist of hyaluronic acid, a naturally occurring polysaccharide that is present in skin and cartilage. Some people may need more than one injection to achieve the wrinkle-smoothing effect. The effect lasts for about six months or longer. Successful results depend on health of the skin, skill of the health care provider, and type of filler used. Regardless of material filler duration is highly dependent on amount of activity in the region where it is injected. Exercise and high intensity activities such as manual labor can stimulate blood flow and shorten the lifespan of fillers.
Facial Autologous Muscular Injection is also known as Fat Autograft Muscular Injection, as Autologous Fat Injection, as Micro-lipoinjection, as Fat Transfer and as Facial Autologous Mesenchymal Integration, abbreviated as FAMI. The technique is a non-incisional pan-facial rejuvenation procedure using the patient'own stem cells from fat deposits. FAMI is an Adult stem cell procedure used to address the loss of volume in the face due to aging or surgery repair in restoring facial muscles, bone surfaces and very deep fat pads. The procedure involves removing adult stem cells of fatty tissue from lower body, and refining it to be able to re-inject living adipose stem cells into specific areas of the face without incision. FAMI is an outpatient procedure and an alternative to artificial fillers, blepharoplasty or various face lifts. The procedure does not require general anesthesia and risks of an allergic reaction are minimal due to the use of the patient's own tissue used as the facial injection.
Dr. Rashmi Shetty is an Indian board certified dermatologist, teacher, author, and entrepreneur with over 20 years of experience in aesthetic and clinical dermatology. She is known for her transformative yet subtle results with facial enhancement procedures and is a pioneer in bringing injectables and laser technologies to India.
Fat transfer, also known as fat graft, lipomodelling, or fat injections, is a surgical process in which a person's own fat is transferred from one area of the body to another area. The major aim of this procedure is to improve or augment the area that has irregularities and grooves. Carried out under either general anesthesia or local anesthesia, the technique involves 3 main stages: fat harvesting, fat processing, fat injection.