The ideal timing for facial rejuvenation surgeries has been classically defined in the plastic surgery literature as the mid-50s. In this age group, almost all signs of facial aging have appeared and patients gain significant visual benefit from the surgeries. At earlier ages, nothing seems to have changed much, but at older ages, more comprehensive combined procedures become necessary to get a good result.
Facial rejuvenation surgery is not a medical necessity, but rather a younger and more beautiful person. It is based on the desire to meet face. The desire for rejuvenation does not arise in people without a reason; each individual has his or her own life experiences and future expectations. It is a fact that life does not treat its children fairly in any regard. Facial aging is no exception to this rule.
Let's take a look at the cases in which facial rejuvenation surgeries are performed at earlier ages than routine:
1. Massive weight loss patient group:Skin elasticity has a limit. As the tissues grow, the skin becomes skinnier, stretches and adapts to growth. However, when the tissue shrinks, the skin cannot shrink along with the tissue. It remains loose and sags. When the growth in the abdomen and breasts of women during pregnancy disappears after pregnancy, sagging in these areas is inevitable. Similarly, people who have been involved in bodybuilding throughout their youth will lose muscle mass and their skin will sag. One of the most important health problems of our age is obesity. When we gain excessive weight, the fat mass under the skin stretches and stretches the skin. They say that an ounce of fat can cover a thousand flaws. With the advancement of obesity treatment, a group of patients experiencing massive weight loss emerged. Imagine a 25-year-old young man who loses his body weight from 130 kilos to 65 kilos with surgery. When I was overweight, my facial skin grew 1-2 sizes, but when I lost weight, it remained loose and sagged compared to the facial skeleton. The massive weight loss patient group classically presents with facial skin laxity and sagging well beyond their age. The 30-year-old patient's face looks like he is 45 years old. In this group, surgery can also be performed in the 30s. It's like saying, "Spend your life between the ages of 30 and 55 looking like your aunt, and when you turn 55, we'll do surgery." There is no luxury. Because in this age range, the patient will experience perhaps the most active period of his/her life emotionally and sexually. A significant portion of patients presenting with facial aging beyond their chronological age frequently experience a weight change of 20 kg or more between the ages of 30 and 50, when skin elasticity decreases.
2. Intense Stress:Cancer treatment, chemotherapy drugs, steroid treatment, busy work and life stress cause premature aging. Look carefully at the faces of people who lost their job, lost their family or spouse, or went through a traumatic divorce. You can observe that some of them have aged 5-10 years in a 1-2 year period. In this patient group, there is no luxury to say, "Fuck your fate, yes you collapsed early, but let's wait until you are 55."
3. Spouse Incompatibility:Our spouse, our darling, we love very much. When two hearts become one, it's like a hayride, but people are talking and we feel sad. They couldn't leave those loved ones alone. One is 37 but looks 45. The other one is 35 but it shows 30. The woman who looks older says, "I'm going to meet someone, I'm ashamed." The man who looks old says, "I don't want them to say that she married a man her father's age." In some of the patients who underwent facial rejuvenation surgery at an early age, the reason why the patient desires the surgery is to appear compatible with their spouse.
4. Previous aesthetic treatments: All aesthetic treatments that reduce subcutaneous fat mass, cause heat damage to the skin and subcutaneous tissues, and cause excessive weakening and thinning of the facial muscles can, on the contrary, cause early signs of aging in a group of patients. This group may become surgery candidates at an earlier age due to the disappointment caused by non-surgical procedures.
5. Early treatment option to support the face in the aging process: When facial rejuvenation surgery is performed in the early age group, there is no striking before-after difference as the signs of aging are not yet fully established. It is necessary to analyze standardized before/after photographs in order to notice what changes in the face of individuals who have surgery in their early 40s. Most of the time in social life, "there is a change in you, but don't understand what it is" Reactions such as "we are stupid" are received. Is it worth having surgery for such early facial aging or such little change? This is a matter of debate. However, it is a fact that since the surgery will surgically support the face, symptoms due to gravity will appear later in the group of patients who have undergone facial rejuvenation surgery. We can explain the protective effect as follows. Consider 2 sisters who are identical twins and are in the early stages of aging. Let's do face lift surgery on one person at the age of 42 and not the other. The sibling who had the surgery will look a little better immediately after the surgery than the sibling who did not have the surgery. Since both are in the early stages, there will not be a dramatic difference between them. However, if you follow both twins until age 55, you can see that the face of the twin who had surgery has aged much better than the one who did not. Twin studies conducted in plastic surgery provide us with information not only about the differences between twins who have undergone surgery and those who have not, but also about the differences between twins who have surgery with different surgical techniques. Surgery can also be performed at earlier ages in the patient group whose facial appearance is professionally/socially critical and who must maintain their facial form.
6. Bone morphology prone to premature aging:The shape of the bone skeleton can vary significantly from individual to individual. Faces with prominent cheekbones and jawbones and where the connections between bone and soft tissue are genetically dense and strong are more resistant to the aging process due to gravity. On the contrary, the cheek falls much faster in patients with underdeveloped cheekbones, and signs of aging around the mouth appear much earlier in patients with underdeveloped upper jawbones. In patients whose lower jaw bone is underdeveloped, signs of neck aging appear at a much earlier age. In people whose forehead bone is underdeveloped, eyebrows fall prematurely and impair eyelid functions. Morphological differences in the bones around the eyes affect aging around the eyes, bags, and the anterior-posterior position of the eye. For example, bags under the eyes appear in some people at the age of 14-15. If there is a bone morphology that is prone to premature aging, surgery for rejuvenation at an early age is required. Procedures may be needed. In this group of patients, unlike the routine, we can place prostheses (implants) on the bone surface in addition to face lift surgery.
7. Connective tissue diseases:Some genetic and acquired connective tissue diseases can cause the face to age very significantly at a very early age. Surgical correction procedures may be required at an early age in the treatment of these diseases. Some people have mild forms of the genetic disorders that form the basis of these diseases. The patient looks older than all his peers, but there is no clearly diagnosed connective tissue disease. In these cases, which are described as "intermediate forms", it may be necessary to perform rejuvenation surgeries at earlier ages.
8. Endoscopic and minimally invasive surgical approaches:The emergence of surgeries that leave shorter and hidden scars has made facial rejuvenation procedures available to a younger patient group. These surgeries are not as effective as classical surgeries, but the young patient group often does not need the effectiveness of classical surgeries. Endoscopic facial aesthetics is often used in combination with surface treatments and fat tissue transfer in the early aging period, when there is no skin sagging on the face yet but soft tissue distribution disorder begins to become evident. This approach is a suitable treatment approach, especially for female patients between the ages of 35-45.
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