With aging, various changes can be seen on our faces just like in all parts of the body. Wrinkles, sun spots, droopy eyebrows, under eye bags, excess skin on the eyelids, sagging and loss of tissue on the cheeks, wrinkles and drooping on the neck are the most common problems.
The indication of aging in the face does not develop the same in everyone. It depends on many factors such as race, genetic-familial structure, climate-environment, facial skeleton and skin structure, weight-social life etc. For example, in people with white-skin-and colored eyes, the wrinkles in the middle begin to appear at an early age, while in dark-skinned people, the cheeks may sag at an early age. In Asian societies which have slightly underdeveloped middle face compared to the lower face, that is to say the cheekbones are not clear-the upper jaw is located a little behind; aging of the mid face and droopy cheeks are seen at early ages. As excessive weight gain and weight loss disrupts the elasticity of the skin signs of ageing can be seen at an early age.
All the anatomical units considered in terms of aging indication, are evaluated in three main sections:
– Upper part of the face: wrinkles and sagging in forehead and temple area, eyebrows drooping with age, excess skin on upper eyelid is evaluated in this area and suitable solutions are produced.
– Middle part of the face: The part between the lower eyelids and the lower jaw. Problems related to aging in the lower eyelids and lateral cheeks are solved using different surgical techniques.
– Lower part of the face: covers the whole neck from the side of the lower jaw. The wrinkles and saggyness in this region are assessed and the surgical approach is applied according to the problem.
In some parts of a person’s face, the effects of ageing may be more and in some parts less. In facial rejuvenation processes, the wrinkles in the skin and the drooping in the soft tissues are evaluated first. Botox, fillers, peeling (chemical, laser, etc.) fat injections from their own tissues can be recommended as the most appropriate solution if there aren’t a lot of wrinkles and drooping in the soft tissues.
If the signs of aging are more evident in the face, surgical procedures are needed if there is drooping in the eyebrows, excess skin on the eyelids and under eye bags, sagging on the sides and deep cheek lines, wrinkles and sagging in the neck. Depending on the requirements surgery can be done separately or together for these 3 regions in the face.
The most common surgical procedure in the upper face region; (Endoscopically) is natural rejuvenation by bringing all the soft tissues which come down from the bone structure of the forehead and eyebrow area back to their younger versions and fixating them to the bone. This procedure is performed with a 3-4 cm scalpel incision on the hairy part of the skin, with the help of an endoscopic camera system. Afterwards, (according to the correct placement of the brow) the skin and excess fat on the upper eyelid corrected. The operation lasts about 2 hours and the average recovery is 1 week.
Mid facial rejuvenation surgery; is performed with an incision in the lower eyelid just beneath the eyelash (leaving almost no marks). The soft tissue (skin, fat tissue and muscles), which descends down from the cheekbone and pronouncing the corners of the mouth, is brought back to its youthful position and restored to the bone structure to provide a natural rejuvenation. The operation lasts about 2 hours and recovery is 1 week.
There are many techniques used in the lower face, ie neck region rejuvenation operations. It is most commonly performed with an incision that starts from the front of the ear and rotates behind the ear. To correct the wrinkles and sagging in skin and soft tissues; the tissue called SMAS (consisting of strong connective tissue content), which holds the soft tissues underneath the skin, is first pulled from under the skin and fixated to the bone structure behind the ear. Then the skin is rejuvenated at the appropriate position and without overstretching. When excessive strain is applied to the skin, there is a risk of expansion.
The operation lasts about 2 hours and recovery is 1 week. All facial rejuvenation surgery is performed under general anesthesia. The surgery varies from 2 to 6 hours depending on the operations to be performed. Depending on the duration of the operation, the patient may need to stay at the hospital for 1-2 nights. The average recovery period is 7-10 days. Most of the stitches are self dissolving, but the stitches on the eyelids are removed after 6-7 days because they are very thin and are not self dissolving stitches.