Facial rejuvenation is a cosmetic treatment (or series of cosmetic treatments), which aims to restore a youthful appearance to the human

face The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may aff ...

. Facial rejuvenation can be achieved through either

surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

and/or non-surgical options. Procedures can vary in invasiveness and depth of treatment. Surgical procedures can restore

facial symmetry Facial symmetry is one specific measure of bodily symmetry. Along with traits such as averageness and youthfulness it influences judgments of aesthetic traits of physical attractiveness and beauty. For instance, in mate selection, people have b ...

through targeted procedures and facial restructuring and skin alterations. Non-surgical procedures can target specific depths of facial structures and treat localized facial concerns such as

wrinkles A wrinkle, also known as a rhytid, is a fold, ridge or crease in an otherwise smooth surface, such as on skin or fabric. Skin wrinkles typically appear as a result of ageing processes such as glycation, habitual sleeping positions, loss of bo ...

, skin laxity,

hyperpigmentation Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. Causes Hyperpigmentation can be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris.James, William; Ber ...

and

scars A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a natu ...

. Surgical (invasive) facial rejuvenation procedures can include a brow lift (forehead lift), eye lift (

blepharoplasty Blepharoplasty (Greek: ''blepharon'', "eyelid" + ''plassein'' "to form") is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With t ...

facelift A facelift, technically known as a rhytidectomy (from the Ancient Greek () "wrinkle", and () "excision", the surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are mul ...

(rhytidectomy), chin lift and neck lift. Non-surgical (non-invasive) facial rejuvenation treatments can include

chemical peels A chemical peel is a technique used to improve and smooth the texture of the skin. Facial skin is mostly treated, and scarring can be improved. Chemical peels are intended to remove the outermost layers of the skin. To accomplish this task, the c ...

, neuromodulator (such as

botox Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium '' Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromus ...

), dermal fillers,

laser resurfacing Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the sk ...

photorejuvenation Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the ...

radiofrequency Radio frequency (RF) is the oscillation rate of an alternating electric current or voltage or of a magnetic, electric or electromagnetic field or mechanical system in the frequency range from around to around . This is roughly between the upper ...

and

Ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...

Visual appraisal of facial youthfulness

Human

visual perception Visual perception is the ability to interpret the surrounding Biophysical environment, environment through photopic vision (daytime vision), color vision, scotopic vision (night vision), and mesopic vision (twilight vision), using light in the ...

is notable for its sensitivity and accuracy in estimating our perceived age by instant

pattern recognition Pattern recognition is the automated recognition of patterns and regularities in data. It has applications in statistical data analysis, signal processing, image analysis, information retrieval, bioinformatics, data compression, computer graphics ...

of facial features. Often, human faces with no measurable difference in

facial geometry A facial recognition system is a technology capable of matching a human face from a digital image or a video frame against a database of faces. Such a system is typically employed to authenticate users through ID verification services, and wo ...

and appearance are perceived as having different ages. This mechanism is not yet entirely understood, but there may be a relation to the subtle changes in facial bone structure related below.

Golden ratio

Facial symmetry Facial symmetry is one specific measure of bodily symmetry. Along with traits such as averageness and youthfulness it influences judgments of aesthetic traits of physical attractiveness and beauty. For instance, in mate selection, people have b ...

has a direct relationship to perceived beauty. A guiding approach to facial rejuvenation and balancing facial symmetry is through an application of the

golden ratio In mathematics, two quantities are in the golden ratio if their ratio is the same as the ratio of their sum to the larger of the two quantities. Expressed algebraically, for quantities a and b with a > b > 0, where the Greek letter phi ( ...

. Artists and architects have been using this ratio to create works that are pleasing to the eye for centuries.

Aesthetic medicine Aesthetic medicine is a branch of modern medicine that can be practiced only by medical professionals with training in aesthetics and lasers. It focuses on altering cosmetic appearance through the treatment of conditions including scars, skin laxit ...

and facial rejuvenation techniques has adopted this mathematical approach to facial restoration and enhancement.

Influence of changes in bone structure

More recent research has pointed out the influence of changes in the facial skeleton with age on the appearance of aging, especially in the mid-face area and the lower part of the

orbit In celestial mechanics, an orbit is the curved trajectory of an object such as the trajectory of a planet around a star, or of a natural satellite around a planet, or of an artificial satellite around an object or position in space such as ...

s around the

nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes ...

. Quantitative study with CAT scans of the faces of men and women in several age brackets has revealed that there is an appreciable amount of

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

tissue loss in these regions with age, leading to changes in angles, lengths and volumes, and also decreasing the distance between the eyes. It has been hypothesized that skin sagging and wrinkles may occur not only because of loss of soft tissue and fat, but also because bone retraction creates an excess of skin which is no longer flexible. Many of the facial manifestations of aging reflect the combined effects of gravity, progressive

bone resorption Bone resorption is resorption of bone tissue, that is, the process by which osteoclasts break down the tissue in bones and release the minerals, resulting in a transfer of calcium from bone tissue to the blood. The osteoclasts are multi-nuclea ...

, decreased tissue elasticity, and redistribution of subcutaneous fullness. Future facial rejuvenation techniques may take into account these findings and restore bone lost by aging processes.

Trends in facial rejuvenation

According to the American Society of Plastic Surgeons, more than 133,000 facelifts and nearly 216,000 eyelid surgeries were performed in the US in 2013, a six per cent increase from 2012. Facial rejuvenation procedures experienced the most growth, as 2013 marked the highest number of botulinum toxin type A injections to date, with 6.3 million injections. A significant upward trend on the number of facial rejuvenation procedures is predicted, and could be due to the following factors: # Men have also started to perform these procedures at increasing numbers; # Emphasis on image of youthfulness by the

mass media Mass media refers to a diverse array of media technologies that reach a large audience via mass communication. The technologies through which this communication takes place include a variety of outlets. Broadcast media transmit informati ...

and

fashion Fashion is a form of self-expression and autonomy at a particular period and place and in a specific context, of clothing, footwear, lifestyle, accessories, makeup, hairstyle, and body posture. The term implies a look defined by the fashion i ...

; # Increasing numbers of senior people enjoying good

health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...

and financial affluence at older ages; # Decreasing costs of surgery and other cosmetic procedures, making them affordable to all However, while surgical procedures are still preferred to achieve a more dramatic improvement, the current trend is towards less invasive procedures, such as injectables (Botox, fillers) and laser skin treatments. While these treatments achieve temporary results, they tend to be preferred because of their reduced cost and less intensive recovery period.

Procedures

Facial rejuvenation procedures can include (but are not limited to): *

Botox Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium '' Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromus ...

injections *

Chemical peels A chemical peel is a technique used to improve and smooth the texture of the skin. Facial skin is mostly treated, and scarring can be improved. Chemical peels are intended to remove the outermost layers of the skin. To accomplish this task, the c ...

* Collagen injection * Cosmetic acupuncture * Dermal filler injections *

Electrotherapy Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term ''electrotherapy'' can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological dise ...

* Facial toning * Fraxel *

Microdermabrasion Dermabrasion is a type of surgical skin planing, generally with the goal of removing acne, scarring and other skin or tissue irregularities, typically performed in a professional medical setting by a dermatologist or plastic surgeon trained speci ...

Photorejuvenation Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the ...

Laser resurfacing Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the sk ...

* Nd:YAG laser *

Permanent makeup Permanent makeup is a cosmetic technique which employs tattoos (permanent pigmentation of the dermis) as a means of producing designs that resemble makeup, such as eye-lining and other permanent enhancing colors to the skin of the face, lips, a ...

* Platelet-rich fibrin matrix method

Visual appraisal of facial youthfulness

Golden ratio

Influence of changes in bone structure

Trends in facial rejuvenation

Procedures

See also

References

Further reading