Face Lift Applications

Facelift (Botulinum toxin), is a toxin derived from a bacterium called Clostridium botulinum. Facelift works by blocking the release of substances that enable transmission at nerve endings, thus interrupting the transmission between nerves and the organs they reach. The cessation of nerve transmission results in a decrease or complete loss of functions in the organ reached by the nerve. The mechanism of action of facelift has been utilized in various medical fields. In the field of plastic surgery, it is commonly used to reduce the appearance of facial lines caused by the movements of facial muscles and to decrease excessive sweating in certain areas.

Over the years, the continuous movement of facial muscles causes the development of visible folds on the overlying skin, leading to dynamic facial lines. The most common dynamic lines appear on the forehead, between the eyebrows, around the eyes, and around the mouth. Lines on the forehead and around the eyes contribute to an older appearance, while lines between the eyebrows give a furrowed, angry expression. By applying facelift to the facial muscles, their movements can be weakened, resulting in a reduction of folding and creasing of the skin caused by muscle movements. This process helps improve the appearance of an aged and angry facial expression.

When facelift is applied to sweat glands, it can reduce their activity by interrupting the transmission between the sweat glands and nerve endings. The areas of the body that sweat the most are the palms of the hands and the underarm region. When facelift is applied to these sweating areas in individuals experiencing excessive sweating and related body odor, an improvement in their symptoms can be achieved.

Facelift is administered through injections and is not a painful procedure, although a mild discomfort may be felt during the injection. When a reduction in the movements of facial muscles is desired, the injections are administered into the facial muscles. When a decrease in sweating is desired, the injections are administered into the skin. The effects of facelift become apparent within the first week after the injection and the duration of the effect ranges from 3 to 9 months, with an average of 6 months. When the effects of facelift diminish, the procedure can be repeated. Individuals who undergo regular facelift treatments for 2 years may experience significant weakening of their muscles and changes in their facial expressions. Therefore, it is beneficial to schedule the treatments at longer intervals after the second year.

Facelift does not have any serious health side effects. Temporary swelling and bruising may occur after the procedure, and in rare cases, temporary drooping of the eyelid may occur. Whether facelift has harmful effects during pregnancy and breastfeeding is not yet fully known. Therefore, it is recommended to avoid facelift procedures during pregnancy and breastfeeding. It should not be performed on individuals with conditions related to the nerve-muscle system, such as Eaton-Lambert syndrome or myasthenia gravis.

Dermal Filler

Do you know why we find full lips appealing? It’s because full and plump lips are not only a symbol of beauty but also essential elements of youthfulness, attractiveness, fertility, sexiness, femininity, and, most importantly, beauty itself. Lips, being one of the most important complementary features in facial beauty, play a crucial role in completing the overall harmony of the face. The size, fullness, thinness, or thickness of the lips should be in harmony and proportion with other facial elements such as the nose, cheeks, eyes, eyebrows, chin, and teeth. Thick and full lips represent youthfulness, while thin and sagging lips are associated with signs of aging. Lips hold significant importance in the aesthetic appearance of the face. Therefore, having firm and plump lips enhances the expression of youthfulness and health on our faces.

Some individuals naturally have thin and undefined lips, while others experience thinning and wrinkling of the lips due to aging, resulting in a loss of fullness and vitality. The decrease in tissue elasticity and volume is the result of decreased skin, muscle, and fat content in the face. Along with facial skin, structures such as cheeks, neck skin, eyelids, eyebrows, and, of course, lips sag downwards due to gravity. In cases of lip sagging, the lower teeth become visible when individuals smile or speak, which is known as “dental show” and is associated with aging. Conversely, in young individuals, when they smile or speak, the upper teeth are more visible, and the lower teeth are not exposed. This represents a youthful facial expression.

Who is it suitable for? Dermal fillers are preferred by individuals who have structurally thin or thinning lips and want to enhance the expression of youthfulness and beauty in their faces. They are also chosen by those who desire firmer and fuller lips. Lip reduction surgeries are performed not only on individuals with thin and wrinkled lips but also on those with naturally thicker lips, such as patients of African descent. Additionally, reconstructive lip surgeries are performed on patients who have lost a part of their lips due to lip cancer. Such lip reconstruction surgeries are of great importance not only aesthetically but also functionally.

How is it done? The aim is to thicken the lips, make the contours more prominent, reduce wrinkles, and make them fuller. However, preserving a natural appearance is the primary objective.

There are various methods available for lip augmentation and wrinkle reduction. We can categorize these methods into three main groups.

1. Foreign fillers:

Liquid Silicone and Silicone Oil: The use of liquid silicone and silicone oil by injecting them into facial tissues became popular in the 1960s and 1970s. However, due to the drawbacks and various complications caused in patients who received these injections, the use of liquid silicone and silicone oil for lip augmentation has been banned by the US Food and Drug Administration (FDA) as an aesthetic filler and direct injection into the tissue. The application differs from the ones used in breast surgeries. In breast surgeries, gel silicone is placed under the breast in a thick shell and can be removed when desired without any harm. However, when injected into the lips, silicone spreads between the tissues as it is in liquid form, making it impossible to remove. It causes inflammation in the lip tissue and can lead to deformities due to its continuous movement. In some unauthorized locations such as hotel rooms, houses, and beauty salons in our country, individuals may secretly perform this type of silicone filling. Therefore, caution should be exercised, and it should never be done. No plastic surgeon in our country performs liquid silicone or silicone oil injections into the face.

Temporary fillers: These are harmless materials composed of substances such as collagen and hyaluronic acid. Collagen is obtained from bovine skin. Its use has almost ceased since the emergence of mad cow disease. It also carries the risk of allergies as it is an animal protein and should not be used without testing. Hyaluronic acid, which is commonly used to correct wrinkles on the face, is the most widely used material. When Hyaluronic acid, known as Restylane®, is injected with a needle, the application is straightforward, and the patient can immediately return to their normal life. The effect lasts for about 4-6 months, and it needs to be repeated after this period. It is chemically synthesized and does not cause allergies, making it safe to use. These substances are injected directly into the dermis for lip border thickening and enhancement. However, they may be insufficient in cases where more thickness is required. They are dissolved and excreted from the body within 4-6 months. Therefore, their effect is temporary, and they need to be repeated every 6 months.

There are many chemical substances that can be injected using needles and provide permanent improvement without being eliminated from the body. These substances can remain in the body for about 4-5 years. Such injection-type applications are extremely simple. After the procedure, the patient can continue their normal daily life immediately.

Other solid form fillers: These are materials that are placed with a small surgery, unlike injectable fillers. Alloderm is obtained from human skin. It dissolves and disappears within 1 year of placement. Gortex, on the other hand, is permanent. It is placed inside the lip through small incisions made at the lip edges. It remains in place and maintains its shape. However, over time, it can protrude through the lip, which is a disadvantage.

2. Filling with the patient’s own tissues: Lip augmentation and enhancement can also be achieved using tissues taken from the patient’s own body. These include:
Fat Cells: Fat cells taken from the patient’s own body are carefully processed and then injected into the lips and, if necessary, other wrinkles. Approximately 20-30% of the cells placed within 3-6 months remain. When the procedure is repeated several times, effective lip augmentation can be achieved. It has no harm and does not carry risks such as allergies. The procedure is performed under local anesthesia. Swelling subsides within a few days. It is an extremely simple application and is highly effective in cases where significant fullness is required.

Skin Cells: Skin and subcutaneous tissue, including fat cells, taken from the patient’s body during procedures such as abdominal or breast reduction surgery, or from pre-existing scar tissue, are mixed together and injected into the lips as a tissue cocktail. This method requires multiple repetitions as a portion of the injected cells is absorbed. It is a harmless and one of the best methods available, with no risk of allergies.

3. Reshaping the lips through surgery: It is possible to thicken the lips through simple surgeries without using fillers. There are various techniques available, and the plastic surgeon selects the most suitable one based on the patient’s lip structure and condition. The best and most permanent results are achieved through these techniques, unlike temporary solutions. Healing is completed within 2-5 days, and the procedures are simple, performed under local anesthesia.

Techniques include:

Marionette Technique: The aim is to elevate the lip edge by lifting it upward. An incision is made at the upper lip edge and from the desired upper area, and then the intervening skin is removed. The lip skin is sutured to the upper skin, resulting in the pink part of the lip being lifted upwards. This technique is an excellent solution for patients with thin lips and heavily wrinkled lip edges. The results are permanent.

Bullhorn or Subnasal Lip Lift: A portion of the skin is removed in a bullhorn shape, following the curves just below the nose, and the skin is sutured back to lift the lip upwards. A small incision scar remains just below the nose. This technique is also used to reduce the distance between the upper lip and the base of the nose in patients with wide upper lip skin. It allows the upper teeth to be more visible. The results are permanent.

Paris Lip: This technique involves enhancing the lip borders and the edges of the philtrum (the indentation between the upper lip and the base of the nose) using fillers or fat cells. The lip borders become more defined and fuller.

V-Y Technique: V-shaped incisions are made inside the upper and lower lips, followed by Y-shaped suturing, resulting in lip augmentation. The results are permanent and do not change.

Lip Suspension: Small sutures passed through a small incision made inside the nose are then threaded through the lip and tied, lifting the lip upwards. No visible scars remain. It is a highly effective method.

Lip aesthetics is highly popular due to its significant impact on facial harmony. It offers effective results and simple application methods.