Facial Rejuvenation, The Philosophy

In my opinion, facial rejuvenation is one of the most difficult and, at the same time, important aesthetic procedures. Our face is the first thing we see after we wake up in the morning. People communicate with us by looking at our faces. Our face reveals our age, reveals our emotional state, and is the most important structure we express ourselves with! It cannot be hidden. So how should one approach this important feature when planning for its “rejuvenation” with non-surgical or surgical procedures? I would like to share with you my philosophy on facial aesthetics: Total facial rejuvenation.

First, how does our face age? Once we find the right answers to this question, going back in time gets easier and the results of the procedures will be more natural.

Aging of the face has three components:

1 – Loss of volume. As we age, some regions of the face experience partial loss in volume, just as some organs do. Bone, soft tissues, and muscles all experience the process called atrophy. But it is the fat tissue which experiences the greatest volume loss.  The under-eye, eyebrows, eye sockets, cheeks, mid-face, and temple area are all examples of the face where this occurs.

2 – Sagging of the tissues and the resulting laxity. Our face would not sag if we were living on the moon. However, like most of the organs in our body, some of the facial structures give in to the force of gravity and begin to drop. Mid-face, soft tissues on the jaw line, muscles of the neck, eyebrows, and eyelids experience this natural loss of tautness and suddenly we look old.

3 – Decrease in skin quality. Yes, our skin ages, loses its elasticity, and loosens when wrinkles occur. The surface structure becomes distorted and color changes occur.

These changes actually begin at young ages, but become noticeable over time. Hence, separate treatment must be planned for each age group. Whilst at younger ages, the aim is to postpone these changes due to aging; at lager ages the aim should be correcting the deformities.

So what should be done for a successful and natural rejuvenation? Is surgery a necessity? Or do non-surgical solutions work? The answer is actually very simple. It is imperative to intervene with all three components in the right proportions as a whole. In other words, “total facial rejuvenation.” The important thing here is to catch the proportion. An old eylid, but a tight face!? This combination will not look natural!

Let’s begin with the loss of volume. As mentioned, some tissues diminish while aging. A natural and correct rejuvenation plan must include “volume replacement.” This can be achieved with your own fat tissue or temporary fillers; the options vary according to the individual. The important point is to add volume to the right planes (areas with reduced volume) and in the right amounts (without over-inflating). As a general principle, I always prefer the patient’s fat tissue, the most natural and high-quality filling found in our body, which is also rich in stem cells.

Let’s move on to how the tissues hang. Unfortunately, options other than surgery may not be very effective for this deformation. Trying to fill and inflate the sagging tissues with the intention of lifting them is the biggest mistake made by non-specialists today. This is why we may see individuals with swollen faces. Sagging tissue can never be cured by filling it. For minimal sagging, it is possible to take advantage of some non-surgical tightening technologies without damaging the underlying textures. However, the most accurate and effective approach to lifting a sagging eyebrow or eyelid, or to repair facial sagging is surgical removal of these tissues, during the process of lifting. Of course, the plan must include a proportional combination of interventions for other aging components.

And lastly, the quality loss of the skin. In fact, the most correct approach to reducing quality loss is delaying the aging process with the help of a combination of different techniques. Timely and correct toxin applications for wrinkling skin, stimulation for self-renewal of skin, skin care routines, nutritive and restorative applications, and sun protection. Despite all this, part of a successful rejuvenation, includes evaluation and surgical removing of the excess skin. Excess skin can be removed in a facelift, neck lift, brow lift, and eyelid surgeries. The “micro needling” procedure can be used for tightening the remaining skin; our own restorative cells, the platelets, are very influential in this regard. And of course, “resurfacing” acts to smoothen the skin’s surface. Peeling, dermabrasion, and laser are other effective options. But, because of the uniqueness of every skin type and stage of the aging process, each patient may require a different application or combination of applications.

If all these types of treatments are planned specifically for the patient and appropriate and proportional treatments are applied for each aging component, getting back the years will not be very difficult!