facial aesthetics

Applications made to the face within the scope of facial aesthetics are a very broad perspective with applications such as facelift at one end and mesotherapy at the other. It is described that ideal patients for facelift should be between the ages of 45-55, have no additional problems and have obvious sagging of the facial skin. My purpose in this article; It is about what kind of procedures can be done and what is aimed at you other than face lift.

A young and ideal face; it is expressed by a thin chin at the bottom, cheeks that follow it upwards and slightly wider, and an ‘inverted triangle’ pattern with cheekbones in the widest part of the face. Because the edges of the lips, the lines that cut the inner and outer edges of the eyes and the axis of the eyebrows always follow this inverted triangle pattern and follow a line from the inside out and the bottom up. The phenomenon called aging; On the one hand, tissue regeneration and tissue elasticity capacity decrease, cigarette, sunlight and damage to the skin by some chemicals, on the other hand, occur with the combination of the constantly existing gravitational effect. The skin, whose regenerative ability decreases and under the influence of factors such as sun and cigarettes, loses its brightness and becomes thinner. While the tissues that lose their flexibility capacity are shifted downwards with the effect of gravity, deep and superficial wrinkles occur with the effect of the muscles on the ground. Therefore, with the effect of both deteriorated skin quality and downwardly displaced tissues; takes the form of a ‘rectangular’ pattern.

In the rectangular face mold, the tissues at the level of the cheekbones descended towards the cheeks, while the cheeks both melted and drooped lower. The edges of the lips, the axis of the eyes and eyebrows undergo similar displacements.

Considering the above-mentioned changes, the targeted aims of the rejuvenation procedures to be applied to the face are also determined. We are with these transactions; 1- We must restore the brightness and quality of the skin. 2- We should obscure the superficial and deep wrinkles on the skin and, if possible, eliminate them. 3- We need to turn the facial features that fit the rectangular pattern back into the inverted triangle pattern.

Attempts to ensure the brightness and quality of the skin: In this section, I will not talk about cosmetic products and their use. However, I would like to talk about the processes that fall within my field of interest and practice. These are ‘Mesotherapy’ and ‘PRP’ applications. In cases where there are deep acne scars or similar conditions on the skin, skin peeling (dermabrasion) is another important procedure. First of all, let’s talk about the dermabrasion process and its types.

Dermabrasion procedure; It is the process of scraping the layer of the skin, which we call the epidermis, with different methods and obtaining a brighter and smoother skin by coming from the bottom of the new skin tissue. Virtually simulated 2nd degree burn damage. It can also be used for different purposes such as reducing dark spots, removing facial hair and tattoo marks, depending on the depth descended during scraping.

The basic logic of the dermabrasion procedure is the same, but the application methods are different. Skin peeling using acidic substances is called ‘chemical peeling’, skin peeling made by burning with heat energy is called ‘fractionated laser’, and mechanical peeling is classically called ‘dermabrasion’.

All of them have strengths and weaknesses compared to each other. My one-to-one application area is classical dermabrasion; It is an unrivaled method especially in removing acne spots, tattoo and facial scars. I think that laser and chemical peeling applications are the field of estheticians.

The application called mesotherapy is; It is the process of applying the products obtained as a result of combining a number of antioxidants, vitamins, auxiliary enzymes and supporting substances such as hyaluronic acid under the skin. These products are ready-made preparations and have types suitable for use for different purposes such as skin rejuvenation, wrinkle treatment, hair loss treatment. It is applied as 4 or 5 cycles and there is a gap of 1 week between each course. It is recommended to be repeated every year for the continuation of the benefit obtained. For a long time, I had doubts that mesotherapy was a useful application. The impression I had after I started using it myself; is that mesotherapy is not a miraculous application, but when it is done regularly every year, it provides a clear improvement in patients. It is possible to describe mesotherapy as a level above personal cosmetic care (creams, tonics and moisturizers, etc.).

PRP (platelet rich plasma) is actually a revolution in medicine. It is a process based on the principle of re-administering the cells and factors obtained from the patient’s own blood to the patient in a concentrated form. Since I have explained PRP under a separate heading, I should state that without going into too much detail; PRP application, at the point of personal care, is a high quality application supported by many data and the benefit of which cannot be denied. Because compared to other applications, its cost is much higher in proportion to the benefit it shows.

Procedures for deep and superficial wrinkles on the skin: Two applications that immediately come to mind under this title are Botox and filler applications. Botox (botalinum toxin) is the most effective poison obtained from a tetanus-causing bacterium. There are preparations prepared in very low doses and its effect is based on temporary paralysis of the muscles under the wrinkles. When the muscles are paralyzed, they remain motionless and many wrinkles disappear because the skin on them does not stretch and contract. Botox application creates miraculous results in a way, but in common and high doses, it creates a confused and dull facial expression in its simplest form.

In such a case, the patient has to carry this blank and confused face for an average of 6 months. The most common complication of Botox application is drooping of the upper eyelid and it is a temporary condition.

I think that when we come across something useful as a nation, we act with the ‘the more the better’ mentality. Because in botox application, situations that act with the same logic and experience visual disasters are not uncommon. Therefore, my humble advice is; I definitely do not recommend the use of Botox application except for crow’s feet extending like a halo around the eyes, vertical lines extending between both eyebrows and making the person look angry, forehead lines, mane on the throat skin in advanced age and in some cases eyebrow lifting. On this basis, in simple terms, the use of botox application should be limited to the upper 1/3 of the face.

Filling applications provide extremely good results when done on-site and in competent hands. Otherwise, I witnessed permanent and disastrous images. The basic logic here is; It is the filling under the deep grooves so that they become less obvious, or the areas you want to be prominent (such as the lips and cheekbones) are inflated.

It is possible to talk about two different materials used in filling applications; The first is products containing hyaluronic acid, collagen or hydroxyapatite, which are available in the market. I personally refuse to use these ready-made preparations unless my patient strongly desires it. The reason is as follows: first of all, it is not permanent and it needs to be repeated in a maximum of 6 months – 1 year, so it is costly.

Secondly, a foreign substance used in the body and the side effects (allergy, granuloma, etc.) that occur following the administration of this substance to the body are not uncommon. Finally, if you make a mistake during the application and give it unbalanced or excessive, there is no compensation, it cannot be corrected. I prefer to do all my filling applications with ‘autogenous fat graft’ taken from the patient’s own body. I think it is far superior to other products. Everyone notices a rejuvenation and beautification on your face, but no one can describe what it is.

Autogenous fat gerft; Since it is the patient’s own tissue, it does not cause any reaction, even if you give more during the application, it achieves an acceptable volume and perfect shape with tiny massages in the first 3 weeks. And finally, purely biological. It can also be used easily for large volume changes such as breast augmentation, hip and hip enlargement. To tell you the disadvantages of autogenous fat graft; It is a little more costly than ready-made fillings and a second application may be required because some of the fat put in the first application melts.

The use of fillers on the face is as follows: filling the so-called ‘nasolabial grooves’ extending from both the sides of the nose to the rim of the mouth, making the cheekbones more prominent, adapting the face to an inverted triangle mold, thickening the lips and removing any depressions due to previous injury.

All filling procedures can be easily performed under local anesthesia. After the application, swelling and redness may occur for about 1 week, depending on the application area. If you still need to pose for a society magazine, I recommend waiting 2 weeks.

Operations for turning the face into an inverted triangle mold

Although the procedures in this title are more radical applications, they create obvious changes after the application. The most radical one is face lifting surgery, which is a separate topic of discussion. The most common application for this purpose is ‘suspension’, which is hanging the skin of the face from the bottom up and from the inside out, with threads made of various materials. In principle, I do not do the hanging process on the face. This is because I do not believe it is actually a treatment method and I have serious doubts that it is actually beneficial to patients. The logic of the suspension is that the excess and sagging skin is pulled to the front of the ear and above the ear area and collected in this area. Potting of the skin becomes very evident in these areas after the procedure. In addition, these threads placed under the skin permanently prevent mimic movements. In my opinion, performing stretching operations with surgery instead of suspending, and manipulating the face with fat injections if it is thought to be early for a stretching operation, gives much more natural and useful results.

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