• Atrophy and loss of skin tone from sun damage.
• Genetic inheritance.
• Morphological changes of the facial bones
• Health-related problems.
• Emotional stress.
• Large weight increases or losses.
• Chronic alcohol abuse.
• Chronic smoking.
• Previous trauma.
• Chronic facial muscle contractions.
• Environmental factors such as excessive exposure to the sun or pollution.

From 30 to 40 years of age:

The upper eyelid skin becomes excessive and crow’s feet are formed in the periocular area. An upper eyelid blepharoplasty and botox injection would solve these problems. Mesotherapy with hyaluronic acid would slow future signs of aging.

From 40 to 50 years of age:

Nasolabial folds become deeper, transverse wrinkles on the forehead and vertical frown glabellar lines are formed. Proper treatment would be a combination of hyaluronic acid fillers and Botox to treat wrinkles and peeling or laser resurfacing to improve skin appearance. If there is a fall in the eyebrow we can perform forehead lift and blepharoplasty if there are bags in the lower eyelids.

From 50 to 60 years of age:

Neck wrinkles are formed, the jawline becomes less distinctive. There are jowls and the tip of the nose descends. The best treatment is a facelift and / or cervical lift and rhinoplasty of the nasal tip. Radiofrequency and more ablative laser treatment would also improve the results.

From 60 to 80 years of age:

Skin and subcutaneous tissue are atrophied, which contributes to the formation of wrinkles and growing skin bags. The best treatment option is surgery.

• Loose sagging cheek and neck skin.
• Depth of the nasolabial folds and perioral commissures.
• Formation of jowls, platysmal bands and skin laxity on the edge of the jaw.
• Brow ptosis.
• Frontal and between the eyebrows wrinkles.
• Increase and laxity of the eyelid skin.
• Increased protrusion of periorbital fat.
• Crow’s feet or wrinkles in the cantal region.
• Hypotonicity and laxity of the lower eyelids.
• Increase of the size of the ears lobes.
• Fall of the nasal tip or decrease of the angle between the nose and lip.
• Flaring of the nostrils.
• Increase of the vertical height of the white portion of the upper lip.
• Appearance of “puppet” furrows.
• Thinning of the red part of the lips.
• Vertical upper lip wrinkles.

• The brow position is different. In women they are generally located above the upper orbital arc and in the male they are at the level of this rim or slightly below.
• Different patterns of hair growth on the scalp.
• Thicker skin in men and greater blood supply to the beard area.
• Psychological differences.

Primary indications include drooping or ptosis of the forehead and eyebrows and lateral bulging of the upper eyelids. It is also useful for the correction of forehead wrinkles, wrinkles between the eyebrows and the back of the nose

There is no best age. The appropriate time for surgery depends on:

• The wishes of the patient.
• His or her overall health.
• His or her mental state of health.
• Signs of aging that the surgeon considers can be corrected surgically.
• The history of sun exposure and environmental damage to the skin.

The answer depends not only on the state of health of the patient, but also on his or her skin type and age at which the procedure is performed.
Usually plasties of the forehead and eyelids do not need to be repeated, but it is considered that facial last from 8 to 10 years.

The type of anesthesia depends on the procedure, general health of the patient and surgeon preference. Local anesthesia may be sufficient in some cases. But for most of them local anesthesia should be combined with intravenous sedation. General anesthesia is used for procedures requiring complete relaxation.