Facial rejuvenation – wrinkle & sagging skin treatments
Ageing of the face and neck causes a slackening and reduction of cutaneous and subcutaneous, fibro-fatty and muscular tissues as well as a reduction in the bone structure of the face. This inevitably leads to the appearance of wrinkles, malar pouches (drooping or slackening of the cheekbones), deep furrows (laugh lines), jowls and folds in the neck’s platysma muscle (optu-angled neck).
Factors responsible for ageing include:
- Time (age, gravitational pull)
- Genetic markers (heredity, skin quality)
- Environment (pollution, stress)
- Lifestyle habits (consumption of tobacco, alcohol, food, sleep habits, frequency of exposure to the sun)
- Significant weight loss.
Each factor and its impact must be taken into account when dealing with the ageing of an individual.
After an examination and analysis of the face to determine tissue quality and the degree of ageing, a decision can be made as to procedures.
|Condition… Physiological changes||Results … Clinical aspects|
- Diminution of natural moisturizing factor
- Shrinking of sweat glands
- Slowing down of sebaceous gland secretions
- Reduced collagen production
- Skin becomes thinner and translucent
- Elastin fibres deteriorate (solar elastosis) and become less extensible
- Skin becomes loose, less elastic and thicker-looking
- Irregular skin texture (skin less smooth)
- Poor functioning and reduction of melanocytes (cells carrying pigment of skin)
- Hyperpigmentation (brown spots – Solar lentigo)
- Hypopigmentation (white spots)
- Molecular deterioration (DNA)
- Decline in cell repair mechanism
A healthy skin is defined with these principal characterisations: smooth, even in color, firm and tight, well hydrated and free of inflammatory reaction.
Facial rejuvenation is beyond an art and science expertise, and not all treatments are suitable for all skin type according to patients: age, ethnicity, skin color and skin thickness. Per example, a patient with a skin type I according to the Fitzpatrick classification chart (figure 1) won’t have the same treatment options as a skin type VI person. A global evaluation must be done to analyze and make a diagnosis by the physician. Dr Mario F. Bernier Board Certified Plastic Surgeon will formulate a comprehensive treatment plan that includes short and long-term goals.
Fitzpatrick classification chart
|Type de peau||Coloration||Réaction face à l’exposition au soleil|
|I||Light, pale white||Always burns, never tans|
|II||White fair||Always bruns, rarely tans|
|III||Beige to pale brown (olive)||Sometimes burns, gradually tans|
|IV||Pale brown to medium||Rarely burns, tans easily|
|V||Medium to dark brown||Very rarely burns, tans very easily|
|VI||Dark brown to black||Never burns, tans easily|
One of Dr Mario F. Bernier’s mentors, the reputed Dr Zein Obagi from Beverly Hills, says that skin’s thickness should be considered in procedure selection to assure the best outcome in skin rejuvenation and healing.
Skin laxity vs muscle laxity
Skin laxity is manifested as wrinkles and fine lines, lower eyebrow, excess of upper and lower eyelid skin, loose skin on the cheeks and jawlines and deep nasolabial folds. Muscle laxity will affect, platysmal banding, (neck) which lead to jowl formation, orbicularis oculi (eyes) and frontalis (Front) muscle drooping, which lead possibility to eyelid and eyebrow ptosis.
|Skin Laxity||Muscular laxity|
|Appearance of wrinkles||Eyelids ptosis|
|Lack of elasticity||Eyebrow ptosis|
|Deepened nasolabial folds and marionette lines||Jowl formation|
|Loose of volume & contour||Redundancy of neck muscles|
|Treatment options||Options de traitements|
|Restoring skin through the use of daily topical products that contains essential agents||Combining surgery & non-surgical treatment as numbered on the left side|
|Ablative & Non-Ablative Fractional Laser treatment or|
|Injectable such as neurotoxins & dermal fillers|
Loose skin, is often the result of pregnancy, or weight-loss and can be quite difficult to get tight again. When the extra skin is not enough to have a surgical procedure done, non-invasive treatments are now available which may improve skin laxity and texture. It’s effective on the neck, abdomen, thighs and even on arms!