Over a period of time, there occurs damage to cells and tissues of the face. Various factors such as aging, forces of gravity, extremes of weather, prolonged exposure to Ultraviolet Rays of sun and various systemic diseases contribute to this damage, which leads to progressive deterioration in appearance of a face. However, loosely, all these changes may be classified as those of an aging face. Procedures of Facial Rejuvenation attempt to slow, halt and in many cases reverse the effects of this damage, thus resulting in an improved appearance of the face.
Hence, "while aging is inevitable, thanks to modern technology, deterioration in facial appearance is not".
If you look into a mirror, keep your fingers over your cheeks and pull your cheeks backwards and upwards, you can get a fair idea of how your face will look with a Surgical Facelift.
Ans1 There are a number of causes, however, the predominant amongst them is Aging. Other causes are a relentless pull by gravity, resulting in sagging of tissues, frequent and repetitive use of expressions, systemic illnesses like diabetes and heart disease, exposure to ultraviolet rays of sun, extremes of weather, smoking etc.
Ans2 There are many. The most important is Sagging of Structures. This is due to the process of aging with loosening of ligaments, as well as forces of gravity. Another component is the loss of volume due to atrophy of fat and loss of bone at crucial areas leading to a sunken appearance and loss of definition. Yet another component is the damage to skin resulting in dryness, appearance of fine lines and wrinkles and increase in pigmented areas (moles) with time.
Ans3 From above downwards, these are-
Ans4 A person should lead a healthy lifestyle. He should maintain the ldeal weight for his height and age. A person should avoid significant, sudden and multiple changes of weight. One should avoid exposure to extreme weather conditions. One should use a good sunscreen with spf>25, to protect the skin from ultraviolet rays of sun. One should drink plenty of liquids and have a balanced diet with sufficient compliment of vitamins and minerals.
Ans5 You should approach a qualified and medical council registered professional, who is an expert in this field, such as a Plastic Surgeon, and a Dermatologist to learn about the modern methods to deal with the signs of aging. After a proper history and physical examination and if required investigations, the professional will work out the appropriate methods and regime for improving your face. One should avoid visiting the self styled and non qualified cosmetologist, who, armed with a machine, prolific advertising, short term education and improper learning, will likely treat you in a piecemeal and non scientific manner and hence, do more harm than good.
Ans6 There are a number of methods available for this. Due to multiple causes and their effects as answered earlier, no single method is sufficient. Also, all faces are unique. Hence, a treatment plan based on a combination of methods is designed and tailored for your face. To enumerate, the methods are-
There are a number of other methods which are combined with above or used in isolation to improve the appearance of face. These are Blepharoplasty (For eyelids), liposuction, double chin correction, rhinoplasty (for improved appearance of nose), facial implants or bone grafts, corrective jaw surgery, hair transplants, scar subcision used with fillers etc.
a) The Surgical Face Lift operation- Surgical Face Lift is considered the Gold Standard. It causes a significant reduction in signs of aging in face and neck, thus pulling back the years. It also takes care of excessive and hanging skin folds and platysmal folds at neck, which are not addressed by other techniques. The results are long lasting. However, it involves incisions around temporal region and ear and a significant recovery time of 5-7 days. The cost of the procedure is around Rs 1-1.5Lacs.
b) Thread Lift- It involves insertion of long lasting surgical threads from the areas of skin laxity to temporal or postauricular region, thus lifting and fixing the tissue in an upward and backward direction and thus causing tightening and rejuvenation. The procedure is done under local anaesthesia and patient can go back to work same evening or next day. The effect lasts 3-4 years and procedure can be done at a cost of around Rs 75000/-.
c) Lipoinjection(Stem Cells Transfer) -This procedure involves harvesting fat with thin cannulae from fat deposits at abdomen/around the hips etc. After refining, this fat, containing a high number of Adipose Derived Stem cells, is injected into areas of loss of fat/ volume at face. Thus, this procedure transfers not only the adipose cells, but also adipose derived stem cells (fatty tissue has around 5lac stem cells per 100mls, which is 100 times higher than in bone marrow). This results in a return of youthful appearance and rejuvenation of face. The effect is long lasting. The patient can go back to work in 1-2 days. No incisions or sutures are required. This procedure can be done under local infiltration anaesthesia and cost may be around Rs 75000/-. However this procedure is unable to address the problem of hanging skin and neck folds, which can be dealt elegantly by a Surgical Face Lift.
a) Liquid Face Lift (Botox and Fillers)- The liquid face-lift uses fillers that are designed to refill areas where you have lost volume. Such areas are under eye hollows, depressions at cheek, nasolabial folds, marionette lines and eyebrows. Most of the fillers used nowadays contain hyaluronic acid, which replaces the tissue, which decreases with aging. At the same sitting, botox is used to reduce or eliminate major lines such as frown lines on forehead and crow’s feet around the eyes. The combination of these two techniques in Liquid Face Lift results in elimination of hollow areas, smoothing out of fine and major lines and results in a lifting effect and a youthful appearance. As it involves only injections, it is essentially a lunchtime procedure and as such, no recovery period is required. Some signs of aging which result from sagging of skin such a Jowls and Vertical folds at neck known as Turkey Gobbler folds cannot be corrected. The procedure costs around Rs 60-80000/- and depends on the injectables used. Botox needs to be repeated every 4-6 months and fillers, at around 1-1.5 years. The patient can go back to work immediately.
b) Contrage Machine- It is amongst the latest methods of rejuvenation and lifting for aging face. It combines the power of ultrasonic, laser and radiofrequency technologies, which are applied sequentially, to address specific components of aging in skin and soft tissue. Ultrasono-dermabrasion removes the stratum corneum, thus promoting production of new cells in basal layer and as a result causing rejuvenation and decrease of superficial (fine) lines. At the same time, it enhances the effect of topical anaesthetic, which is applied next. The treatment is continued with 980mm diode laser, which acts on the subdermal layer, thus sparing the epidermis unlike ablative lasers ie CO2. This causes modification of fibroblast from contractile to synthetic type. The older collagen fibres are denatured and phagocytozed. New collagen is synthesized, which is more oriented, thus decreasing the deeper lines and wrinkles. After laser, radiofrequency is applied. This produces local heat in subdermal layer causing partial denaturing of collagen, resulting in three dimentional compacting and, as a result, a lifting effect. In addition to immediate effect, improvement continues for many weeks. Five sittings are given at intervals of 2 weeks between each. The procedure is done under topical anaesthesia. Patient can go back to work immediately. No injections or sutures are required. The package cost is around Rs. 75000/-. The effect lasts 2-3 years and maintenance sittings may be required after that.
c) Fractional Laser, Dermaroller and Chemical Peels are helpful in getting rid of fine lines and wrinkles by removing the outer (dead) layer of skin and promoting collagen synthesis, thus causing a rejuvenating effect. Fractional, Dermaroller and superficial chemical peels require no downtime and you can go back to work immediately or the next day. Deeper peels may require you to be off work for upto 7 days.Case -1