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The article was translated into English using automatic translation. The editors are working on its improvement.

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<hr />Ivan Badin , Ph.D., leading specialist in the biomedical direction of BioPro Stem Technology Anastasia Kozachenko , assistant at the Department of Human Anatomy, Odessa National Medical University<hr /> Relevance of the problem The aging process in the lower third of the face is a pressing problem that requires timely and multifaceted correction. Due to the fact that they occur very intensively, and this is associated primarily with the characteristics of facial and functional activity, such aesthetic age-related changes as loss of clarity of the contour of the lower third of the face, nasolabial and labiomental folds, drooping corners of the mouth and perioral wrinkles rapidly increase. . These changes are usually progressive and difficult to correct. To defeat these defects you will have to literally roll up your sleeves. Aesthetic problems of the lower third of the face and their correction are significant details that affect clients’ self-esteem and the degree of their satisfaction with the services of a cosmetologist. Thus, the most successful and in demand, from the point of view of patients, will be those specialists who use in their arsenal methods that slow down the progression of the aging process and eliminate these aesthetic defects for a long period. The study and implementation of special techniques, training of specialists in the field of aesthetic medicine, dermatology and cosmetology are priority areas in the work of the author of this article. Dangerous area The oval of the face loses the clarity of its contours over time. The deformation of tissues, the rate of gravitational ptosis, the formation of wrinkles and folds have a huge impact:<ul><li> genetic features of the architectonics of soft tissues of the face;</li><li> ultraviolet radiation and ecology;</li><li> clients&#39; lifestyle - weight fluctuations, smoking, diet, posture, sleeping position;</li><li> age-related decrease in the production of elastin and collagen;</li><li> hormonal changes and much more.</li></ul> The combination of these factors predetermines one or another morphological type - a complex of external signs that describe the type of aging (tired, wrinkled, deformed and muscular) of the face. On the one hand, the causes of early aging of the lower third of the face, as well as the appearance of some other aesthetic defects, are diverse, heterogeneous and, unfortunately, not yet sufficiently studied. Although, on the other hand, the market more fully presents methods and products that eliminate, if not the root causes, then the manifestations of aging in the lower third of the face: numerous fillers, laser and radio frequency lifting, reinforcing threads, and, of course, botulinum toxin. Unfortunately, despite their undeniable effectiveness, these approaches cannot be the only correct ones, and some of them have serious drawbacks, the main ones being cost and safety profile (contraindications). Insufficient availability of drugs and equipment, lack of knowledge of other highly effective methods leads to the fact that many cosmetologists lose part of their clientele with the age-related problems described above. In fact, this age segment of clients can and should be retained and developed without offering them only expensive and often risky procedures. Safe rejuvenation strategy Course recommendations for individual selection of a set of procedures to solve the above problems - be it correction of the oval of the lower third of the face, nasolabial and labiomental folds, drooping corners of the mouth and perioral wrinkles - must necessarily include activator methods of influencing the muscular and skin aspect of the soft tissues of the face. These are, first of all, soft massage technologies, and for the lower third of the face - intraoral massage is mandatory. Intraoral massage is a technique of mechanical impact on the tissues of the lower third of the face through access through the oral cavity, allowing to achieve a pronounced positive therapeutic effect on the condition of muscles, skin, blood vessels, nerve endings and tissues of the peripheral articulatory apparatus. This massage affects facial tissues both from the inside and outside, which provides the facial muscles with so-called passive fitness: after a course of such massages, the muscles return to tone due to special myoextensive, myofascial massage techniques and regular training. Intraoral massage includes all the benefits of an effective anti-age procedure with the complete absence of risks and contraindications inherent in expensive hardware, injection and surgical techniques. Main indications for intraoral massage:<ul><li> loss of clarity of the contour (“blurry” oval) of the face;</li><li> ptosis of the lower third of the face;</li><li> pronounced nasolabial fold;</li><li> double chin (often found with excess body weight);</li><li> excess, sagging tissue (a common deficiency with frequent weight fluctuations);</li><li> “square” deconfiguration of the lower third of the face;</li><li> volume deficit in the lower third of the face;</li><li> thin, sensitive skin;</li><li> rosacea;</li><li> problematic skin prone to inflammation;</li><li> conditions after any mechanical or chemical peelings.</li></ul> One procedure of intraoral massage itself lasts on average 10-20 minutes. As a rule, a session of this type of influence should be carried out in four stages:<ol><li> general warming of the soft tissues of the face immediately before intraoral massage;</li><li> work with the oral cavity (gums, hard palate, salivary glands, genioglossus muscle, geniohyoid muscle);</li><li> working with the chewing muscles;</li><li> working with facial muscles.</li></ol> In turn, work with facial muscles is divided into work with depressor muscles in the perioral zone and levator muscles, including the muscles of the zygomatic, buccal and perioral zones. Basic massage movements: stroking, squeezing, acupressure, vibration, myoextensive kneading. The massage is performed manually, without the use of any apparatus or devices; Only sterile medical gloves and mouthwash are required. Unlimited possibilities Since with this massage we influence involutional changes in the lower third of the face at many deep levels, the benefits of intraoral massage are numerous - this includes sculpting (returning the original oval shapes) of the face, lifting, and deep restoration, relaxation of the facial muscles and the temporomandibular joint. More detailed presentation is required to fully understand the effectiveness of such procedures. So, the main effects and benefits of intraoral massage.<ul><li> Facelift is the effect of a lifting operation without surgery, that is, without health risks and the need for long-term rehabilitation.</li><li> Rejuvenating effect without injections - without the risk of facial muscle atrophy and drug load.</li><li> Normalization of tone and deep relaxation of facial muscles, which reduces the severity of wrinkles and also stimulates the natural synthesis of collagen and elastin.</li><li> Lymphatic drainage effect, providing detoxification and cleansing of the skin, reducing swelling, eliminating congestion, restoring complexion.</li><li> Osteopathic effect - a youthful, clearer facial contour returns by reducing muscle spasticity.</li><li> The sculpting effect is a truly filigree effect and changes in the aesthetics of the face with the help of jewelry-precise micro-kneading, requiring the specialist to develop his micromotor skills to the level of a master.</li></ul> The high effectiveness of our own intraoral massage technique has been confirmed by years of work on thousands of clients, people with various types of aging. Therefore, we can safely say that this approach, that is, the intraoral massage itself, has been rightly recognized by many specialists and clients as an ideal alternative to a facelift. After the first procedure, the tightening effect can last up to three days or even longer, although, of course, repeated procedures in the form of a course of treatment are necessary to achieve a lasting result. The undoubted advantage of this type of massage is also the possibility of using its individual elements for local treatment of problem subareas in combination with other facial massage techniques. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/01/top/%D1%812.jpg" style="width: 900px; height: 742px;" /> The effectiveness of intraoral massage has also been confirmed by modern diagnostic tools, in particular using three-dimensional computed tomography (3D CT): analysis of morphological changes in the soft tissues of the face showed a positive trend after just one course of intraoral facial massage in women aged 30 to 54 years (see. <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/srt.12345">Analysis of morphological changes after facial massage by a novel approach using three‐dimensional computed tomography</a> ). This massage is a highly specialized technique that only a few specialized specialists can offer. We have devoted years to developing our own method of intraoral massage, its implementation, research of results and training of new specialists. One of the important points that are taken into account in this technique is oropuncture, an adequate acupuncture effect on the points of biological correspondence to the internal organs located in the oral cavity. Thus, this improved proprietary technique, aimed at permanently correcting ptosis of the soft tissues of the face and restoring volume loss, enhancing skin turgor and other persistent involutional changes in the face, also helps to achieve a positive effect on internal organs and has a general health effect. Nota bene As the practice of using intraoral massage shows, this non-invasive and accessible method helps to correct all of the above-listed deficiencies and age-related characteristics of the lower third of the face. And when solving these problems, a specialist, first of all, should remember to determine the causes of premature involutional changes - accurate diagnosis is also important for predicting effectiveness. Thus, the search for pathogenetic factors and differentiation of age-related changes is crucial for determining the algorithm and effectiveness of exposure when choosing various methods. The main task of diagnostics is to provide a comprehensive assessment of:<ul><li> condition of the skin and muscles;</li><li> state of the dental system;</li><li> tissue trophism;</li><li> neurological and endocrine (the estrogen-dependent zone includes, for example, the perioral region) status.</li></ul> Thus, taking into account the multifactorial nature of involutional changes in the lower third of the face, we can conclude that the problem of their diagnosis, correction and rejuvenation is interdisciplinary, affecting aspects of related areas of aesthetic medicine. These (and other) important points are taken into account when teaching the author’s technique of intraoral massage, which is designed for practicing cosmetologists of various levels of training. First published: Cosmetologist No. 5-6, 2020

Intraoral massage as anti-age therapy for the lower third of the face