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Rehabilitation

Care methods

<hr />
Lyudmyla Moroz, dermatologist of La Feme beauty studio (Vinnytsia), anesthesiologist, trainer of &quot;MERTS Aesthetics&quot; company (Ukraine)

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All soft tissues of the face and bones of the facial skull undergo age-related involution, so changes in the lower third are only part of the general degenerative process. Tissue aging caused by exogenous and endogenous factors is morphologically manifested in the gradual atrophy of skin, muscle, fat, bone tissue and loss of volume. These tissues determine the architecture of the face, therefore, the loss of elasticity of collagen structures in them leads to a loss of resistance under tension, that is, a negative vector of aging is formed.

<h2>Skin layers. Tesser&#39;s theory </h2>

Skin 

With age, the epidermis and dermis lose the quantitative and qualitative composition of cellular components and the matrix of connective tissue, tissue microcirculation is disturbed, metabolic acidosis prevails, which causes thinning and laxity of the skin. It has been proven that the human dermis thins by about 6% every 10 years.

Subcutaneous adipose tissue, separated by septa of the superficial fascia of the face

A large number of scientific works prove the aging of adipose tissue. Subcutaneous adipose tissue with superficial fat packs successively loses volume in the central, medial, temporal-buccal-mandibular superficial fat packs, which leads to loss of volume and the formation of folds and furrows. 
 
SMAS and superficial fat compartments with facial ligaments

The superficial musculo-aponeurotic system (SMAS) and facial ligaments (infraorbital, zygomatic, mandibular, masseter) are thinned, stretched without displacement, and the depressor muscle group prevails over the levators. These changes lead to the formation of folds, furrows, hernial protrusions and the contour of the lower third of the face, leading to ptosis of the soft tissues of the face.

DMAS and periosteum

Atrophy of DMAS, deep fat (Bish&#39;s corpus callosum), bones of the facial skull occurs in pre- and postmenopause against the background of hypoestrogeny and is morphologically manifested by volume loss and facial skeletonization. 
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Anatomical aspects of age-related involution of the lower third of the face