En una entrevista exclusiva con el Dr. Eduardo Sosa, tratamos uno de los temas más consultados, tanto por hombres como mujeres, el Envejecimiento Facial.

¿Qué es el envejecimiento facial ?

Es un conjunto de manifestaciones que se observan en el rostro con el paso del tiempo que comienza aproximadamente a los 30 años de edad y que no se detiene, existen factores que contribuyen al mismo como es la genética o herencia por eso vemos pacientes de poca edad con un rostro más avejentado que otra con más edad con un rostro de paciencia más juvenil este factor es del cual no podemos escapar ni modificar, existen variables como el sol , el cigarrillo y la gravedad.

¿Qué ocurre en el rostro?

Si estudiamos al rostro de superficial a profundo vemos que en la piel se pierde tanto en cantidad como en calidad las fibras colageno y pérdida de la elástina aumentando así la flacidez y la caída de la misma. La grasa facial también sufre una disminución y una migración por gravedad, sucediendo lo mismo con el sistema músculo aponurotico del rostro.inclusive en algunos casos la peridida de volumen óseo o huesos de la cara.

Todo esto genera un desbalance contenido ( hueso músculo grasa) continente (piel ) del rostro.envejecimiento facial

¿Qué manifestaciones clínicas se presentan?

Si dividimos al rostro en tres tercios de arriba hacia abajo tenemos:

Tercio superior, que comprende desde el nacimiento del pelo a la nariz, allí encontramos las arrugas de la frente producidas por él músculo frontal, las arrugas al costado de los ojos (las famosas patas de gallo) producidas por el músculo orbicular, el exceso de piel en los párpados superiores, producidos por el aumento de la laxitud del mismo y bolsas grasas, que en algunos casos compromete el campo visual pasando de estético a un compromiso distinto. Un signo característico en el envejecimiento, es la caída de la cola de la ceja por entre otras cosas la acción predominante del músculo orbicular.

El Dr Eduardo Sosa es Especialista en Cirugía Plástica Estética y Reparadora.
Director Nefertiti Cirugía Plástica
Médico egresado de la SACPER
Médico egresado de clínica juri cirugía plástica
Ex residente clínica planas Barcelona España

Tercio medio, uno de los más importantes a la hora de evaluar un rostro envejecido. Encontramos al párpado inferior con el aumento y caída de la piel y el aumento de las bolsas grasas de los párpados con una imagen de paso del tiempo en la zona peri ocular, pero en algunos casos comprometiendo la recolección de la lágrima y exposición del ojo, como es el caso del ectropion, senil o de los adultos grandes.

También encontramos el hemisferio facial, la zona triangular que se encuentra por debajo de los ojos con un aspecto de vacío y chato, llamado rostro negativo, producido por la dominación de volumen en donde la grasa de relleno se achicó y migró por gravedad hacia abajo en el rostro, profundizando así estructuras de sostén como son los suecos a los lados de la nariz o naso genianos.Y sin lugar a duda la estructura más importante, piramidal y tridimensional, que se encuentra en el centro de la cara y que no tenemos que olvidar al evaluar un rostro envejecido, que es la nariz con aspecto de envejecida cuando está grande o con la punta caída

Siguiendo esta misma línea no hay que olvidarse de los lóbulos grandes y caídos en las orejas, muchas veces vemos pacientes operados de rostro, que al hacer una mala evaluación quedan con este signo de vejez.envejecimiento facial 1

Tercio inferior, acá encontramos una estructura por sí sola, bien proporcionada en volumen y tamaño. Proporciona juventud y belleza, como son los labios, al envejecer disminuyen su volumen, aumentan sus arrugas y cae aumentando su largo en superior, dando el aspecto del llamado labio de mono. Acompañado a esto, la expresión de tristeza que da la caída de la comisura a los costados e incluyendo los surcos la famosa línea de marioneta.

Incluimos también la pérdida del dibujo triangular de la mandíbula, que presenta por ejemplo una mujer joven y, que con el paso del tiempo por migración o caída de los tejidos, terminan dando ese aspecto de carne sobrante a los costados de la cara.

El cuello y la mandíbula forman un ángulo característico en la juventud, que al perderlo por aumento de la piel o de la grasa, dan un signo más de envejecimiento facial. Es una zona muy importante a la hora de mejorar el rostro, por más esfuerzo que uno haga por mejorar la cara en su totalidad, si el cuello no es tratado correctamente el resultado siempre termina siendo pobre.

¿Qué tratamientos existen para tratarlo o prevenirlo?

Primero es importante, más allá de la buena evaluación clínica de cada caso, entender que el rostro se trata en forma tridimensional sacando las teorías ya viejas en donde sólo estirando la cara se creía que se mejoraba el aspecto de un rostro.

Se puede prevenir o enlenteser en alguna medida el proceso del envejecimiento, realizando disminución de la exposición al sol, cremas, disolución del tabaco, etc.

Entre los tratamientos de las primeras consultas, realizadas por pacientes que rondan los 30 años (cuando empezamos con los primeros signos de envejecimiento), para las arrugas frontales y para las patas de gallo  encontramos el bótox, una toxina que relaja los músculos y atenúa así las arrugas; el plasma rico en plaquetas, que reestructura el colágeno y mejora el aspecto de la piel; y el ácido hiaulurónico, un material de relleno que se usa para devolver el volumen que se perdió en el rostro al pasar el tiempo.

Hay que tener en cuenta que a esta edad, se consulta mucho, sobre todo la mujer joven, por ojeras tratadas con la técnica llamada NaNofat y por aumento de la bolsa de grasa en el párpado inferior sin aumento de piel. Éstas son tratadas con la Blefaro plástia transconjuntival. Cirugía muy realizada en el adulto joven con resultados muy aceptables por los pacientes.

A medida que aumentamos la edad, estos tratamientos ya no son tan favorables como los enumerados anteriormente y más tarde nos servirán de complementos a los que mencionaremos a continuación.

Siguiendo la línea del tratamiento tridimensional se realiza un lifting o levantamiento del rostro (incluido el cuello),  reponiendo con grasa propia del paciente el rostro, generando así el volumen perdido. Dependiendo el caso clínico, la elevación de la cola de la ceja, la cirugía de párpados superior e inferior, el achicar lóbulos de oreja, acortar el labio superior y en algunos casos no olvidar la rinoplastía o cirugía de nariz, es muy importante tener en cuenta estos procedimientos, para poder llegar a tener una resultados más armónicos y estéticamente aceptables por la paciente y por uno como profesional.

Eduardo SosaEl cirujano plástico, aparte de conocer en detalle cada técnica quirúrgica, siempre tiene que tener presente el sentido artístico a la hora de evaluar y trabajar un rostro, y no olvidarse así de perseguir la armonía del mismo.

Turnos y consultas en C.W. Lencinas 66 1er Piso – San Rafael Mendoza Argentina – +549 2604 064 064 – info@nefertiticirugiaplastica.com – www.nefertiticirugiaplastica.com

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