Bryli – the consequence of weakening of a tone of skin and fatty cellulose in the field of a middle part of the person leading to an obvisaniye of fabrics and violation of a natural face form. The become swollen cheeks and "bryl" make heavier the lower part of the person and visually add excess years. Usually persons face this esthetic shortcoming 40 years as with age production of collagen and elastin is reduced by cells of skin are more senior. It leads to loss of elasticity and an obvisaniye of skin of cheeks and the lower jaw. It is possible to fight from a brylyama by means of hardware cosmetology (thermolifting, ultrazvekovy SMAS lifting, etc.) or radical surgical techniques – different types of face lifting.
So-called "bryl" are the drooped sites of skin and hypodermic and fatty cellulose in a zone of the lower jaw and neck breaking a normal face contour. Their emergence is connected with decrease in the general tone of the person and weakening of the chewing muscle sagging on both sides from a chin forming senile sacks (or as they are called still, "bulldog's cheeks", or "brylk").
Omission () of soft facial tissues is a characteristic sign of age weakening of a framework of skin. After 30-35 years the content of collagen and elastin – the structures supporting skin is sharply reduced; the sheaves fixing hypodermic cellulose weaken and cannot resist gravity. Fatty tissue on a face is displaced down, stretching skin. So gradually on edge of the lower jaw the "bryl" giving to a face form a wavy contour are formed.
Stages of age changes of the person
In the course of age changes persons distinguish the early, moderated and expressed aging signs.
Early signs of age changes of the person are observed at 35-45-year age. They are characterized by the minimum flabbiness of skin on the neck moderated by extent of omission of soft facial tissues, emergence of the first signs "bryly", insignificant deepening of a nasolabial fold and emergence, so-called, "grief folds" in mouth corners. On face skin emergence of a small amount of pigmentation is noted. Ptoz of soft fabrics of an average face zone is expressed minimum therefore it is often imperceptible for the patient. Flabby skin in a cervical podborodochnoy to a zone and profound nasolabial folds are clearly noticeable only during the bending of a neck and a ducking forward.
Moderate signs of age changes persons are noted at the age of 45-55 years. During this period skin in a neck becomes more flabby and through it konturirut edges of the fallen superficial cervical muscle - platizm. Are clearly visible to Bryli on a contour of the lower jaw, folds in corners of a mouth and nasolabial area are rather noticeable. Ptoz of soft fabrics on cheekbones and change of a face contour are noticeable to the patient, but are expressed moderately. Such patients can have a heavy constitution and excess fatty deposits on a body.
The expressed signs of aging of face skin can meet at any age, but to a thicket are shown at patients 55 years are more senior. Soft tissues of a neck odryabshy, with low sagging edges platizm and quite often excess amount of excess fat on a neck. The expressed "bryl" are noticeable from any foreshortening. Folds of nasolabial area and "grief folds" are deeply cut in skin and lowered. In cheekbones also loss of volume is noted considerable soft fabrics. Elasticity of skin is lost, on it pigmentation is considerably expressed.
Methods of face lifting and neck
"Bryly" and other age changes of the person it is possible to execute elimination by means of various techniques of face lifting - face lifting.
1. Endoscopic face lifting (face lifting) (Subperiosteal Facelift) – one of the most modern techniques of face lifting combining in itself the good rejuvenating effect, the smallest quantity of hems and rather short term of postoperative rehabilitation. Operation is performed by means of the special endoscopic equipment equipped with the video camera allowing to watch on the monitor work of the plastic surgeon. In a zone of a hairy part of the head and, if necessary, before an auricle several small becomes (to 2 cm) cuts through which the surgeon carries out podnadkostnichny lifting of facial tissues. At the same time excess skin is not removed therefore carrying out endoscopic tightening is possible, generally at early age changes of the person.
2. MACS-face lifting (Minimal Access Cranial Suspension Lift) – the modern technique of face lifting leaving the minimum hem only ahead of an auricle. By means of MACS-lifting rejuvenation of a cervical and podborodochny zone is carried out, folds of nasolabial area are smoothed, "bryl" are eliminated. The rehabilitation period at the same time is minimum. At MACS-tightening surpluses of skin are removed, and strong vertical fixing of the fallen fabrics is carried out. This technique is applicable at patients with various extent of age changes of skin and are most effective at the expressed signs of aging of area of a neck.
3. Korotkorubtsovy face lifting (mini-face lifting) (Short-Scar Lift, SSFL) – the face lifting technique which is carried out through a section before an auricle. Indisputable advantages of tightening with a short hem is small traumatism and short postoperative rehabilitation. As well as MACS-lifting this technique is not applied in the presence at patients of the expressed flabbiness of a neck.
4. Expanded cervical and front face lifting (Superficial Muscular Aponeurotic System Lift, SMAS lifting) – the most known and the method of face lifting which is widely applied around the world. SMAS is a complex musculo facial tissues, also subject to aging and gravitational omission. SMAS participates in change of a facial expression, helping the person to express the emotions: to smile, grin, frown etc. During expanded cervical and front face lifting cuts are made ahead of and behind an auricle with calling on a hairy part of the head. The complex musculo fabrics will be mobilized and fixed in new vertical position. SMAS lifting is followed by the long rehabilitation period, however is effective as a method of the fullest face rejuvenation at all stages of age changes.
5. Deep face lifting (face lifting) (The Deep Plane Lift) – a technique of tightening of deeper layers of the person, than at SMAS lifting. Otsloyka (mobilization) of fabrics at deep lifting is carried out under a complex musculo fabrics. Carrying out deep face lifting smoothes gubnopodborodochny and nasolabial folds, saves from "bryly". As the big thickness of fabrics is involved in deep face lifting, in them blood supply improves, and performance of deep tightening can be recommended to smokers. On the other hand, performance of tightening of deep layers of facial tissues increases risk of a travmatization of motive branches of facial nerves.
6. Lifting of a midface (Mid-Face Lift) – the technique of the isolated face lifting applied at the patients who are not needing performance of full face lifting yet. With its help the rejuvenating effect of area of eyes, cheekbones, cheeks, a nasolabial triangle is provided.
Lifting of a midface can be carried out by two main accesses – temporal and subciliary.
In the first case operation is performed by an endoscopic method from two accesses in a hairy part of temporal areas and consists in diagonal raising of fabrics. Temporal access reaches correction of appearance of eyes, eyebrows and malar area.
The second technology of carrying out median face lifting is carried out through a small subciliary section of a lower eyelid and allows to lift the fallen fabrics vertically up.
7. Tightening of SOOF (Suborbicularis Oculi Fat Lift) – this technique of face lifting is intended for the repeated placement of fatty cellulose to the infraorbital area that allows to correct the "sunk-down" look formed after carrying out a blefaroplastika in the course of which removal of fatty cellulose under eyes was made.
8. Temporal (temporal) tightening (Temporal Lift) - a technique of face lifting of side diagonal tightening of the top third of the person. With its help raising of corners of eyebrows, upper eyelids, malar fatty cellulose and the fallen tissues of cheeks, "bryly" smoothing of wrinkles in corners of eyes is carried out. Temporal tightening is carried out through a small section in a temporal zone of hair and assumes removal of excess skin, an otsloyka and movement of fabrics on diagonal up.
9. Lifting of a neck (Platysma Lift, Neck Lift, Platysmaplasty)
Braces in a neck promote creation of the expressed podborodochno-cervical corner, disposal from "bryly", the second chin, flabbiness of skin on a neck. In a combination to SMAS lifting this technique of rejuvenation of the growing old skin of a neck surpasses the others in cosmetic effect.