Nowadays the way we look is very important and being the face the first impression you get from other people; facial rejuvenation has become a very important chapter of modern plastic surgery.
Not long ago this meant a huge surgery with a very long recovery time and often with different stigmas that easily showed that a surgery was performed.
Later in time skin fillers and skin resurfacing appeared in the scene; it was a raffle to know which was going to give the patient longtime problems.
Scientific studies, time, and experience have allowed at this moment to deliver, with a high degree of safety, surgical and non-surgical methods to aid in facial rejuvenation. The surgical and non-surgical methods do not exclude each other.
At one point in a patient’s history one can be a better indication than the other; but they work usually in a complementary way. Each time patients seek a more natural look and shorter recovery periods.
When one looks at the face of another person the first thing that one sees are the eyes, so the eyelid area is of utmost importance. There is very little that can be done in the non-surgical aspect in this area.
One of the few things that can be corrected is the “crows feet” area which can be treated with botiliun toxin (Botox® or Dysport®). A surgery is indicated when the patient has certain characteristics such as: excess of skin, which in some cases can hamper peripheral vision, fat pads in the upper inside or in the lower eyelid, and closing of the orbital opening.
The surgeon will indicate the patient if in the surgery lower or upper eyelid have to be performed, and what other structures have to be taken into consideration such as the brow or forehead or frown area.
In the mid part of the face the cheeks are what take most of our attention. Earlier in time the folds that start at both sides of the nose get deeper and filler is the best option for improvement.
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Here the two safe molecules to be injected are hydroxyapatite (Radiesse®) and hyaluronic acid (Juvederm®, Restylane®, or Teosyal®). These would also work for the marionette lines at the side of the mouth that are going downwards.
The fillers could work well in other areas of the cheek and in combination with botolinium toxin in the frown area too.
Being that the main concern is the lost of tone and consequent laxity of the tissues, there is technology to reverse this effect. A control heating of the tissue by ablative and sublative radio frequency can help greatly.
In the lower part of the face, the neck, is more often addressed by surgery. Non-surgical procedures serve in very mild form to correct the of laxity of the tissue, and here equipment with ablative and sub ablative technology would be the way to go. And in very select cases the use of Botox® for strong muscular bands could be indicated.
Any more than mild cases would require surgery, that would be a neck lift by itself or as part as a full face-lift. For the cheek and neck area such techniques as those involving some types of threads have shown, until now, that they are not long lasting, have a very limited effect, and only good for very thin faces.
A patient may want to start by non surgical procedures, if that is what they require. Afterwards, they can then move to a surgery when the correct time comes.
Some may need when addressing their concerns to start with a surgical procedure and in time complement with non-surgical procedures. It is really not a formula, but the coarse of action has to be individualize to each patient.
All patients will benefit from general measures such as skin moisturizer, sun protection, balanced diet, regular exercise and appropriate daily rest.
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