Facial rejuvenation aims to restore a youthful appearance to the human face. With aging, various changes manifest on our faces, like in all parts of the body. The most common problems include sagging and loss of tissue on the cheeks, and wrinkles and drooping on the neck. Treatment also targets droopy eyebrows, under-eye bags, excess skin on eyelids, wrinkles and sun spots,
The signs of aging in the face develop differently in different persons. It depends on many factors. These include race, genetic-familial structure, climate-environment, facial skeleton, and skin structure. A person’s weight and social life also contribute. For example, in people with white skin and colored eyes, wrinkles in the middle of the face appear at an early age. In dark-skinned people, the cheeks may sag at an early age. In Asian societies. aging of the mid-face and droopy cheeks appear at early ages. Excessive weight gain and weight loss disrupt the elasticity of the skin. Accordingly, signs of aging appear at an early age.
The face is divided into three anatomical units evaluated in respect of aging. These are:
– Upper part of the face: wrinkles and sagging in the forehead and temple area, eyebrows drooping with age, excess skin on upper eyelids are evaluated in this area and suitable solutions 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. Wrinkles and sagginess in this region are assessed and a surgical approach is applied according to the problem.
In some parts of a person’s face, the effects of aging may be more and in some parts less. In facial rejuvenation processes, the first conditions to be evaluated are the wrinkles in the skin and the drooping in the soft tissues. If there are not a lot of wrinkles and drooping of the soft tissues, then Botox, fillers, peeling (chemical, laser, etc.) fat injections from the patients’ own tissues can be recommended as the most appropriate solution.
Surgical procedures are needed when signs of facial aging are more evident. These include 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 three 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. Afterward, (according to the correct placement of the brow) the skin and excess fat on the upper eyelid are corrected. The operation lasts about 2 hours and the average recovery is 1 week.
Mid facial rejuvenation surgery: This 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 pronounces the corners of the mouth, are brought back to a 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, i.e. neck region rejuvenation operations. These are 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 the 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 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. However, stitches on the eyelids are removed after 6-7 days because they are very thin and are not self-dissolving stitches.