How to slow down the passage of time by eliminating age-related changes on the face, aif.ru told plastic surgeon Alexander Katkov.
Why does the face age?
Facial aging is a multifactorial process, the main cause of which is gravity. There are fixation zones on the face. It is they that hold the soft tissues of the face relative to the bones of the facial skull. But around these ligaments, the soft tissues are mobile and can “slide” under the influence of gravity. This process is called ptosis.
Signs of aging are associated to a greater extent with the middle zone of the face – conditionally, its borders go from the tips of the eyebrows to the wings. This area is free from the ligaments holding the face, where the mimic muscles are located, therefore it is most susceptible to ptosis. So without rejuvenation of the middle part of the face, a pronounced result cannot be achieved.
Nevertheless, in order to choose the right operation that is suitable for a particular patient, a consultation with a surgeon is needed. A dialogue with him will also help you understand whether you have chosen the right specialist and clinic.
How to restore youth to the face?
There are many methods by which you can throw off a few years. Katkov spoke about some of them.
Endoscopic subperiosteal lifting of the middle zone of the face
The technique is fundamentally new, very effective and versatile. With the help of an endoscope, a subperiosteal (i.e., right along the bone) detachment of the soft tissues of the middle zone of the face and its movement upwards is performed. To fix tissues, sutures, screws, holes in the bone, endotines (they look like ribbons with spikes) can be used. “As a result of the operation, the middle zone of the face rises to its place, and the appearance at the same time looks very natural. There is no specific type of “operated” face, when all the tissues seem to be stretched, and nothing sags, but at the same time it is impossible to recognize a person, explains Katkov. “This technique is also suitable for people with initial signs of age-related changes who want to improve the attractiveness of the face, for example, emphasize the fullness of the cheekbones and achieve the so-called apples of cheeks.”
Extended lower blepharoplasty with lipofilling of malar areas
This complex operation is designed to eliminate flaws not only on the lower eyelids, but also in the cheekbones. It can also be used to lift drooping corners of the eyes. With this variant of blepharoplasty, the look becomes younger, dark circles and furrows (scallops) under the eyes disappear, the transition of the eyelid to the cheek is smoothed out, the lower eyelid itself becomes shorter, which is typical for young faces.
The operation can be combined with lipofilling in the area around the eyes, which creates the lost volume of the soft tissues of the paraorbital region. Transplantation with own adipose tissue occurs by injection. The eyelid incision is made just 1 mm below the ciliary margin of the lower eyelid. The tone of the circular muscle of the eye is restored, and it itself rises. Fatty hernias (bags under the eyes) are partially removed or moved along the lower edge of the orbit, creating additional volume at the transition point of the eyelid to the cheek, which makes the appearance very young.
Installation of implants in the cheekbones and chin
Europeans often have flat cheekbones. To increase them and add the missing volume to the middle zone of the face, implants of the zygomatic bones can be installed. In this case, the face will look younger and more attractive.
Accesses can be different: through the infra-ciliary incision, with lower blepharoplasty, through the conjunctiva of the lower eyelid or through the vestibular incision in the oral cavity. And when performing smaslifting – through the superficial fascia of the face. “In order to improve the geometry of the face, implants can also correct the chin, if it is small, underdeveloped or sloping,” Katkov adds. “This is a small operation, it is performed through an intraoral access or through a crease in the chin area.”
According to the expert, this is by far the most innovative technique in anti-aging operations. Sometimes it is also called by the name of the author of the method – prof. B. Mendelssohn. During the operation, special anatomical formations, the so-called spaces, are isolated. On young faces they are practically absent, they are formed only with age. The surgeon needs a good knowledge of the anatomy of these spaces, since there are no nerves or vessels inside them (all of them are localized only in the partitions between such formations), due to this, such operations are more safe.
“The Mendelssohn operation most effectively restores the middle zone of the face, where age-related changes are most pronounced. After all, these anatomical spaces are located in this zone. And the point of application of tension is located directly in the place of the greatest ptosis, which contributes to a harmonious appearance after the operation without any traces of a constricted face, says Katkov. – Anatomical connections between tissues are restored by applying special non-absorbable threads and restoring each ligament. Unlike conventional lifting, the surgeon works within the problem area, and not beyond the edge of the tissue flap. The operation is practically bloodless, making rehabilitation easier.”
Face oval liposuction
Over the years, chiseled features are lost, because due to the accumulation of superficial fat, the entire face or its individual zones “swell up”. To remove excess subcutaneous adipose tissue, liposuction can be done. But before deciding on the type of liposuction, the doctor evaluates the required amount of intervention and the patient’s skin turgor. If the skin is elastic, then mini-liposuction is enough, using cannulas. You can limit yourself to simply removing Bish’s lumps – this variant of liposuction has been most in demand lately. Bish’s lumps are fat capsules, which also sag with age and create extra volume. For an experienced specialist, the operation is quite simple, without complications.
Hardware Smas-lifting of the face
“The technique is carried out by means of the impact of ultrasonic waves not only on the surface, but also on the deeper layers of the subcutaneous fat. Does not leave visible traces, rehabilitation is mild, says the expert. “But this is an option for those who do not yet have pronounced signs of aging. If the patient has: large excess of skin, soft tissue ptosis with the formation of paint bags, nasolabial folds and jowls, non-surgical techniques are ineffective. In addition, they are not as safe as they seem, for example, they can lead to pronounced subcutaneous fibrosis.
Thread face lifting
A minimally invasive alternative to plasty is chosen by those patients who are afraid of radical interventions with tissue incisions. During thread lifting, the doctor inserts absorbable or permanent threads made of inert material into the required area of the face. The threads have notches or knots that capture the skin, pull it in the right direction, creating a network-frame. “The problem is that there are a lot of varieties of threads, as well as methods of the intervention itself,” says A. Katkov. – In addition, the indications for this method are rather limited: it makes sense to do it only for those who do not have excess skin and severe ptosis, the quality of the skin itself is good, and the face is not full. The procedure is most effective in combination with liposuction, lipofilling, blepharoplasty and other minor facial surgeries.”
The expert also adds that, despite the fact that all the described methods are the “last word” in aesthetic surgery, there are contraindications.
- Oncological diseases.
- Mental disorders.
- Chronic diseases in the acute phase.
- Acute infectious diseases.