Aging face

How to get rid of age-related face sagging

(scientifically - ptosis)?

First, let's talk about why aging face .

1. In the dermis ( middle layer skin) there are different fibroblasts that produce 2 types of collagen:
- collagen 1
- collagen 3
Collagen 1 is a thick fiber that provides resistance and firmness to the skin
Collagen 3 is a thin, water-soluble fiber that gives the skin elasticity and tone.
By the age of 30, the production of collagen 3 slows down, and at the age of 45-50 it practically stops.
Thus, the aging of the face occurs: loss of elasticity and sagging of the skin. To slow down this process, we need to activate the fibroblasts.

2. But not only fibroblasts are to blame for aging face and sagging skin. There is also aging of muscle tissue. With age, the muscles shorten and decrease in volume, the tone decreases. There are many systems for training the muscles of the face.

3. To avoid early aging faces - do not lose weight abruptly. Prevention is always cheaper and safer. Therefore, while losing weight, you need to develop an action plan in advance that will allow the skin to not sag when losing weight. The most important thing is the complex effect.

Aging face:

procedures for prevention

1. Training of facial muscles:

• - Gymnastics for the face 1-2 times a day (including ice cube)
• - bodyflex for the face
• - yoga for the face
• - gymnastics by Camilla Voler or Nadia Payo
• - Eva Fraser's face-building
• - facelift of Maria Runge

other.

2. Dietary supplements, vitamins, minerals

3. Cosmetics to increase the elasticity of the skin (there are 2 types: with delayed effect and instant action), they must be combined.

Creams with "delayed effect" - these are creams, the result of which can be seen in 3-4 weeks. Small molecules called cytokines serve as transmitters of information. Also, these creams protect against ultraviolet radiation, dehydration and oxidation.

-Instant creams, the so-called tensins instantly tighten sagging skin, such a tightening lasts until the first wash.

4. Mesotherapy (cocktails of antioxidants, amino acids, vitamins, coffee enzymes, etc.

5. Cryoplasty (including home - wiping with a piece of ice or frozen decoction of herbs.)

6. Plastic and drainage massage (facial massage with spoons, etc.)

7. Acupuncture or needle self-massage (a massager with spiked protrusions, made of a stone or wood species suitable for you).

8. Regular contrast shower.

9. Firming face masks (including homemade ones made from natural products).

10. Mesothreads

Plastic surgery, no doubt, works wonders, but what about when there are already signs of age-related changes, but you want to preserve your youth without resorting to plastic surgery?
The answer to this question is mesothreads. As a result of the development of new methods and the improvement of the old ones, well known and proven in cosmetology, this new non-surgical technique for rejuvenating and treating aging skin has appeared.
A new technique of mesothread reinforcement was developed in the leading clinics of Southeast Asia. During the procedure, thin self-absorbable sutures are used, which today are already actively used in cardiovascular surgery. The thread is inserted under the skin using a thin, atraumatic needle, lifts sagging tissue, and also activates and stimulates the synthesis of new collagen, which in turn makes the skin more elastic and elastic. Blood circulation and skin structure are improved.
Mesothreads form a new volumetric frame of the facial skin, which is created taking into account anatomical features and points of fixation of soft tissues. Reinforcement with mesothreads allows you to save the result for up to 1.5 - 2 years. It is also very important that mesothreads are completely non-traumatic. No cuts are required for installation, and the thickness of the threads themselves is only 0.1 mm. The inserted mesothreads dissolve after 8 months, leaving a layer of new collagen in their place, which will keep your skin elastic, soft and smooth for a long time.
Mesothreads allow:
raise eyebrows;
restore the shape of the cheeks;
eliminate nasolabial folds;
create a clear oval of the face;
eliminate wrinkles and improve the structure of the skin on the neck and décolleté;
eliminate laxity of the skin of the face and body.
Who is this procedure indicated for?
Anyone who wants to improve their appearance nor does he want to undergo a surgical lift. The procedure for reinforcing the face with mesothreads has no age restrictions and is indicated for both women and men.

Aging of the face. Homemade masks for prevention.

These are masks - with a "delayed effect". Do it 2-3 times a week. Mix all ingredients until smooth. Apply to face for 15-20 minutes. Be sure to lie down, because if we walk with a mask, then we will achieve absolutely the opposite result. Wash off cold water... It is highly advisable to rub with an ice cube.

• Lemon zest 1 tsp
• Sour cream 1 tsp -
• Mandarin juice 1 tsp.

• Potato starch 1 tsp
• Milk 1 tsp.
• Honey 1 tsp.

• Banana
• 1 drop of vit. E
• Cream 1 tsp.

• Oat flour 2 tbsp
• Honey 1 tbsp

• Persimmon pulp 1 tbsp. l.
• Potato starch 1 tsp

• Grated potatoes 2 tbsp.
• 1 tbsp. olive oil

Try another miraculous mask.

The desire of a person to preserve beauty and youth as long as possible is natural and correct. However, there are two main forces opposing him, which are extremely difficult to deceive. It's about age and ... gravity. "Together," these two factors seriously spoil our appearance.

Gravitational ptosis is a condition in which, under the influence of gravity, the skin sags, and the contour and facial features are significantly deformed. This phenomenon is associated with age-related changes in tissues: with aging, the skin loses its firmness and elasticity. And as soon as the process reaches a certain point, gravity comes into force - you can't get away from it.

The skin weakened by age is "attracted" to the ground, as a result of which hateful wrinkles are formed, the corners of the mouth drop, bags under the eyes appear, the former oval of the face is lost ... In a word, the whole skin slightly "slides" down.

It is not easy to more or less accurately predict at what age this can happen - there are too many individual factors involved here. The better the body is in general and the skin in particular, the more carefully you take care of it, the later you will have to face gravitational ptosis. Someone will notice the first signs of it already at 25-30, others are lucky enough to remain in the dark until 40-45. However, sooner or later, this problem will affect everyone.

What does gravitational ptosis look like?

The dynamics of the development of this phenomenon has been well studied by specialists: there is an established classification of 3 degrees of gravitational ptosis, each of which has its own changes in appearance:

Power	Characteristics
1	The appearance of the first folds in the upper eyelid, which are visually noticeable only when the eyes are open Weakening of the circular eye muscle and, as a result, the appearance The bend of the eyebrows is gradually lost - their outer part comes to a horizontal position. Signs appear (of varying severity - depending on genetic and other prerequisites) The appearance of mild and nasolabial folds Slight drooping of the corners of the mouth Violation of the clarity of the contours of the lower jaw - the lower part of the oval of the face is slightly blurred
2	Includes all signs of grade 1 gravitational ptosis, which become more pronounced and are complemented by the following factors: The appearance of wrinkles on the forehead and between the eyebrows The appearance of "crow's feet" (the outer edges of the eyebrows are significantly lowered) The outer corner of the eye drops - if normally it should be 4-5 mm higher than the inner corner, now they are at the same level. The situation can be aggravated by severe The fold of the upper eyelid is close to the eyelashes, and this situation persists even when the eyes are closed Fat "slides" from the cheekbone downwards, as a result of which bags under the eyes are formed, deepens, and the soft tissues lying deeper begin to shift towards the nasolabial fold, significantly hanging over it The corners of the mouth are lowered, as a result of which the face takes on a characteristic "sad" look. The emergence of the so-called. - the skin of the face sags, its contour is lost, the oval is distorted. Similar processes occur in the neck.
	All of the above signs are further aggravated. They are joined by significant changes in the condition of the skin: it noticeably becomes thinner, deep wrinkles and folds appear, and the oval of the face is seriously changing. As a rule, this does not happen earlier than 50-55 years.

Correction of gravitational ptosis of the face: how to get rid of age-related changes?

Since facial rejuvenation is one of the key areas of modern aesthetic medicine, there are plenty of ways to cope with both gravitational ptosis in general and with its individual manifestations. The most popular and effective techniques are:

Hardware and therapeutic procedures

• Different kinds massages aimed at increasing the tone of the facial muscles
• Hardware tightening of the skin and muscle structure of the face (,)

Injection procedures

• and other preparations based on botulinum toxin
• (with drugs based on or stronger drugs such as calcium hydroxyopatitis)
• Botox - we will not form a young V-shaped contour and, in addition, significantly spoil facial expressions.

  That is why, in the fight against gravitational ptosis of the face, it is important to select not individual procedures for yourself, but a competent specialist who will compose a rejuvenating course depending on the degree of the problem and the individual condition of the patient, and will also advise on the optimal preventive measures.

Ptosis translated from Greek means "omission". Today this intricate word has become one of the key words in the discussion of beauty issues. Thanks to the answers of our expert, head of the "Aesthetic Medicine" project, candidate of medical sciences, lecturer of the section "Injection Methods" of the Department of Dermatovenereology of the KMAPO and the chief physician of the Sandler style studio Elena Stoyanova, we tried to understand the nature of ptosis, its types and methods of dealing with it.

Elena Stoyanova
Project Manager AESTHETIC MEDICINE
Candidate of Medical Sciences
Lecturer of the section "Injection methods" of the Department of Dermatovenereology, KMAPO
Chief Physician of Sandler Style Studio

The causes of ptosis

Elena Viktorovna, how and how does ptosis begin?

In fact, everything is simple: ptosis begins from the moment of birth. The point is that cosmetological ptosis consists of two important components that affect the appearance: gravity and age. It is these two factors that affect the prolapse of body tissues.

So, gravitational ptosis is a condition in which, under the influence of gravity, the skin and all structures of the face and body sag. As a result, facial features and contours are significantly deformed. This phenomenon is also associated with age-related changes.

As soon as the process reaches a certain point where the skin loses its elasticity, gravity takes over.

Skin weakened by age is "pulled" to the ground, which causes wrinkles to form. In the mirror, we begin to see drooping corners of the mouth, emerging nasolacrimal grooves, folds of skin over the eyes, bags under the eyes. The former oval of the face is lost. The first to age is the skin around the eyes and nasolabial folds appear. Such women may seem young for a long time, but they age at once.

What factors affect the drooping of the oval of the face?

It all depends on the type of aging. We consider four of them:

• Deformation type of aging is the most common among women in Ukraine. Outwardly, it is characterized by the omission of the muscles and skin of the face, general lethargy, a decrease in the elasticity of soft tissues, the appearance of flews and a double chin. The face seems to slide down, but there may be very few wrinkles.
• Tired type of aging face. It occurs in thin women with diamond-shaped or oval-shaped faces. Eyes and cheeks sink, the corners of the lips sink, tear grooves and a tired look appear.
• Fine wrinkled type of aging. In such women, the oval of the face almost does not deteriorate, there is no sagging, flews, double chin. However, the face is completely covered with a net of wrinkles, as in old paintings, and in many at a very early age.
• Muscular type of facial aging. The rarest among our women. This type of aging occurs mainly in the Mongoloid race. With it, there are no severe wrinkles, no noticeable ptosis. This is due to the flattened facial skeleton and the developed muscle layer.

What does ptosis of the upper eyelid mean? It is believed that it may be a symptom of a serious illness.

You shouldn't think so, the point here is somewhat different. It is important to distinguish between different types of ptosis of the upper eyelid. There are four of them. Neurogenic ptosis occurs as a result of damage to the nervous system due to injury or disease.

Aponeurotic ptosis occurs when the muscles that lift the upper eyelid are stretched or weakened.

Mechanical ptosis - as a result of eyelid deformation by tears or scars. And false ptosis is associated with the appearance of excess skin.

What are the effective methods of dealing with ptosis?

Since the main manifestations of ptosis are wrinkles (between the eyebrows, nasolacrimal grooves, drooping of the lower and upper eyelids, drooping of the corners of the mouth, changes in the oval of the face, wrinkles in the area of \u200b\u200bthe ear tragus) and changes in the volume of the face, this is exactly what the cosmetologist should pay attention to.

Methods for dealing with ptosis can be divided into several groups.

1. Preventive. "Forewarned is forearmed!". If you, looking at your relatives, understand that there is a reason to think about ptosis, start fighting it in advance. The more effective the result will be. Suitable for you:

• Gymnastics for the face - this technique will strengthen the muscles, keep them in good shape, and you will be in a good mood;
• Facial massages. Plastic and Spanish massages are especially relevant;
• Modeling masks.

2. Hardware techniques:

• RF lifting;
• SMAS-lifting;
• microcurrent therapy;
• fractional photothermolysis, etc.

3. Injection procedures:

• Botulinum therapy. If you have a tendency to ptosis, then this type of correction should be started at a young age. If deformities of the face from prolapse become obvious enough, botulinum therapy can be used only after surgical correction;
• Fillers (based on hyaluronic acid and calcium hydroxyopatite) are important to use both for correcting wrinkles that have appeared and for correcting lost facial volumes. This method can easily eliminate nasolacrimal grooves, drooping of the corners of the eyebrows and corners of the lips, restore the volume of the cheekbones, restore beauty to the lips;
• Plasmolifting is a method of stimulating the tone of the face due to the body's own forces. This method is now becoming more and more popular due to its high efficiency and the ability to combine it with filler injections. Which makes it possible to get a beautiful natural face.
• Mesothreads. Strengthens the skin and resists sagging.

4. Various types of peels.
5. Surgical methods:

• Facelift (facelift);
• Blepharoplasty (plastic surgery of the upper and / or lower eyelids);
• Platysmoplasty (neck lift).

Nowadays, a disease is increasingly common, which is a change in the location of certain organs in humans. Internal and external organs can be lowered or displaced. When their location is changed internal organs, it is not so noticeable. But if, for example, the upper eyelid drops or the skin on the face shifts, it becomes visible to others. For a woman, these modifications are especially painful.

In this article, we will take a closer look at ptosis. What it is? After all, this is a common question.

This disease is a fairly common pathology among the population, which can be triggered by various factors. It is worth considering this type of disease carefully, as it can have serious consequences in the future. Not only adults but also children are susceptible to this ailment.

Initially, you might think that there is nothing wrong with such a defect. Of course, the visual appearance deteriorates, but many believe that this does not cause any harm to health. But this is a complete inconsistency with reality. For example, ptosis of the eyelid affects vision, while it is necessary to strain the eyelid, in order to better see the world around it. Note that ptosis can be congenital or acquired, for example, deformity of the face. To begin with, let's take a closer look at such ptosis as drooping of the eyelid.

There can be many reasons for the appearance of this disease. Ptosis can be a sign of any disease, it all depends on the factors of its formation.

Congenital ptosis

Several factors are distinguished here. If one of the parents suffered from this type of disease, then the child is likely to be born with this disease. It will be passed on by genetic inheritance.

Often, the work of the nerve, which is located in the ocular nucleus, can be disrupted. It is responsible for the correct position of the eyelid. Sometimes ptosis affects the muscular system of the eye itself. For a child, this causes difficulty when getting acquainted with the world around him, since he cannot see it well. It's all to blame for ptosis. The upper eyelid overhangs and interferes with full vision.

The rarest syndrome is palpebromandibular. This type usually goes in a complex of diseases such as strabismus or amblyopia. This is where the eyelid is lifted when working completely other muscles of the face. This affects the fact that innervation starts from the trigeminal nerve ending.

A very rare genetic disorder is blepharophimosis. It is typical for this type of pathology to have a very small palpebral fissure. This defect is usually accompanied by two sides. The muscles of the upper eyelid are simply poorly developed here. May be accompanied by inversion of the lower eyelids. Note that this is very rare and is mostly inherited.

Acquired ptosis

This type is much more common than acquired and has several subspecies.

With myasthenia gravis, myogenic ptosis is formed. It usually develops on both sides, and changes over time. In order to start diagnostics, it is necessary to remove double vision. Endorphin can relieve the symptoms of the disease for a short time.

Paralysis that forms in the motor nerve of the eye is called a neurogenic defect. It can be triggered by other diseases that affect the muscles of the eyelids. And sometimes doctors specifically cause this disease in order to cure another, for example, an ulcer that has formed on the corneas.

An elderly person may face the disease, as the muscles have lost their strength over time. The upper part of the eyelid moves away from the plate, the attachment to the base weakens. This becomes the factor that causes the defect. Also, aponeurotic ptosis of the eyelid is possible after receiving various injuries.

The tumor can provoke mechanical disease. It manifests itself in violation of scarring.

There are the main types of eyelid ptosis:

• complete closure of the eyelid;
• partial closure of the pupil, by about 1/3;
• incomplete closure when the pupil is half closed.

Signs of the disease

We figured out the diagnosis of ptosis, what it is, it became clearer.

Of course, the disease can be seen immediately when the eyelid is out of place. However, there are some signs that tell us that a disease may appear that can affect the functioning of the optic nerve.

1. Appearance of irritation on the surface of the eyes.

2. It takes a lot of effort to close your eyes.

3. Doubling or squint.

4. Eyes get tired quickly, cannot focus in one position.

What does ptosis look like? The photo is presented below.

Diagnostics

Diagnostics is needed to identify the factors that provoked this disease. The doctor will be able to draw up a treatment plan for the patient.

The doctor is obliged to ask the patient in detail about the disease, about whether any of the relatives suffered from this disease. The patient may be suffering from concomitant diseases. The integrity of the vision of the disease depends on how the attending physician conducts this survey.

A routine visit to an ophthalmologist can provide a complete picture. Identify violations from the moment of the onset of the disease. The doctor is obliged to check the pressure inside the eye, the vision itself. On examination, a specialist can easily identify abnormalities in the work of the muscle, which is located in the upper part, especially in newly born children.

To diagnose nerve palsy, it is necessary to diagnose with an MRI of the brain.

Eyelid ptosis - treatment

The fight against this ailment is possible in two ways:

• traditional;
• surgical.

The traditional method is ineffective. Medications can temporarily reduce the defect in the upper eyelid. There is also a patch, but it doesn't look very pretty. Therapists may refer to UHF therapy.

Surgical method

How else can ptosis be removed? The operation in this case is an exit.

In most cases, the disease can only be treated with surgery. Especially in young children who are just beginning to form internal organs. The disease can affect their development. Therefore, you should not postpone treatment.

The surgical method can be used in different ways, it all depends on the stage of the disease.

1. The most difficult operation, when there is ptosis of the upper eyelid, is its suturing, when it does not have any mobility. Of course, this method will not give tangible changes, but it will reduce the risk of disease progression.

2. With a medium overhang, it is possible to perform muscle resection. This will lift the upper part of the eyelid slightly by removing unnecessary skin on it.

3. In cases where the eyelid moves, a duplication is simply applied to control the eyelid.

Now, consider those cases where ptosis develops due to aging. What is facial ptosis? And how to treat it?

Of course, no one has invented the elixir of eternal youth, and it is impossible to avoid aging. Over time, the skin loses its elasticity, various deformations occur on the face, and skin folds form. For women, ptosis of the face is undesirable at any age. However, do not be upset, as cosmetologists have found ways to solve this problem. But first, let's figure out how such changes can be caused.

Causes of occurrence

• Poor outflow of venous blood.
• Disruptions in the circulation of venous blood.
• Increased tone and persistent muscle spasm.
• Changes in tissue fibers.
• The appearance of various internal inflammatory processes.
• Imbalance in the tissues.
• The skin is poorly moisturized.
• Failure to regenerate the skin.

These are the causes of ptosis.

If these factors are avoided in youth, then in old age everything will be in order. Better to prevent than to cure later. For this it is necessary to conduct healthy image life, observe proper nutrition, pay due attention to the skin. It is imperative to take care of her.

Note that the procedures to combat the disease are mainly aimed at slowing down the aging process. Since this is the main reason why the disease occurs. Therefore, from a young age, it is necessary to protect the skin of the face in order not to have big problems with it in old age. And do not spend money on various cosmetic procedures to restore the skin.

Ptosis symptom

Ptosis has different degrees of development. Each age has its own stages. He cannot develop in everyone in the same way, this is out of the question. In order to prescribe treatment, you need to know to what extent the disease belongs. Knowing it, a specialist can easily develop a plan for treating a disease.

1st degree

The first degree is different:

• the corners of the mouth dropped down;
• reduced clarity of the jaw contour;
• a nasolacrimal groove appears;
• ptosis of the upper eyelid;
• depression in the nasolabial fold;
• eyebrows are located at different levels.

2nd degree

The second degree is characterized by the following symptoms:

• violations of the level of the corner of the eye;
• fat passes into the cheekbones;
• a fold hangs over the bridge of the nose;
• a crease appears between the lip and chin;
• a second chin is formed;
• violation in the corners of the mouth;
• ptosis of tissues on the face;
• the lower edge of the eyelid is rounded.

Grade 3

The third degree manifests itself like this:

• deep wrinkles, an abundance of tissue folds;
• complete change in the shape and proportions of the head;
• the skin is very thinned;
• clear lip contours are invisible.

For the first degree, the age is about 35 years old, but at 45 years old, the manifestation of the second and third degrees is possible. Before starting treatment, you should decide what stage a person has. The effectiveness of the entire treatment will depend on this.

Ptosis can be treated both in the salon and at home. Of course, the effect of such procedures will vary greatly. In the salon, beauticians will be able to choose the path of treatment that corresponds to the type of stage of the disease.

Therapies

In the first degree, apply:

• Plastic surgery with hyaluronic acid.
• Botox.
• Peeling.
• Thread lifting.
• Resurfacing with a laser.
• Massage.

In the second degree, blepharoplasty and mesotherapy are added.

The third degree is not easy to cure.

The most difficult and dangerous way treatment is plastic surgery. After the operation, special cosmetics are used. And during the recovery period, it is necessary to properly care for the skin of the face.

Home treatment

For those people who cannot decide on an operation, or cannot afford the procedures that beauty salons offer today, treatment at home is possible. The effect of such procedures will not be quick. However, this will slow down the development of the disease, but will have a positive effect on the skin of the face.

Various masks can be made. They can be made by yourself or purchased from stores. However, hand-made face-lifting masks will be more natural than store-bought ones. It is good to give yourself a massage is effective method in the fight against ptosis. You should also perform facial gymnastics, it will help to make the contour clearer.

If you are being treated at home, be patient. And perform the procedures daily. Of course, such a result as in a salon is impossible to achieve at home.

We have examined the disease ptosis. We figured out what it is and how to treat it.

Gravity is relentless and plays a key role in aging. The soft tissues of the face that have lost their elasticity, under the influence of gravity, descend with age, forming a picture of gravitational ptosis.

Quite often, women 35-45 years old first turn to a beautician with a complaint about the so-called flews and changes in the oval of the face. It should be noted that "flew" is an everyday concept, but, unfortunately, in the Russian language there is no capacious and accurate analogue,
but in English there is: jowl. If "flews" became noticeable on the face, then the process of gravitational ptosis began a long time ago, and changes in the oval are its obvious result.

Gravitational ptosis occurs from about 35-40 years of age and affects, first of all, the soft tissues of the middle third of the face. Therefore, with a visible lack of volume in the medial part of the middle third and with pronounced nasolacrimal and nasal grooves, as well as nasolabial folds, it is high time to deal with their correction and prevention of more pronounced changes.

Why does the face sink down?

For the most effective correction of ptosis, which would satisfy the doctor and the patient, a clear understanding of the processes of its formation, points of application of correction methods (targets) and classification of changes are required. Only in this case it is possible to choose the optimal solution and achieve the desired result. Gravitational ptosis, as one of the manifestations of aging, is not a pathology, but a natural process in a person's life, since age-related changes affect all tissues and structures of the face. Although the process is called gravitational ptosis of soft tissues (skin, subcutaneous adipose tissue and muscles), age-related changes in bone structures should also be taken into account, because resorption of certain parts of the facial skeleton leads to the fact that soft tissues lose their support points.

The following processes take place in the soft tissues themselves. Dystrophic changes lead to thinning of the skin and a decrease in its elasticity. Degradation of collagen fibers, a decrease in water reserve and a slowed down regeneration are felt by the first wrinkles and a decrease in skin tone.

In the subcutaneous adipose tissue, on the one hand, there is atrophy of fat packets, both deep and superficial, and on the other, they are displaced and accumulate fat in certain areas, for example, the infraorbital (SOOF), cheek fatty body, etc. The ligamentous apparatus and The superficial musculoaponeurotic layer (SMAS), which acts as a retaining frame for soft tissues, weakens with age and allows adipose tissue to shift downward. Aging facial muscles are characterized by a decrease in muscle mass and a decrease in fiber contractility.

Clinical signs

All of these changes lead to the formation of clinical signs of gravitational ptosis:

• ... drooping of the eyebrows and sagging of the upper eyelids;
• ... the formation of nasolacrimal and nasal grooves;
• ... the formation of nasolabial folds;
• ... drooping of the corners of the mouth;
• ... change in the oval of the face, the appearance of flews;
• ... sagging chin;
• ... drooping of the tip of the nose and sagging of the earlobes.

For a more accurate determination of the severity of gravitational ptosis, a classification of changes is required. However, a universal classification has not yet been developed, since it is almost impossible to unify age-related changes for all individuals, even if we take a racial characteristic.

In people of the same age, the changes can be different, the parts of the face (upper, middle, lower third and neck) also change at different rates, almost every person has differences in the changes in the halves of the face, sometimes they can be quite pronounced. Thus, it is optimal to navigate according to the classification of Professor A.E.Belousov, who created a gradation of signs according to facial zones and highlighted the degrees of ptosis of the eyebrows, ptosis of the cheeks and soft tissues of the neck.

Eyebrow ptosis is determined by the presence and severity of the upper eyelid fold:

• 1) initial: the skin fold is minimal;
• 2) moderate: the skin fold is significant, but does not reach the lash line by two to three millimeters;
• 3) significant: the skin fold reaches the lash line or is one to two millimeters higher;
• 4) extreme: a skin fold overlaps the field of view.

Cheek ptosis is determined by the clarity of the contour of the lower jaw:

• 1) initial: there is practically no prolapse of the cheek tissues;
• 2) moderate: noticeable relaxation of tissues, the cheek has a double contour;
• 3) significant: pronounced "flews" that do not extend to the neck;
• 4) extreme: pronounced "flews" passing to the neck.

Thus, the main task for a cosmetologist when working with gravitational ptosis is lifting: lifting soft tissues, returning them to their original position and fixing, if the technique allows it.

Methods for correcting gravitational ptosis

Modern cosmetology offers a wide range of methods for correcting gravitational ptosis, the use of which can postpone surgical intervention for several years, which, however, serves as the most effective solution to this issue.

In addition, the use of lifting threads, which occupy an intermediate niche between cosmetology and plastic surgery, also allows you to achieve excellent results without resorting to surgical interventions.

Methods for correcting gravitational ptosis can be divided according to the points of application: into methods that stimulate the formation of collagen and skin elasticity, reduce the volume of fatty deposits, compensate for the volume deficit in deserted areas and ensure the redistribution of volumes on the face, as well as change muscle activity.

• ... Mesotherapy (the main drug is DMAE for skin contraction, as well as indirect lipolytics to reduce the volume of fatty deposits in problem areas). ... Mesoscooter therapy to stimulate regeneration after injury and skin contraction.
• ... Biorevitalization with preparations based on collagen or its stimulants (amino acid compounds and peptides). Combined drugs act as not only building material, but also a stimulator of collagen synthesis by the skin's own cells.
• ... Hardware resurfacing, laser and RF technologies, used to tighten the skin frame and, again, reduce the skin flap; radio wave lipolysis.
• ... Chemical peels (especially effective peels of the mid-level TCA and Jessner's solution), as well as retinoic peels (in mono or in combination with chemical) for strengthening and lifting the skin.
• ... Contour correction in the aspect of volumetric correction and reinforcement taking into account the reference points.
• ... Botulinum therapy to eliminate the negative effects of depressor muscles, especially in the lower third of the face.

The most effective, giving the fastest clinically pronounced result is a combination of contour plastics and BTA therapy.

In the upper third of the face, where the main clinical symptom of gravitational ptosis is drooping of the eyebrows, with the help of botulinum toxin injections, it is possible to raise the tail of the eyebrow and the entire eyebrow by about two to three millimeters. Modeling the temporal region with fillers and injecting them directly under the tail of the eyebrow also helps to recreate the natural volume and achieve eyebrow elevation.

The middle third of the face is a vast field for work, where volumetric correction allows you to restore the lost volume of the cheeks, zygomatic zone, infraorbital region and affect the manifestations of ptosis in the lower third and in the neck.

Fillers can be used to correct nasolacrimal and buccal zygomatic grooves. Layer-by-layer injection techniques allow you to create volume, giving the face a more youthful appearance and tightening sagging tissues. Lost support points for soft tissues are restored with denser fillers located on the periosteum, and gels with a more elastic structure, inserted into superficial fat packs, form the lost volume.

In the lower third of the face, combination therapy is most effective, taking into account all the mechanisms of occurrence external signs ptosis. If in the middle third the volume restoration was true, then when correcting the contour of the lower jaw, we can use "masking" methods, injecting gels based on hyaluronic acid so as to align the oval line with the level of already descended tissue and soften the visible drop. In addition, reinforcing techniques with the direction of the vector to the reference point of the angle of the lower jaw will allow you to slightly smooth this line. As for age-related changes in the lips and the periorbital zone, correction of lowered corners of the lips by injecting gel into the commissures and lateral edges of the lower lip, as well as correction of marionette wrinkles, is effective.

The second participant in the combination therapy, botulinum toxin, allows, when used correctly, to achieve amazing results in terms of lifting. Muscles-depressors of the lower third of the face, with their activity increasing with age, contribute to the formation of manifestations of gravitational ptosis. Relaxation of the muscle that lowers the corner of the mouth, with a minimum dosage, gives an effective result in the form of lifting the corners of the lips and changes the facial expression to a more positive one. And the correction of the subcutaneous muscle of the neck, platysma, is able to redistribute muscle activity and volumes, which will be expressed in lifting not only the lower third, but also the middle.

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