Facial Rejuvenation

Three basic changes take place in the face during aging:

· Due to gravity, tissues sag downwards. This effect is more marked in thick skin. The eyebrows, upper eyelids, cheeks and neck are the structures most affected by gravity. As age advances, our eyebrows and upper eyelids pile downwards, the cheeks sag downwards and the lines running from the nose to the lips deepen. Accumulations begin at the edge of the jaw bone, the neck skin loosens and the double chin becomes prominent.

· Soft tissue loss occurs in the face. Due to the loss of subcutaneous tissue, the skin thins, the cheeks lose their fullness, the eyes become sunken, the under-eye bags become prominent and the midface region flattens. As the midface loses its fullness, the facial skin accumulates at the jaw edges. The face, which is oval when young, becomes round over time and later takes on a rectangular shape.

· Skin aging begins. The skin thins and loses its elasticity. Especially due to the sun, spots and skin lesions that may later turn into cancer form on the face. Expression lines form due to the effect of the facial expression muscles. These appear most in the form of crow's feet at the corners 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 pronounced in people with thin skin.

Perhaps the most important factor determining aging is genetics. A person with a good genetic make-up ages late even if environmental conditions are poor. Apart from this, ethnic characteristics are important. While sagging due to gravity is observed more in the thick-skinned Mediterranean type, wrinkles are more marked in thin-skinned, fair Northern Europeans. The factors we can control regarding aging are the following: sleeping regularly, eating well, staying out of the sun, drinking plenty of fluids, not smoking, not drinking too much alcohol, staying away from tension and sadness, living in a clean environment, avoiding excessive make-up, and regularly using moisturisers and skin care products.

We divide facial rejuvenation operations into three: Upper face rejuvenation: The forehead region, temples, eyebrows and upper eyelids. In this region, lifting procedures are mostly performed to address the sagging created by gravity. These include endoscopic and open forehead lift procedures, temporal lift, brow lift, brow suspensions, upper eyelid surgery (upper blepharoplasty) and filler applications. Midface rejuvenation: The lower eyelids, cheeks and cheekbones. In this region the aim is to correct the disturbed lower eyelid-cheek relationship, to move the cheek that has sagged downwards back up, and to replace the soft tissue loss that has occurred. These procedures include lower eyelid surgery (lower blepharoplasty), endoscopic midface lift, midface lift procedures performed through the lower eyelid, midface suspensions, fat injections and fillers. · Lower face and neck lift: the jaw edges, lower lips and neck. In this region the aim is to lift the face that has sagged downwards under the effect of gravity, to correct the skin accumulations that have formed over the jaw bone (jowl), to remove excess fat in the neck and to tighten the neck. These procedures include face and neck lift operations and liposuction procedures for the neck.

Non-surgical rejuvenation procedures include suspension (thread) procedures, skin peeling procedures and filler applications. With suspensions performed using a closed method and special sutures, the eyebrows, midface region and neck can be suspended. They are effective on mild sagging and their effects are temporary. However, they are a suitable method for patients for whom it is thought to be too early for surgery and for patients who do not want surgery. They are applied under local anaesthesia and the recovery process after the procedure is very short. The aim of skin peeling procedures is to remove the spotted, damaged and wrinkled upper layer of the skin so that new, fresh skin takes its place. This procedure is carried out either by mechanically sanding the skin (dermabrasion), by peeling it through burning with various acids (chemical peeling, chemical peel), or by peeling it with the help of laser beams. Besides peeling the skin, lasers and other light applications also stimulate collagen production under the skin, enabling the skin to thicken and be refreshed. The aim in filler applications is to prevent expression lines from forming and to delay their deepening by rendering the facial expression muscles inactive. They are very effective on crow's feet at the corners of the eyes, vertical lines between the eyebrows and horizontal lines on the forehead. Various filler substances are used for filling deep wrinkles on the face, replacing volume loss in the midface, defining facial contours and plumping the lips. While fat tissue taken from the patient is preferred for large areas, ready-made fillers are applied for smaller areas. The most frequently used of these is the substance called hyaluronic acid, which is found in the connective tissue between cells in the body.