The patients who visit the clinic of aesthetic surgery with the aim of rejuvenation for the first time are often 25-30 years old. It is at this age that the mimic wrinkles on the forehead and in the corners of the eyes begin to bother the patients.

Early age-related developments can be caused by incorrect or inadequate care of the skin of the face or by general disturbances of the state of organism (syndrome of chronic tiredness, chronic diseases of alimentary canal, etc.). In this case the selection of cosmetics and professional care and recommendation will assist to eliminate the problem for a certain period.

In case of excessive mimic and when the unwanted mimic wrinkles remain we can recommend at this age additional injection of botulotoxin A.

A network of small wrinkles in periorbital regions or longitudinal wrinkles on the forehead (at the age of 30-35 years) will be the indication for laser peeling of this part of the face.

In case of minor ptosis of forehead and eyebrows and excess of skin in periorbital area (as a rule at 35-40 years old) surgical operation carried out.

If there is a necessity to correct lower or upper eyelids, an operation of blepharoplastic should be done. In case there are indications for laser peeling, provided the patient desires so, surgical lift of tissues and improvement of the skin surface can be done in the course of one operation under one narcosis.

Occasionally, to improve and retain the rejuvenation effect resulting from the operation the applying of the botulotoxin A and fillers is necessary: in case of habitual frowning of the forehead, atrophy of hypodermic adipose cellular tissue in the region of nasolabial wrinkles or upper lip.

For extensive post-operation period the post-operation rehabilitation is most important.

Later the optimal choice of cosmetic means and good care of the skin will enable to retain the rejuvenation effect for more extensive period.

For prophylaxis of early age-related changes the diagnostics of the causes of early ageing and the conception of the real state of skin structures of the patient is very important. After a number of examinations: histological, microelements contents, evaluation of the state of microcirculation, testing of the hydration level and the state of sebaceous glands, etc., one can choose the procedures for local improvement of the skin (stimulation, regeneration, saturation with necessary substances) as well as improvement of the state and stimulation of the organism in general: revitalization, mesotherapy, etc.

The process of ageing can be retarded. But by 40 the state of skin becomes worse - there appears flabbiness. In this case together with blephoroplastic and endoscopic forehead lift the laser peeling of skin is carried out to stimulate its spontaneous contraction and to put off the necessity of facelift.

If the age-related changes are growing progressively worse and the acute form of ptosis of the face tissues (after 45) appear it becomes necessary to remove the excess of skin. To achieve the effect of rejuvenation the facelift and neck is necessary using the classic method combined with the peeling of the whole surface of the skin. In the neck region one may perform the laser peeling. To improve the effect of rejuvenation the surgical methods are also combined with injections of the fillers and with injections of Botulotoxin A when necessary.

Recently in aesthetic medicine the prophylaxis of age-related changes and early ageing of organism is ranking high (The new conception of the problem of ageing).

Correction of the age-related changes

Age	Gravitational wrinkles	Static wrinkles	Mimic wrinkles
25-30	***	Cosmetology	Injections botulotoxin A
30-40	Endoscopic forehead and brows lift, blephoroplastic foreheadlift	Cosmetology, fillers injections, laser peeling, lipomedelling of chin area	Injections botulotoxin A
40-45	Endoscopic forehead and brows lift, endoscopic face and neck lift, blephoroplastic	Cosmetology, laser peeling, after surgical correction in case of retaining of tissue breaks or to enlarge volumes - fillers injections	After surgical correction, in case of necessity to add to the result of the operation - botulotoxin A
45-55 etc.	Face and neck lift, blephoroplastic, foreheadlift	Cosmetology, laser peeling, after surgical correction, in case of retaining of tissue breaks or to enlarge volumes - fillers injections	After surgical correction, in case of necessity to add to the result of the operation - botulotoxin A

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