A Systematic Review Of Age Selection For Facial Rejuvenation Surgery

Objectives:There are many kinds of facial rejuvenation surgery,and the ideal facial rhytidectomy has the characteristics of less complications,long postoperative effect and high patient satisfaction.Most surgeons rely on a non-standardized comprehensive assessment of skin relaxation,volume reduction and anatomical targets(midface,mandible,neck)during the initial face visit.Due to the existence of many different technologies,The characteristics of different methods of traditional rhytidectomy and whether there are age indications are still worthy of further discussion.This paper intends to study this problem.Methods:We searched English articles in Pubmed,Embase databases,Cochrane library,and searched Chinese literature in China biology medicine disc(CBM),China national knowledge infrastructure(CNKI)data.The time limit was from January 1980 to January 2021.The key words were:facial promotion,facial rejuvenation,facial wrinkle removal,and age.Inclusion criteria:facial wrinkle surgery,or facial lifting,is defined as surgical treatment to restore facial rejuvenation by lifting and supporting facial and neck tissue.Facial rhytidectomy,although there are many different methods in face and neck rhytidectomy,it can be divided into four types according to the tissue plane used for rhytidectomy:(1)subcutaneous,(2)above SMAS,(3)below SMAS,(4)subperiosteal.Traditional facial lifts do not essentially improve wrinkles unless deep rhytidectomy,liposuction or direct wrinkle removal are added.SMAS is essentially the middle of the face,the extension of the platysma fascia under the cheek fat,Recent evidence shows that SMAS dissipates before reaching the zygomatic major muscles,so the force exerted on SMAS is difficult to transmit to the nasolabial fold,so it will not improve wrinkles.Subperiosteal facial lifting treats aging faces by improving the relationship between soft tissues and the underlying bones and reconstructing their appearance.This is an operation that can lift the upper and middle 2/3 of the face.Included articles include major clinical studies or systematic reviews of surgical techniques for facial rhytidectomy,which must also include 5 or more patients,and for cosmetic reasons,a narrative review of rhytidectomy,clinical confirmatory studies,or techniques involving upper or midfacial rhytidectomy must be carried out.Exclusion criteria:exclude facial anatomy,animal experiments,facial wrinkles using botulinum toxin,facial filling techniques,facial laser,facial chemical peels,non-surgical treatment of facial aging,non-English and non-Chinese literature.Research related articles After reading the articles according to the inclusion criteria,the articles are selected and excluded,and evaluated and discussed,and the reference parts of all related articles are researched to obtain more relevant publications.According to the Oxford Centre For Evidence Based Medicine(Oxford Centre For Evidence Based Medicine)scale,the obtained literature was graded.Results:A total of 1535 articles were obtained through preliminary search.According to the exclusion criteria,the non-conforming articles were excluded,and the remaining 102 articles.Through further reading of the full text,19 articles were excluded,and finally 83 articles were obtained.According to the Oxford Centre For Evidence Based Medicine scale,the higher-scoring literature has level 1(7 studies[8%])and level 2(13 studies[16%]),the results of literature analysis The majority of documents showing evidence levels of level 3 and 4 used retrospective case studies,and documents with evidence levels of level 1 and 2 were used as an important part of this study.Among all the procedures of facial rhytidectomy,SMAS rhytidectomy is the most suitable for age,Deep plane rhytidectomy tends to be 50-60 years old,Subperiosteal rhytidectomy tends to be between 60 and 70 years old,Comprehensive rhytidectomy should be considered for patients over 70 years old,Patients between the ages of 30 and 40 tend to have subcutaneous or subperiosteal rhytidectomy(The age is still young,but it shows obvious nasolabial folds,The infraorbital margin is relaxed and prolapse is obvious,showing signs of aging.)Conclusion:Patients between the ages of 50 and 69 tend to get better results in SMAS or Deep-plane technology,Patients between the ages of 70 and 80 tend to achieve better results in deeper plane(subperiosteal)plastic surgery.