Facial Rejuvenation

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Facial signs of aging

Most people believe that wrinkles are the only facial sign of aging. That is why they only seek to remove wrinkles. Wrinkles can be removed using a variety of procedures including anti-wrinkle creams, laser, peeling, Botox injection, facelift, etc. But are wrinkles the only facial sign of aging? Which procedure is well suited for removing wrinkles? Will it work for all people? Is it enough to remove wrinkles?




The following sections provide a more detailed description of facial signs of aging along with examples that can help you choose a proper rejuvenation procedure.

Aging reduces collagen, elastin, and hyaluronic acid, giving the face a thinner skin on which small wrinkles will appear. Wrinkles often become visible once you reach the age of 35.

However, they may appear earlier on facial skin of some other people. These wrinkles get deeper over time, used as an indicator by others to estimate one’s age.



However, signs of aging are not limited to wrinkles. Facial muscles and soft tissues (in particular fatty tissues) become softer, giving a lax appearance to the eyelids, the eyebrows, and the cheeks.

We can tell someone’s approximate age by looking at laxities and wrinkles in different parts of the face. These often occur at the age of 35 and are intensified as the individual gets older.

The figure below shows a schematic of facial features at the age of 35, 45, and 55.



As noted above, facial features start to change once you reach the age of 35. But how can we tell a 20-year-old person from a 33-year-old one, as usually no wrinkles or sagging skin are visible from 20 to 33? The answer is by looking at facial bones. During these years, facial soft tissues, and in particular facial tissues, are reduced, giving the face a more boney look.
In the figure below, the left section shows reduction in fats (yellow) while the right part indicates how muscles are reduced as one ages.



Therefore, aging not only affects the skin, but it also involves changes in all subcutaneous facial tissues. So, rejuvenation requires compensations for reduced soft tissues using fat transfer or filler injection.

Common procedures

A number of common methods used for facial rejuvenation are described here.
Botox injection

Botox injection is an inexpensive, convenient procedure with no significant complication for achieving highly desirable effects in terms of removing wrinkles, particularly on the forehead and around the eyes. Botox removes all shallow wrinkles to a large extent, and semi-deep wrinkles to a lesser extent. But it is not that effective in removing deep wrinkles for which Botox injection should be combined with other procedures (for more detailed description of Botox injection see other sections of our website).

Filler injection

As noted earlier facial fats and muscles are reduced as a result of aging, which usually manifest itself in the form of thin face, bags under the eyes, wrinkles around the lips, and boney look of the face. Fillers can be used to modify this situation. Fillers are especially helpful for people who are 35 to 40 (for more detailed description of filler injection, see other sections of our website).

Laser and chemical peels

Rejuvenating effects of laser and peeling are limited to the skin and subcutaneous tissues. While different types of laser are used for this purpose, their effects vary in terms of the extent to which wrinkles are removed and the time over which the effects will remain. It should be noted that at old ages, changes occur not only in fatty tissues but also in muscles and bones. Therefore, laser and peeling are not effective on their own and should be combined by other rejuvenation procedures.

Platelet rich plasma (PRP)

Platelet rich plasma is used to form collagen and thicken the skin and subcutaneous tissues. In older individuals, this method should be used in combination with other procedures. Although PRP is useful in many cases, its effects are only transitory and will not last longer than a few months. The procedure is surrounded by exaggerations promoted by manufacturers and distributors who advertise PRP as the magical procedure of the century.

Fat transfer

Fat transfer or injection rejuvenates your face by increasing the volume of soft tissues. In this case, fat functions as filler. In addition, subcutaneous injection can have thickening and collagen-producing effects similar to those of laser and peeling. Therefore, in addition to compensating for the reduced volume of the face, fat transfer can enhance facial skin. Contrary to what most people believe, fat transfer has permanent effects. Short-term effects are the result of improper techniques. It should be noted that in this procedure live fat cells are transferred from one part of the body to another, and the effects will be lost if these cells are lost as a result of improper techniques. Some doctors recommend keeping extra fat in freezer for later injection. Clearly, this will only have transient effect as there will be no live cell for injection (fat transfer is described in more details in other sections of our websites).

Facelift (rhytidectomy)

Most people have only limited information on this procedure. For example, if the only thing someone knows about cars is that they are used for travelling, they will be unaware of safety issues, auto options, different models, possibility of carrying loads, after sale services, prices, and other things related to cars. This is also the case for facelift. Young and middle-age people apply for facelift, while they don’t know that they do not need a facelift. They can solve their problems through a simpler, more inexpensive procedure. It should be noted that facelift is performed through various methods. Some surgeons only remove parts of the skin, while this will only have temporary effects. Permanent effects (in the sense that the patient will look younger that people of the same age for any years) can be observed when subcutaneous layers are lifted and fixed at proper points. Except for lifting the forehead and the eyebrows, many people do not need any form of lifting when they are under 55 to 60, as their problems can be solved by simpler rejuvenation procedures. However, depending on genetic background and individual characteristics, some people may need a lift in their eyebrows or forehead at younger ages. The requirement for facelift can be met for many younger individuals using methods like endoscopy.

Important recommendations for choosing rejuvenation procedure

Delineate your problem. For example, you don’t need a procedure that will affect all parts of your face if you are only complaining about wrinkles around your mouth.
Know more about different rejuvenation procedures, particularly those that can help solving your problem. You should consult your doctor to gain more information on these. Things that you should usually know include how the procedure works, costs, durability, complications and side effects, alternative procedures, and the like.
Seek consultation from a doctor who is familiar with different rejuvenation procedures since some doctors are only familiar with one procedure and they deny their patients of the right to try other procedures by recommending the method they are familiar with as the only possible option.
Avoid trying new, untested rejuvenating methods as possible. Wait for some years to make sure that these procedures are safe. For example, permanent fillers were used for a while and then banned because of side effects like abscess and flow of fillers. However, many people who went under these procedures are still involved with these side effects.
Remember that each procedure has some advantages and disadvantages. No procedure is free of complications. Just because you don’t know about these complications does not mean that they don’t exist. Try to choose procedures that have minimum, reversible, short-term side effects.
Do not go for free consultations. It is ok to ask a question which takes about 5 minutes to answer. But in some free consultations clients are tricked into believing in the effectiveness of a particular procedure. A useful consultation session sometimes take half an hour or longer (do you expect consultants to give you this time for nothing in return?) Fairness requires that your doctor sometimes ask you not to go for something which is financially profitable for him or her but not appropriate for you. On the other hand, consultation fees are often negligible compared to what you pay for a surgery or rejuvenation procedure. But on the other hand, paying this fee will create a commitment for your doctor to observe principles of fairness and honesty. So, a fair consultation will ensure that what you pay for next procedures will pay off.
You can go to another doctor if your first consultation has no useful outcome. You can also seek information from people with similar problems who have received effective treatments.
Higher price does not mean better solution. Although costs and expenses are very important, but do not make financial issues your priority when choosing a procedure.
Procedures like fat transfer, facelift, and the like should be performed under standard conditions, and preferably at operation rooms. Currently, some of these procedures are conducted under substandard conditions that can lead to unwanted results in addition to pain and inconvenience during treatment.


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