The aging process of the face affects all layers, including the skin, muscular aponeurotic system and fat deposits. Facial involution is caused by elongation of the retaining ligaments and displacement of the facial layers at fixation points. It is believed that the middle part of the face ages first: there is a omission of the circular muscles of the eyes, dissociation of adipose tissue, a decrease in the anterior-posterior projection.
plastic surgeon, candidate of medical sciences, associate professor of the department of plastic surgery of St. Petersburg State Medical University, chief physician of the MEDICI clinic,
member of the European Academy of Facial and Plastic Surgery - "Secondary rhinoplasty" ,
Member of the Society of Plastic and Reconstructive Surgeons (SPRES),
Member of the International Society of Aesthetic Plastic Surgeons (ISAPS),
Member of the European Academy of Facial Plastic Surgery (EAFPS).
Lipofilling as the "gold standard" for rejuvenation of the middle third of the face
Fat grafting for mid-face rejuvenation
Surgical facial rejuvenation should aim to elevate the soft tissues and restore the projection and contours of the face. SMAS lifting and endoscopic facelifts have already proven their effectiveness in improving the condition of the peripheral and central parts of the face. In order to volumize the middle third of the face, both procedures can be combined with lipolifting, fat transplantation (lipofilling) or imbrication (excision of excess skin).
Today,
lipofillingis the gold standard procedure for correcting adipose tissue hypotrophy, although techniques such as imbrication and fat redistribution are also effective invariants to achieve this goal. Personal experience
In his practice, Dr. Agapov observed 282 patients with various manifestations of signs of aging in the middle third of the face, who underwent an endoscopic facelift with extended dissection. The key point of the procedure is the transplantation of adipose tissue into the nasolabial sulcus, upper buccal fold and other areas where there is a lack of it, smoothing wrinkles in this area. The transplanted adipose tissue adapted to the "mask of the face", improving the contours and turgor of the skin. In 64 patients, this method of volumization of the middle third of the face was combined with a course of SMAS-lifting procedures, in 24 patients it was aimed only at restoring the facial framework.
After undergoing the procedures, 267 patients said they were satisfied with the result. The rest noted some distortion of the face, caused by individual manifestations of signs of aging. Analysis of pre- and post-operative photographs shows a significant improvement in facial contours and skin rejuvenation.
Endoscopic rejuvenation of the middle third of the face with the redistribution of adipose tissue can become not only a rejuvenation procedure, but also a volumization procedure that improves the projection of the face.
Source estet-portal.com
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