Facial rejuvenation is a significant process involved in restoring youthfulness. The introduction of less invasive procedures has increased acceptance of such procedures. Often a combination of different techniques allows individualized treatment with optimal outcomes. Furthermore, this leads to a natural look without a significant downtime. We report herein the use of such a combined approach in middle-aged women with particular emphasis on botulinum toxin type A, dermal fillers, and chemical peels. Keywords: facial rejuvenation, middle-aged females, botulinum toxin, fillers, chemical peelsIn the past the concept of facial rejuvenation was dominated by invasive surgical procedures, in particular different techniques of partial and full face lift. Nowadays there is a clear tendency for less invasive procedures which are quicker and simpler and that do not divert patients from their daily routine and activities for prolonged periods. They can provide effective, safe, relatively long-lasting, and natural results.
1,2With the development of new technologies and techniques, greater knowledge of tissue anatomy and physiology, stem cells, lasers and other energy sources, new fillers, and the ever more versatile use of botulinum toxin type A (BTX-A), a new perspective in cervicofacial rejuvenation treatments has been established. In the following we will describe our practice and experiences. We believe that needs for rejuvenation and the appropriate choice of the medical armamentarium are age-and gender-dependent so we focused on women aged 30 to 50 years.
Etiological factors related to skin agingThe aging process is related to intrinsic and extrinsic factors. The main frequent changes observed among women aged between 30 and 60 years due to the natural and continuing aging process are the appearance of small wrinkles, atrophy of subcutaneous fat, and decreases in collagen and elastin production. There is also an evident decrease in the turnover of skin cells. Gravidity and muscular aging are involved in more evident folds, increasing skin flaccidity. Repeated contractions of the mimic muscles might be involved in the process. In young participants an magnetic resonance imaging (MRI) study was used to demonstrate that the anterior convexity curve of the mimic muscles is due to the existence of a deep fat pad at the back of these muscles. While this mass of fat is effectively a mechanical sliding plane, its convexity constitutes the founding principle of a youthful midface appearance. With age, the muscle gradually straightens and shortens, Clinical Interventions in Aging downloaded from https: //www.dovepress.com/ by 34.214.212.150 on 11-May-2018 For personal use only.