We have come across news from time to time that the average human lifespan is getting longer. As life expectancy increases, it is inevitable that the physical changes caused by aging will become more severe. In fact, aging begins in the 20s. The fact that it is not the same density in everyone depends on some external factors and genetic infrastructure. Photodamage, that is, the damage to the skin by ultraviolet light, comes at the beginning of the external factors. As the exposure time to sunlight increases, the amount of destruction increases proportionally. As the age progresses, the total time also lengthens along with the exposure time. The second important external factor is smoking. Smoking disrupts the nutrition or blood supply of the skin by destroying the medium and small vessels throughout the body.
Genetic structure or familial predisposition is related to the protective support differences that tissues give to the aging process. Skin damage caused by external factors is constantly repaired. This capacity decreases with advancing age.
A number of anatomical and histological changes occur due to aging on the face. Although it occurs most clearly in the skin, changes are inevitable in the subcutaneous tissues, muscles and bones. Over time, the skin becomes thinner and stains appear. Some support structures such as hyaluronic acid, which are already present in the skin and give a lively and fresh appearance, decrease and the skin loses its tension. Elastic fibers and collagen are other structures that suffer from aging. Losing their properties also causes a decrease in skin elasticity and loss of volume. Muscles are also shortened and thickened by this process. In this way, mimic muscles cause wrinkles on the skin that falls on them and deepen over time. Subcutaneous adipose tissue is the structure that causes great changes with age. They experience two important changes, the most important of which is loss of volume. With the loss of volume, the skin that is tense on it will gradually lose this feature. Another important change is the dragging or sagging of the skin due to gravity. The factor that reduces the tension of the skin and exacerbates the negativity in the skin and subcutaneous tissue is the loss of volume in the facial bones. The loss of volume in the deepest, which increases with time, increases the shriveling and sagging of the tissues above it. The most obvious recession is around the eyes, in the upper and lower jaw bones. While the fragility of these bones increases over time, their support to the tissues above them decreases considerably.
All these changes are tried to be reversed with treatments suitable for all ages. The treatment methods we use at an early age can be very different from each other in older ages. In the treatment, it is important to make a plan by considering the different tissue layers. The laser, peeling or cream treatments we use for the skin should be combined with the filler or botox used for the treatment of the middle layer. Again, deep fillings or implants for bone resorption are one of our important weapons. In recent years, fat injections have been included in important treatment protocols, especially because they cause dramatic changes in the face. Anatomical regions should be handled separately and the type of treatment should be noted. As a result of the examination of the face, what will be used in the rejuvenation of each region and layer should be planned before the treatment like a prescription writer.
In general, the primary weapon for wrinkles on the forehead and around the eyes is botox. Deep lines can be supported with filling, but filling should never replace botox here. Fat injections and brow lift should also be considered. The main weapon in rejuvenating the middle face, that is, the cheekbones under the eyes, is deep, medium deep and superficial hyaluronic acid fillers or fat injections. Mid-face lift-hanging is another option in advanced ages. The tear trough is the area that needs special attention. Fine-particle hyaluronic acid, called light filling, is a good option for the improvement of this area. Macrofat (on the bone), microfat (under the muscle) and nanofat (intradermal) applications give satisfactory results. The treatment of the lower face also requires special attention, and this area benefits from surgical treatments such as facelifts. Again, around the mouth is one of the areas that requires careful planning. While filler is one of the most valuable tools in this area, botox helps to optimize the result. The fold that separates the upper lip from the cheek and the valley-like formation (Marionette groove) in the lower lip cheek connection are one of the areas where the filling is used most frequently. The neck area is one of the areas where aging relentlessly manifests itself. Although it is not very well known in this region, botox application reduces horizontal lines. The most reasonable treatment in advanced ages is again neck lift.
As a result, the face deserves a careful and detailed approach, as it is the area where aging is felt most severely. Planning is done both in layers and regionally as lower, middle and upper face. There is no doubt that there will be great advances in the rejuvenation of this region in the future with the help of technology.
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