Objectives: To learn and understand the anatomical and physiological changes during facial ageing. This should allow for trying to compensate for these changes, without creating an abnormal anatomy
Introduction: Knowledge of the physiology of facial aging allows us to understand the changes in the "youth appearance" anatomy.
Materials / method: Changes involve muscles, which become thinner and permanently contracted, leading to displacement of peri-muscular fat compartments.
Superficial fat, accounts for 57% of total facial fat, and has two components: the Hypodermis, third layer of the skin, and the fat in superficial compartments. It does not change with age, but with weight.
Deep Compartment fat looses about 1% of its volume every year as from the age of 30,and is displaced through muscular movements and contracture.
Results: All these changes lead to the formation and deepening of the functional folds, naso-labial and genio-labial.
It has been well demonstrated by V. Lambros that skin does not move as we believed, but follows the changes of the deep fat structures. Therefore, we have to try to correct these changes, but without creating an abnormal anatomy.
Conclusion: Restoring volume losses can be achieved by deep, pre periosteal injection of volumizing fillers, to lift up the anatomical structures, and/or direct repositioning of the fat compartments through tensioning threads. The skin, which follows fat displacement, is therefore repositioned and tightened, in a physiological way that cannot be maintained through simple superficial pulling.
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