the facial aging process from the inside outthe facial aging process from the inside out

A surgeon needs to have a good knowledge and understanding of the superficial musculoaponeurotic system (SMAS) because the threads are fixed underneath the skin tissue in the face and neck [122]. 233242, 2015. The fibroblasts need to be screened for pathogens, and the collagen they produce is affected by viral inhibition. By selecting appropriate patients and attaining proficiency in periorbital anatomy and infraorbital hollow rejuvenation techniques, clinicians can safely and successfully perform hyaluronic acid filler injections that result in high patient satisfaction. The silhouette suture was approved by the FDA in April 2015 for use in draping midface tissue. The various layers of the face and neck affected by ageing are described, including the fat compartments, superficial musculoaponeurotic system (SMAS), potential facial spaces, facial ligaments, and facial nerve. 6, pp. 3, pp. N. F. Boas, Isolation of hyaluronic acid from the cocks comb, Journal of Biological Chemistry, vol. Infraorbital Hollow Rejuvenation: Considerations, Complications, and the Contributions of Midface Volumization. Figure 2 shows the injection of botulinum toxin into the five glabella sites and 3-4 sites on each side of the face. 5, pp. 11071119, 2020. A. M. Albert, K. Ricanek Jr., and E. Patterson, A review of the literature on the aging adult skull and face: implications for forensic science research and applications, Forensic Science International, vol. Human-derived bioengineered collagen(1)Bioengineered human collagen: cultured bioengineered human fibroblasts derive nutrition from the culture medium and produce collagen and extracellular matrix proteins, which can be used to manufacture the required face-filling implants. With the degradation of hygroscopic glycosaminoglycans, the moisture in the skin is also gradually lost. Studies are increasingly suggesting so. F. Briguglio, E. Briguglio, R. Briguglio, C. Cafiero, and G. Isola, Treatment of infrabony periodontal defects using a resorbable biopolymer of hyaluronic acid: a randomized clinical trial, Quintessence International, vol. 2, Article ID e2633, 2020. How important is the genetic makeup? Although different serotypes of botulinum toxin have unique biochemical properties, all have a semblable mechanism of action: they cause muscle paralysis and relaxation by blocking cholinergic nerve transmission. With aging, the orbital width increases, and the contours of the eyes gradually change [39]. doi:10.1046/j.1365-2133.2002.04991.x However, studies have demonstrated that chin deformities can result when the jaws soft tissue drops to overfill the chin [44]. Sulamanidze's Antiptosis (Aptos) Subdermal Suspension Thread hooks a special thread on the skin to make it tense, which counteracts the laxity of the tissue and finally achieves a cosmetic effect of eliminating wrinkles. Activation of herpes may occur after hyaluronic acid injection with symptoms of erythema and crusted papules that require antiviral treatment with acyclovir. They occur occasionally and are related to incorrect injection areas and techniques. It has nine knots in the middle and spans 8cm (knots are approximately 10mm apart). Combination of epidrugs with immune checkpoint inhibitors in cancer immunotherapy: From theory to therapy. Park, J. M. Kim, J. Seok, S. J. Seo, M. N. Kim, and C. S. Youn, Comparative split-face study of durational changes in hyaluronic acid fillers for mid-face volume augmentation, Dermatologic Therapy, vol. eCollection 2023. R. S. Narins and P. H. Bowman, Injectable skin fillers, Clinics in Plastic Surgery, vol. 2023 May 31;4:1178566. doi: 10.3389/fragi.2023.1178566. 143, no. 248251, 2018. M. Matecka, M. Lelonkiewicz, A. Pieczyska, and M. Pawlaczyk, Subjective evaluation of the results of injectable hyaluronic acid fillers for the face, Clinical Interventions in Aging, vol. In the young face (left), the subcutaneous fat deposits (yellow) are masked by the fullness provided by extracellular colloidal fluids (purple). Poly-L-lactic acid (PLLA) is a biocompatible, biodegradable, -hydroxyl-based synthetic polymer, which has been used clinically as the main component of some surgical absorbable sutures for over 20 years [58]. 4, no. Other environmental factors that are purported to affect facial appearance include mental stress, diet, work habits, drug abuse, and disease. 40, no. 231240, 2013. T. Hotta, Dermal fillers. 4, pp. They discussed the anatomic alterations that underlie the changing appearance of specific facial areas. 117122, 2013. An official website of the United States government. In addition to redistribution of facial fat and concomitant loss of surrounding fullness, the fat pockets become more discernible as separate entities, as do many of the underlying facial structures, such as the submaxillary glands and bony protuberances (Figure 1).6 With age, the malar fat pad gradually slides forward and down to bulge against the nasolabial crease, giving rise to the prominence of the nasal fold in the aged face.8 This redistribution and demarcation of fat gives the senile face an unbalanced appearance. Rocha Mota L, Motta LJ, Duarte IDS, Horliana ACRT, Silva DFTD, Pavani C. BMJ Open. [77, 78]. J. F. Scheuer 3rd, D. A. Sieber, R. A. Pezeshk, C. F. Campbell, A. Rohrich et al aimed to predict facial fat atrophy, which directly influences both the volume and shape of the aging face. A. Vierktter, T. Schikowski, U. Ranft et al., Airborne particle exposure and extrinsic skin aging, Journal of Investigative Dermatology, vol. Before A. Woodward, Analysis of the anatomic changes of the aging facial skeleton using computer-assisted tomography, Ophthalmic Plastic and Reconstructive Surgery, vol. 22, no. T. C. Laurent, U. 1990 Apr;122 Suppl 35:1-3. doi: 10.1111/j.1365-2133.1990.tb16118.x. The reduction of fat in this area can also be a cause of thinning of the temples, which results in an emaciated look [40]. The recovery period with Aptos threads is short; however, patients need to follow their doctors advice, such as avoiding sudden chewing and adhering to a massage for 1-2 weeks, to ensure that the results last longer. E. S. Marmur, R. Phelps, and D. J. Goldberg, Clinical, histologic and electron microscopic findings after injection of a calcium hydroxylapatite filler, Journal of Cosmetic and Laser Therapy, vol. The fibroblasts need to be screened for pathogens, and the collagen they produce is affected by viral inhibition. Adverse reactions to bovine collagen include allergy, bruising, local necrosis, bacterial infections, and reactivation of herpes virus infection [62]. Acute complications with hyaluronic acid injections are rare; they include nerve damage, pain due to venous and lymphatic injury, severe bruising due to vascular injury, partial pressure necrosis of the skin, and distal soft tissue necrosis, which can have serious functional and esthetic implications [93, 94]. The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. Each of them offers unique advantages and disadvantages (Table 2) and can solve different aspects of facial aging, such as the loss of collagen, fat displacement, and hypertrophy. 3, pp. After 30 years of age, there may be pit regression [25] and maxillary retrusion, which may lead to flat cheeks as well as depression and widening of the upper lip [26]. A1A7, 1996. Moreover, the decomposition of collagen was increased by upregulating protease [8]. FOIA Typical A-frame deformity in this 49-year-old Caucasian female (A) and sunken eye appearance in this 45-year-old Asian male (B). 43, no. 45, no. Common signs of aging, such as dyschromia, rhytids, loss of skin elasticity, soft tissue deflation, and descent, should be clearly defined and discussed from perspectives of both the patient and plastic surgeon.3 This enhances the process of shared decision-making, in which an agreement on realistic procedural outcome expectations is established in accordance with the physiologic etiology of aging for each respective facial component. 510512, 1998. Swift, S. Liew, S. Weinkle, J. K. Garcia, and M. B. Silberberg, The facial aging process from the inside out, Aesthetic Surgery Journal, vol. Additionally, injections should be avoided at sites of inflammation [12]. Additionally, minimally invasive rhinoplasty, lip surgery, and lower eyelid lifting are becoming increasingly popular among patients. On the right side, these changes cause the face to rotate clockwise relative to the skull base: the brow, orbit, piriform hole, and maxilla rotate downward, thus resulting in a flattened facial angle [28, 29]. 263273, 2012. Facial cosmetology has entered a period of antiaging and rejuvenation . Often, volume deflation will precede changes in volume distribution. HHS Vulnerability Disclosure, Help Introduction: Please enable it to take advantage of the complete set of features! L. Devgan, P. Singh, and K. Durairaj, Minimally invasive facial cosmetic procedures, Otolaryngologic Clinics of North America, vol. Dermatol Clin. Loss of facial fullness and the ensuing facial fat redistribution provides the visual clue to an individual's age (Figure 2).6 Accordingly, the primary goal in any rejuvenation procedure should be to restore the ample, balanced distribution of facial fullness that exemplifies the youthful face.4 The fat compartmentalization of the aging face must be smoothed over, and the former primary arcs and convexities of youth, rebuilt. 5, pp. 26, no. In the past two decades, the use of injectable botulinum toxin has increased by 621% [1]. D. McKee, K. Remington, A. 134140, 2006. The most common complications are temporary. To promote heart health: Include physical activity in your daily routine. 231238, 2016. M. Maia and F. N. Lukash, Autologous fat grafting in young patients: a simple and effective way to achieve facial balance, Annals of Plastic Surgery, vol. Conclusion: 44, no. In the middle part of the face, the reduction in the volume of facial fat and sagging caused by gravity are the main causes of aging [47]. Fine lines and wrinkles. In this part, it is limited for botulinum toxin to treat facial aging, whereas fillers are more commonly used. Fine lines around the lower eyelids and crow's feet emerge 7,8,10. Accessibility A convenient method for assessing the morphological effects of aging is to divide the face into the upper third (forehead and brows), middle third (midface and nose), and lower third (chin, jawline, and neck). 5, pp. Facial aging is an intricate process involving interrelated changes to bone, muscle, fat, and skin. The most common complications are the same as those with most logical surgical procedures, such as pain, swelling, and bruising. 5, pp. A. 12 months after treatment of sectional scars using Bellafill (Suneve Medical, San Diego, CA), significant recovery of scars can be observed in the cheek [, Copyright 2022 Kelun Li et al. official website and that any information you provide is encrypted E. Rostan, Collagen fillers, Facial Plastic Surgery Clinics of North America, vol. Other more common signs of facial aging include horizontal forehead creases, temporal or brow hollows, tear troughs, nasal wrinkles, vertical lip lines, thinning lips, irregular jawline, atrophy of the preauricular fat, and thinning earlobes [30, 31]. With internal aging of the skin, the synthesis rate of collagen decreases and its degradation rate increases [7]. S. Humphrey, J. Carruthers, and A. Carruthers, Clinical experience with 11,460mL of a 20mg/mL, smooth, highly cohesive, viscous hyaluronic acid filler, Dermatologic Surgery, vol. The Aptos approach is considered by Sulamanidze et al. J. de Benito, R. Pizzamiglio, D. Theodorou, and L. Arvas, Facial rejuvenation and improvement of malar projection using sutures with absorbable cones: surgical technique and case series, Aesthetic Plastic Surgery, vol. B. Scott, A. Rosenbaum, and C. C. Collins, Pharmacologic weakening of extraocular muscles, Investigative Ophthalmology, vol. government site. B. Laurent, and J. R. E. Fraser, The structure and function of hyaluronan: an overview, Immunology & Cell Biology, vol. D. R. Hart, S. G. Fabi, W. M. White, R. Fitzgerald, and M. P. Goldman, Current concepts in the use of plla: clinical synergy noted with combined use of microfocused ultrasound and poly-l-lactic acid on the face, neck, and decolletage, Plastic and Reconstructive Surgery, vol. 128138, 2017. This review introduces the possible causes of facial aging and its related topics with a focus on facial injectable drugs, main filler materials, and some current antiwrinkle technologies, such as thread lift and radiofrequency rhytidectomy. 5, pp. 12, pp. 78, no. Images depict the integrity of the medial cheek fat pad, periorbital bone, medial brow, and lid-cheek junction in a young adult (A) vs the age-related changes in an older adult (B), including exaggeration of the brow and tear troughs as well as smaller, rounder-looking eyes. 20, pp. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. Pathways were subdivided into intrinsic and extrinsic senescence mechanisms. In: Baker SB, Patel PK, Weinzweig J, eds, Prediction of facial aging using the facial fat compartments, The lift-and-fill facelift: superficial musculoaponeurotic system manipulation with fat compartment augmentation, The Author(s) 2021. 99, no. Mr. Kelun Li had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Why your face ages and what you can do February 12, 2021 Beneficial ways to turn back time for your aging face A gracefully aging face is a beautiful thing, but there are changes that occur with age that we would like to slow down. Department of Plastic Surgery, Cleveland Clinic. With aging, the skin envelope, Superficial temporal compartment: volume and, Superficial temporal compartment: volume and size by age group. If it is used for lip augmentation, it may result in a large number of nodules. 2, pp. Nonanimal sources of hyaluronic acid are of bacterial origin. Tan SL, Brandt MG, Yeung JC, Doyle PC, Moore CC. The main facial filler materials include hyaluronic acid, calcium hydroxyapatite, poly-L-lactic acid, collagen, autologous fat, and polymethyl methacrylate. Dry skin patches feel rough and scaly. Overview. and transmitted securely. 436443, 2019. Every knot is inset into an assimilable hollow cylinder made of copolymers containing levulinic acid and acetyl cross-esters. M. Gierloff, C. Sthring, T. Buder, V. Gassling, Y. Ail, and J. Wiltfang, Aging changes of the midfacial fat compartments: a computed tomographic study, Plastic and Reconstructive Surgery, vol. 3, pp. 129136, 2015. Mild postoperative erythema and volume asymmetry have also been reported [110]. suppl_1, pp. J. C. Lee and Z. P. Lorenc, Synthetic fillers for facial rejuvenation, Clinics in Plastic Surgery, vol. Images depict, Fat compartments in the face are broadly characterized as superficial (A) or deep, Perioral dynamic discord is illustrated across the ages. The most common postinjection side effects are usually limited to 2 weeks and include erythema, ecchymosis, and edema. Fat grafting can fill the hollow spaces in the orbital and temple areas and improve the contours of the cheekbone areas and jaw. 30, no. 2, pp. It may also have hidden dangers of animal-derived pathogens, such as mad cow disease. Objective: This review aims to summarize different kinds of applications of minimally invasive surgery in improving facial aging to provide a comprehensive and accurate introduction on the issue of esthetic treatment of facial skin.Overview.In the twentieth century, facial rejuvenation has become a new beauty trend. 102, no. Before Sculptra (Galderma, Fort Worth, TX, USA) injection. 52, no. The volume loss of the nasolabial sulcus and the head of the medial buccal adipose septum may also lead to lacrimal groove deformities, which aggravates facial aging and makes the nasopharyngeal folds and palpebral sulcus more obvious [18]. Collagen is an excellent coagulant with hemostatic effects, does not easily diffuse distally, and does not easily embolize (does not mean that it will not embolize). 45, no. The correct injection method should be mastered, and its abuse must be avoided. 245250, 2014. 1277e1289e, 2019. The symbols represent different injection depths: the squares represent the full depth of the needle; X represents half needle depth; asterisk indicates one-third of the needle depth [, (a) 67 year-old patient shows multiple signs of aging due to loosening of the soft tissues in several areas, such as sagging in the mid and lower face, and resorption of the upper and lower jaws. Ideally, longitudinal imaging studies in the same patients over a lifetime would further the understanding of the dynamics of fat distribution in facial aging. Der Hautarzt; Zeitschrift fr Dermatologie, Venerologie, und verwandte Gebiete. Combinations of these treatments can provide patients with reasonable, comprehensive, and personalized treatment plans. 136, pp. Conclusions. If it is injected at a site of inflammation, it will worsen the inflammation further. These microspheres dissolve in a piecemeal manner into calcium and phosphorus ions within a few months to a year [57]. M. A. Sulamanidze, T. G. Paikidze, G. M. Sulamanidze, and J. M. Neigel, Facial lifting with APTOS threads: feather lift, Otolaryngologic Clinics of North America, vol. 28202829, 2020. Nasal reconstruction with the expanded forehead flap: Long-term follow-up of esthetic outcome and 12-year experience. -. Facial plastic surgery clinics of North America. Z. J. Berbos and W. J. Lipham, Update on botulinum toxin and dermal fillers, Current Opinion in Ophthalmology, vol. S. R. Coleman and E. B. Katzel, Fat grafting for facial filling and regeneration, Clinics in Plastic Surgery, vol. Drink plenty of water, eat well, and exercise regularly so you can detox for skin problems, promote healthy circulation, and keep those dead skin cells moving to make space for vibrant, new cells. Bethesda, MD 20894, Web Policies eCollection 2023. The pursuit of beauty has promoted the development of minimally invasive plastic surgery. 3, pp. 367371, 2002. Finally, we appreciate the authors valuable overview of the aging process. 265e276e, 2017. 7, pp. 433444, 2009. 6, Article ID e13963, 2020. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. J. d. P. Tavares, C. A. C. P. Oliveira, R. P. Torres, and F. Bahmad, Facial thread lifting with suture suspension, Brazilian Journal of Otorhinolaryngology, vol. s1, pp. 15, no. 34, no. Objective. Careers. Botulinum toxin is most commonly used to treat the upper part of the face to eliminate or reduce frown lines (prebrow and wrinkle muscles), forehead lines (frontal muscles), and periorbital or crows feet lines (lateral to the orbicularis oculi muscle). Facial muscles can be divided into expressive and masticatory muscles. R. J. Rohrich, A. Ghavami, and M. A. Crosby, The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations, Plastic and Reconstructive Surgery, vol. Wrinkle prevention Use sunscreen Try a retinoid Use a moisturizer Stay hydrated Eat right Sleep on your back Don't smoke Relax Takeaway. Perioral dynamic discord is illustrated across the ages. Introduction: 5, pp. Lower facial rejuvenation is an expanding area in facial plastic surgery with both surgical and nonsurgical treatment options, with an emphasis on evidence-based medicine. Skin nodules can easily appear, if the dose or concentration is too large or the preparation time is insufficient. Oxford University Press is a department of the University of Oxford. 4, pp. 2432, 2008. 13, no. 11031108, 2017. Although hydroxyapatite calcium has become the second most popular filling agent after hyaluronic acid due to its short marketing time and good biocompatibility with the human body, its use is limited to the lacrimal groove area of the lip and the lower orbital margin. It also attracts moisture into the skin [81]. 75, no. Hyaluronic acid injections can, therefore, be used to replace the loss of volume on the face to restore its youthful appearance [82]. 2003;14(2):14959. Methods We conducted a qualitative study using semi-structured face-to-face interviews with 20 older adults in their early 90 s. A . JAMA Facial Plast Surg. 13671376, 2007. Both shallow and deep fat tissues are separated into multiple smaller pieces of fat [12]. Epub 2020 Apr 12. 23, no. There are several signs of aging on the face. Understanding the effects of bone resorption on the aging mandible allows the facial plastic surgeon to augment the mandible appropriately to achieve a more effective rejuvenation of the lower face. Patients with neuromuscular diseases, such as myasthenia gravis, EtonLambert syndrome, and multiple sclerosis, are unsuitable for botox injections [52]. In addition, contraction of the platysma muscle, caused in part by the need to support the deeper neck and floor of mouth structures, gives rise to vertical fibrous bands on the neck, whereas laxity in the overlying skin can create horizontal rhytides. 25, no. Better yet, strategic facial massage methods can also accelerate the removal of toxins and excess fluids to help your skin look refreshed, calm, and clear. 330339, 2010. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. D. Kahn and R. Shaw, Overview of current thoughts on facial volume and aging, Facial Plastic Surgery, vol. P. Oyetakin-White, A. Suggs, B. Koo et al., Does poor sleep quality affect skin ageing? Clinical and Experimental Dermatology, vol. 15, no. The product that fills the dermo-epidermal junction is used for superficial skin lines (eyebrow lines, fine lines, crows feet, scars, and horizontal forehead lines), while the product that contains more collagen is better suited for moderate and deep lines. [125] to be the most effective in the midface region. -, Welle S, Brooks AI, Delehanty JM, Needler N, Thornton CA. The hypertrophic cheek area would be expected to lie further down the face when the subjects were upright.