Facial Aesthetics

1. Facial Aesthetics Tal Marom, M.D. May 2006

2. The aging skin Intrinsic aging � ????? ????-????, ?????? ??????; ?????? ????????? ???????, ??????? ?? ????? ???-????, ????? ????? ????? ?????? Photoaging � ????? ?????? UV, ????? ?? ?????, ????? ??????, ????? ???? ??????- ????? ???? ???????? (????), ??? ??????? ????? ???? ???? ????? ?????? ???????? ????.

3. The aging skin ??? ??????? ???????? ???? ??, ???? ???? ??????. ????? ???? ?????? ????? ???? ?????? ??????? . ??????? ???? ?????? ???????, ????? ????, ????? ????? ???? ???? ???? ?? ????? ?????????? ?????? ?????? ????? ??? ?? ??????? ???? ????? ???? ?? ?????? ????? ?? ???? ????? ?????? ???? ??????

4. 1. Chemical peeling

5. ??????? ????? ??????, ??? - ???? ????? ?????? ????? ??????? ??????? ?????, ??? ???? ???????- ????? ??? ?? ??? ???? ?????? ???? ???? ?????? ??????? ????????? 1960- ????? ????? ????? (Brown) ???? ?-60'- ????? ?-TCA ??? ????? ????? ?? ????????? ?????????? ?????- ??????? ?????? ?????

6. Nasolabial fold � Flemming-Poff scale

7. ???? ?????? ????? ????? ????? ????? ????, ????? ?????? ????? (?? ???? ??????) ?? ????? ???? ?? ????- ??? ????????? ?????? ??? ?????? A ???????-????? ?????? ???? ?????? ????? 4% to 8% hydroquinone gel ???? ?????? ????-??? ?????? ?????????????

8. Chemical peeling ????? ???? ???? ?"??????", ????? ??????? ????? ???? ?? ??? ???? ?????? ?????? ????? ??????? ?????? ?????? ????????? ???? ???? ??? ???? ??? ?"????" ???? ??' ?? ?? ??????? ??????? ?"? ????? ?????????/????? ??? ??????? ????? "anti-aging� ???? ????? ??? ???? ??????? ??????

9. Fitzpatrick skin type classification (1988) Type I (very white or freckled) - Always burn Type II (white) - Usually burn Type III (white to olive) - Sometimes burn Type IV (brown) - Rarely burn Type V (dark brown) - Very rarely burn Type VI (black) - Never burn

10. ??? ????? ??????? ????? ?????? ?????? ?????? ????? ????? ???????? ???? ???? ????? ?????? ?????? ?????? ????? ????? (????) ????? ??? ("??????") ??????? ??????, ???? ???? ???? ???? ??? ????? ???? "???" ?? ?????? ?????? ??? ???? ???? ????? ?????? ????? ???? ????? ??? ????? ??????? ?? ????? ???, ????? ??? ????? ??? ?? ????? ???? ??????.

11. ?????? ?????- ?????? ??? ?? ??? ????? ?????? (????????+?????) ??? ?? ??? ???? ???????? ?? ???? ????????? ????? ?????? -"??? ?????" ???? ???? ????? ?????? ?? ?????? ?????? ? ??????? ????

12. ?????? ??????? ?????? Lactic Acids Glycolic Acids Beta Hydroxy-acids (salycilic acid) Trichloreacetic Acid Non Acid Enzyme Peel Topical 5-FU

13. ?????? ???? ????? ????? ??????? : triretenoin, 10%-20% TCA, 5-FU, salicylate, Jessner�s solution (salicylate, ethanol, lactic acid) ????? 6-8 ????? ?????, ???? ??' ?????? ???? ???? "????" ???? ?? ?? ???? ?????? ??? ?????? ???? ????

14. ?????? ?????? ????? ????? ?????? ?? ???? ?????? ?????? ????? ?????? ?????? ????, ???? ???, ????? ????? ????? ?? TCA 35% ?????? ?? Jesnner�s solution, ?? ?? ???? ??? ?????? 88%. ???? ???? ????? ?? ??????. ????? ???? ????, ???? ??' ??????

15. Pre- and post-treatment medium-depth chemical peel

16. ?????? ???? ?????? ?? ????, ?????? ???? ????? ????? ???? ?????? ?? ??? ????? ?????? ????????? ?? ????, ?????? ?????????? ????. ????? ?????. ???? ??????- ???? ????? ?????? ???????? ???? ?????? ????. ????? ????? ????? 24-48 ???? , ??"? ????? ???? ????? ??? ???? ??????. ??? ???? ???? ????? ????? ???? ??????? ????? ??? ????? ????. ?????? ??????: Baker�s solution - 88% ????, ??? ?????? (????? ????? ????? ?????), ???????

17. Pre- and post-treatment with Baker's deep chemical peel

18. Pre- and post-treatment with Baker's deep chemical peel

19. ?????? ???? ????? ???? ??????? ?????? ??????? ????? ???? ???? ?????? ??? ???? ??????? ?????? ????-??? ?? ????? ???-???? ????? ???? (TCA) ???????? ????? (????? ????? ??????) ?????? ???? � ?????? ????? ????, ??? ?????? ??????? ?????.

20. Lunchtime peel 2-3 ??????? ??????, ?? ????? ?-20 ???? ?????? ???????- ?????? ?????? "???????"

21. ?????? ?????? ??????? ?? ?????? !! "?????? ????? ??????? ??? ??? ???? ????? ??????? ?? ????" ??????

22. ?????? ??????

23. 2. Botox ???? ???????? ???? ?????? ????? ???? ?????, ?????? ????? ???? ??? 7-10 ???? ????? Ach-R ??????? ?? ???? ????? ??? ???? ???

24. Relaxation of prominent corrugator muscle with BOTOX

25. 3. Intense Pulsed Light (Thermage) ????? ?????? ??? ?????? ?? ????? (??????? ?"? ?????? ?????) ??????? ??????? ????? ?"? ??? ?????? , ????? ???? ???? ?? ?????? ????

26. 4. Laser resurfacing ????? ??????? ????? ????? ???????? ?????? ?? ??? ?????? ???? ?????? ?? ???? ?????? ???? ?? ?? nm 1064- ????? ?????? ??"? ????? ???? ???? ?? ?? nm 1320- ????? ?????? ????? ???? ?? ????? (???? ??????)

27. 5. Facial serum ????? ??????? ????? ?? ???? ?????, ?????? E ??????? ??????, ?????? ????-?????????? ?????? ???? ?? ?????? (vitamin A) ????? ????? ???????? ?? ?????

28. 6. Dermal fillers ????? ?????? ?? ????? ???? ???? ?????? ????? ???-??????? ????? ??????? ?-hydroxyapatite ?????? ?????? ?????? ??? ???? ????- ????? ???? ???? ????? ?????? ???-????? ???? ????? ?????? ???????????, minimally-invasive

29. Dermal fillers ?????? ???? ????: Restylane�, Hylaform�, Hylaform Plus�, Captique, Cosmoplast and Radiesse ???? ??? ???? � SCULPTRA : ????? ????? ??????????. ????? ?????: poly-L-lactic acid  ?????? ?? ?????? ????? ????? ?? ????? ?????- ??????, ????.

30. Hyaluronic acid injection

31. Micro-lipo-injection

32. Lip augmentation- Restylane

33. Cheek augmentation

34. 7. Mechanical peeling (dermabrasion) ????? ????? - 1905 ????? ????? ?????, ?????? ??? ????? ?? ????? ??????, ??????? ??????? ????? (?????? ?? ????? ????????? ?? Al2O3 ) ????? ?????, ??? ?????? ??? ??? ????? ?????? ?????? ????? ??? 10 ???? ???????

35. Dermabrasion

36. 8. Pigmentation removal ???? ???? ????, ?????????, ????? ???? ????? ????? � ??????? ????, ?????? (?)

37. 9. Face lift (Rhytidectomy)

38. ????? ???? "????? ????" ?????? ??????? ??? ??? ???, ????? "?? ????" ?????? ???? ???? ????? ?????: ????? ???? ?????????? ????? ???? ??????, ????? ??? ?????? ????? ????? ?-laser resurfacing ?/?? ????? ???? ???? ????? ???? ?????? ?? ??? ???? "????" ?/?? ???? ??????.

39. SMASsuperficial musculo-aponeurotic system ????? ?????? ?? ?????, ?????? ???????? ????? ?????? ?????????? ?????? ????? ??? ????? ?????? ???? ?-SMAS ?????- ???? ?????? ??????? ?????? ?? ?-SMAS ??????? ????

40. Rhytidectomy 1901- ????? ????? ???????, ?????? ???? ????? ????? ????? ????? 1974- Skoog ???? ?? ????? ???????? ???? ?-SMAS ??? ????? ??? ?????- ????? ???? ?-melolabial fold ?????? ???? ???? ?????

41. Face lift ???? ?????? ?? ???????? ??? ???? ????????: Subcutaneous (????? ??????, ?????? ?? ????? ????? ?????) Sub-SMAS dissection (Skoog, 1974) (???? ???? ??? ???????, ???? ?? ???? ???? ?????) Extended supra-SMAS dissection (Owsley, 1993) (??????? ????? ?-SMAS ?? ????? ?????, ????? ??? ????-????????? ???? = BLAIR) Complete subperiosteal undermining of mid-face bones) Ramirez, 1991) (???? ???? ????, ??? ??????, ????? ???? ???????, ???? ????? ?????????? ??? ??? ???? ???)

42. Face lift ????? ???????? ??? ????? ???? ???? ?????? ????? ??? ????? ???? "?????" ?-SMAS ????? ?? ????? ?????? ???? ???? ???? ????? ??????????

43. ???? ????? (suspension threads) ??? ????? ?????????, ???????? ????????: Aptos thread � ???? ?? ????? ?????? ????? ????? Contour thread � ???? ??? ????? ??????? ?????? ???????? ?????? ?????? ??? ???? ?????? ?"? ????, ????? SMAS, ?????? ?-undermining � ??? ?????? ???.

44. Aptos = �anti� + �ptosis� ???? ???? ??????? ???? ?????? ?? ????? ?? ???? ??????, "??? ??????" ??????? ?????? ???????????? ??????? (barbed) ????? ????? ???? ????? ???? ??? ???? ????? ?????? ???? ?????? ????? ????? ????? ??????, ??"? ????? ???????-???? ????

45. Aptos procedure

46. Final results ????? ??????????? ???? ??' ???? ???? ?????????

47. Aptos procedure ????????????? ???????- ???? ????? ??????? ?????? ????? ????? ????? � ??? ??? ???? "????" ????? ???????? ???? ??????, ??? ??? � ???? "??" ????? ?????: ????????, ?????, ????? ?? ??????, ???, ????? ??? ????? ???? ????

48. Contour procedure

49. ??????? ????? ?????? ??? ????? ????????? ???? ?????? ??????? (?????? ??????) ????? ???????- greater auricular ????? ??????? ?????? ?? ??????? ???? ??? ?????? ?????? ??? ?? ??????? ????

50. 10. Blepharoplasty

51. Blepharoplasty ?? ????? ????? ???? ?????, ??????? ?? Grave�s ?? ?????, ???? ???????? ???? ????? ???? ?????? ??????? ????? ????????? ????? ????? ????? ?? ?????: ?? ????? ???? ????????? ????? ????? ?? ???? ??? ? ????? ?

52. Blepharoplasty ??? ?????, ????? ????? ??? ???????? ???? ???? ?????????, ????? ????? ??? ????? ????? ?????? ?????? ???? ???? ?? ???? ???? ?????? ??

53. 11. Allopecia ???????- >60% ???????, >10% ?????? 2 ??????? ???? ?????? ????????? ?????? ???? ????? ????, ??? ??????, ??????, ?'? : ?????????? ?????????? ???????? ??? ????? ????? ???? ???? ????? ?????? ?????? ????: follicular-unit grafting , ????? ????? ???? ???????? ??????

54. Follicular Unit Hair Transplantation (FUT) ????? ????? ???? ???? ??? ??????? ????? ???? ??????, ??"? ????? ????? ????

55. 12. ???? ???? ?????/????? ????? ????? ??????????? ???? ?????? !! ?????- ????? ????? ??????? ???? ?????? ????- ??????

56. 13. Tatooing ?????? ??? ?????? ??? ???? ?????? ????????, ?????? ?? ????????? ???????? ????? ????? ???? ??? ?? ?????? ????? ???? ?????? "????" ???? ?? ?????? ??????? ??????, ??? ??? ????? ?? ?????? ????? ????? ????? ???? � ????? ??????

57. Cosmetic tatooing "????? ????" � ????, ???????, ?????? ????? ???? ??? "??-?????", ???? ???? 3-5 ???? ?"? � ?????, ???????, ????????, ?????? ??????????????, ????? ??????, ?????? ?????? ???? ????? MRI

58. 14. Liposuction ???? ????? ???? ???? � ?? ?????? ?????: ultrasound-assisted lipoplasty tumescent technique, super-wet technique ?????? ????? ?????? ?? ???? ???? ???? ??? "?????" ??? ????? !! ????? ???? ??-????? ?????? ???? ????? ????? ????? � ????? ?????? + ???????? + ??????

59. 15. Mentoplasty (chin surgery) ?????? ???? ?? ?????? ???????????? ?????? ???? ?? ?????? ????? ????? ?????- ????? ??? ??-???? ???? ????????/ ???? ??? ??? ????? ????? � ???? ????????? (???????????? ?????)

60. 16. Rhinoplasty ?? ????? !! ?? ?????? ?? ??? 15 � ?? ???? ????? ??? ????? ????????? ????-??????? ?? ????? ????? ?? ????? ??? ??-?????

61. 17. Otoplasty

63. Otoplasty "????? ????", "????? ????-????" ?????? ?????? ?????; ??? 5% ???????? ?????? ???? ??????? ?? ?-anti-helix ?? ??????? ??? ?? ?-concha; ??-???? ??"? ????? ????? ??????/?????/?????/????? ???? ?? ???? ??????? Diffenbach � 1845 � ????? ????? ??????

64. Causes for prominent ear

65. ????? ?????? ????? anti-helix ?????, ??? ????? ???? ????? conchoscaphal angle ?-900 ????? ??? ?-concha ????? ?? ??????? ?? ??? ???????? ????? ????? ???? ?????? ????? ?????? ????? ?? ???? 6-7 ???? (?? ??????? ????? ?????)

66. ????? anti-helical fold ????? ?? ????? ??? ?????? (scoring) ?? ????? ?"? ????? ?? ?????. Scoring:

67. Mustard� suturing approach

68. ????? ?? Conchal Defect ???, ????? ?? ????? ??? ?????? (scoring) ?? ????? ?"? ????? ?? ????? ???? ?????- concha-mastoid sutures

69. ????? ?? Conchal Defect ???? ?? ?????? ?? ??? ?????? ?"? ????? ??? ?????? -

70. Protruding lobule

71. 18. Scar revision- Z-plasty ????? "????" ????? ????? ???? ????? ?????? ???? ???? ? ????????? ????? ??? ????? ??????? "???? ?????" ??????? ?? ?????? "??????" ?? ???? ??? ????? ???? ???? ????: ?????

72. Z-plasty