Facial rejuvenation

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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.

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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.

Visual appraisal of facial youthfulness

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]

Golden ratio

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]

Influence of changes in bone structure

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. [4] 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. [5] Future facial rejuvenation techniques may take into account these findings and restore bone lost by aging processes. [6]

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. [7] A significant upward trend on the number of facial rejuvenation procedures is predicted, [5] and could be due to the following factors:

  1. Men have also started to perform these procedures at increasing numbers;
  2. Emphasis on image of youthfulness by the mass media and fashion;
  3. Increasing numbers of senior people enjoying good health and financial affluence at older ages;
  4. Decreasing costs of surgery and other cosmetic procedures, making them affordable to all

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. [6]

Procedures

Facial rejuvenation procedures can include (but are not limited to):

See also

Related Research Articles

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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.

Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity (mouth), head and neck, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.

<span class="mw-page-title-main">Rhytidectomy</span> Type of cosmetic surgery

A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure intended 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.

<span class="mw-page-title-main">Blepharoplasty</span> Surgical modification of the eyelids

Blepharoplasty is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper portion of the cheek. The procedure is more common among women, who accounted for approximately 85% of blepharoplasty procedures in 2014 in the US and 88% of such procedures in the UK.

Lip augmentation is a cosmetic procedure that modifies the shape of the lips using fillers, such as collagen or implants. The procedure may be performed to increase lip size, correct asymmetry, create protrusion, or adjust the ratio of the top and bottom lips. The procedure typically involves surgical injection, though temporary non-surgical alternatives exist.

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<i>10 Years Younger</i> (American TV series) American reality series

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<span class="mw-page-title-main">Buccal fat pad</span> Organ of the face

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.

<span class="mw-page-title-main">Nasolabial fold</span> Two skin folds in the face

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 natural or acquired unwanted appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, spider veins and or any unwanted externally visible appearance. 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.

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, Queens, Brooklyn, Westchester, 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.

Non-surgical rhinoplasty is a medical aesthetic procedure in which injectable fillers, most commonly hyaluronic acid ones like Restylane and Juvederm or calcium hydroxyapatite (Radiesse), are used to alter and shape a person's nose without a surgery. The procedure fills in depressed areas on the nose, lifting the angle of the tip or smoothing the appearance of bumps on the bridge. Non surgical rhinoplasty is an augmentation procedure, so it cannot reduce the size of someone's nose. The cosmetic procedure carries the risk of causing serious skin damage or distant complications like blindness. If the filler product is injected into an artery, filler can travel in the arteries and blocks smaller size arteries like ophthalmic artery and cause blindness. If blood vessels of the skin is blocked, skin necrosis can develop. Hyaluronic acid based fillers can be reversed even if injected into a blood vessel with an enzyme called hyaluronidase, which can be also injected like fillers.

Injectable filler is a soft tissue filler made of polysaccharides injected into the skin at different depths.

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's 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.

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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.

Lip flip is a cosmetic procedure that modifies the shape of the lips using botulinum neurotoxin type A and occasionally adding hyaluronic acid fillers. The procedure is performed in order to increase the size of the lips. The procedure typically involves injection of the neurotoxin along the vermilion border of the lips. This leads to a relaxation of the underlying muscle and eversion of the lip. Hyaluronic acid fillers are sometimes added in order increase volume in the lips.

References

  1. Wulc, Allan E.; Sharma, Pooja; Czyz, Craig N.; Czyz, Craig N. (2012). "The Anatomic Basis of Midfacial Aging". Midfacial Rejuvenation. pp. 15–28. doi:10.1007/978-1-4614-1007-2_2. ISBN   978-1-4614-1006-5. S2CID   1713289.
  2. Pallett PM, Link S, Lee K (2010). "New "golden" ratios for facial beauty". Vision Res. 50 (2): 149–54. doi:10.1016/j.visres.2009.11.003. PMC   2814183 . PMID   19896961.
  3. "Leonardo da Vinci's Polyhedra".
  4. 1 2 Pessa, Joel E. (August 2000). "An Algorithm of Facial Aging: Verification of Lambros's Theory by Three-Dimensional Stereolithography, with Reference to the Pathogenesis of Midfacial Aging, Scleral Show, and the Lateral Suborbital Trough Deformity". Plastic and Reconstructive Surgery. 106 (2): 479–88, discussion 489–90. doi:10.1097/00006534-200008000-00040. PMID   10946949. S2CID   23822193.
  5. 1 2 "The Anatomy of the Aging Face: Volume Loss and Changes in 3-Dimension…". Archived from the original on 19 November 2014.
  6. 1 2 "The Anatomy of the Aging Face: Volume Loss and Changes in 3-Dimensional Topography". Archived from the original on 2014-11-19. Retrieved 2014-11-18.
  7. "2013 Plastic Surgery Statistics Report" (PDF). Archived from the original (PDF) on 2015-02-09. Retrieved 2014-11-18.

Further reading