This week’s Tuck Talk will feature facial secrets. Is it true that your face starts to deteriorate before you’re even 30? Frequent yawning, teeth grinding, and prolonged screen time are the causes of premature aging. Is getting rid of excess fat the key to a youthful appearance? Revealing anti-aging techniques using cells with Dr. Ton Piyaphon, a specialist in cosmetic and facial reconstructive surgery. Understand before it’s too late because the word “old” hurts even when spoken softly.
What are the characteristics of a person’s facial structure that indicate a sagging face? Where does it start?
Dr. Ton: It starts to deteriorate at the cellular level. Normally, people start to age in their late 20s. Symptoms of aging start when cells stop dividing. When we are young, our skin is clear. As we grow older, our skin starts to lose its clarity and starts to dry out. Our cells start to stop dividing around our late 20s. The remaining amount will gradually decrease like water in a glass that gradually decreases with age. When we start our 30s, we will start to see small wrinkles on our cheeks and under our eyes because the fat in these areas starts to decrease. When we are 40, our cheeks start to disappear, the sides disappear, the nasolabial folds start to appear, and our temples start to sunken in. When we are 50, the jaw area starts to sag. There are two levels of aging: the cellular level and the loss of fat, including sagging. Sagging cheeks at 50 is caused by the sagging of the Retaining N that is holding it in place. Around 60, the bone starts to erode and collapse, especially the jawbone. We will notice that our teeth will start to lengthen.
Are skinny and fat people equally flabby?
Dr. Ton: If a fat person loses weight quickly, their face will sag quickly because the fat is like a bag (skin). When the fat shrinks quickly, the skin may not be able to shrink fast enough, causing sagging. If weight doesn’t change much, sagging will depend on the number of cells that decrease with age. As you get older, cells decrease every 10 years.
Is there anyone who isn’t like that (who doesn’t have a sunken face)?
Dr. Ton: It really depends on genetics and self-care. Some people in their family have youthful faces, but others may still look young even as they age. However, some people have had little facial fat since childhood and appear thinner as they age. Hormones also play a key role. For example, when women reach their 40s and enter menopause, estrogen levels decline, causing cells to age more rapidly. Women are more influenced by hormones than men.
Is there an easy way to tell if your skin is starting to age or break down?
Dr. Ton: Problematic skin will first develop small wrinkles and become dry because the sebaceous glands are less active. You’ll notice that children with a lot of acne will eventually disappear as they grow older because these cells are less active. They’ll start to develop spots on both their faces and throughout their bodies. This is because as cells age, they create more pigment, causing dark spots, freckles, and other blemishes. This is because the cells are aging.
What behaviors can make your face look older?
Dr. Ton: Things we use frequently can cause problems. For example, some people wear makeup frequently or rub their faces frequently, which can easily lead to wrinkles. Or some people make facial expressions frequently, which can easily lead to wrinkles. These factors are quite difficult to avoid, as they depend on each person’s habits.
How should we smile?
Dr. Ton: Smile sincerely. There’s some funny research that says that some people smile with a stiff smile, which can make them look older than their age. But this is a matter of belief. But normally, it’s both internal and external.
Does frequent yawning and teeth grinding while sleeping make your face age faster?
Dr. Ton: Frequent yawning is a behavior that causes muscles and tendons to be stretched. When they are stretched frequently, they can become fatigued and slack. Or some people like to grind their teeth while sleeping, causing stress, causing teeth to clench. There is research that shows that frequent teeth grinding can cause the jawbone to shrink or erode faster than normal. Sometimes teeth grinding has many causes. The cause must be found and treated according to the factors.
Is it true that frequently checking social media, looking down at it all the time, or watching it for long periods of time, makes us age and wrinkle?
Dr. Ton: There is also research that shows that looking down at a screen for long periods of time, more than 4 hours, can cause the face to sag due to gravity.
Are there any innovations that can help slow down and reverse facial aging?
Dr. Ton: As I said, we age from our early 20s on a cellular level. The question is how to get the cells back to the same amount as when we were younger. Currently, there is a technique called Fat Grafting, or fat grafting.
How many years younger will my face look after filling it?
Dr. Ton: Normally, the skin will immediately look younger after dermal fillers. Under the eyes, cheek grooves, temples, and forehead are the main problems that make us look older. After dermal fillers, the forehead will look rounder, wrinkles will be reduced, and the forehead will be smooth and not dented. You can look 5-10 years younger. Sunken cheeks will also become fuller. What’s more, your cells will completely change. Fat dermal fillers are the addition of cells that change the skin and fat. Cells improve at the cellular level. When healthy cells increase in number, they create fibroblasts and collagen, making the skin firmer and stronger. The skin will return to its youthful appearance. Melasma and dark spots will fade and improve because the new cells created will not create pigment.
Where can the doctor extract fat for use in the filler?
Dr. Ton: It is the process of taking excess fat that has accumulated without our knowing and recycling it for use. It can be sucked from the outer thighs, which are excess fat that is difficult to remove and have relatively dense cells. The cell quality is better and thinner.
People ask if you can get liposuction on your stomach. It can be done anywhere, but be warned that if you’re older and have sagging skin, the amount of cell removal you’ll get will be less than if you have more fibers (scar tissue) attached to your legs. If your stomach is very loose, you may need to tighten it.
What are the problems with fat grafting?
Dr. Ton: A common problem is that there’s no fat to add. The fat we’re liposuctioning is of good quality and can only be used once or twice per location. It’s not like we can keep adding fat. The body has a limited amount of fat. Some people have had liposuction on their entire body until there’s no more fat left. This presents a challenge for doctors, especially if they’re using a machine that uses heat to remove it. Sometimes the remaining fat cells are of very low quality, for example, from 100%, only 20% remain. So you have to be sure you won’t be using the fat if you’re going to remove it.
Some people say that fat injections will make your face look older. Is this true?
Dr. Ton: That’s true. Certain areas are already prone to sagging. If we add too much to them, they’ll become heavier and weigh them down, making them sag even more. Or, in areas where lumps shouldn’t exist, they can become lumps if we add them. This depends on the cosmetic procedure. It’s an art.
If we get fillers from an inexperienced doctor, what are the worst dangers or negative effects? I’ve heard that some people have gone blind after getting fillers. Is this true?
Dr. Ton: That’s true. Fat cells are larger than the gel in fillers, and they’re more likely to become clogged. However, the risk of fat injections and blindness is generally lower than with fillers. The area around the eyes, along the sides of the nose and around the eyes, has many blood vessels, so when injecting fat or fillers, you have to be very careful in this area.
If someone has a very sagging face, aged 70-80 years, will fat injections help support the face or should a facelift be done?
Dr. Ton: Fat is like adding volume to a glass of water. But we must not forget that sagging is also involved. Fat injections help with the volume effect, filling in sagging bags and making them firm. When the volume effect is full, but sagging remains, a tightening treatment is also required. Fat injections in the upper half of the face (around the eyes, forehead, temples, and under the eyes) are relatively firm and effective when the volume is fully replenished. However, in the lower half (down the cheeks), if only fat is added without addressing sagging, the face can become swollen. Therefore, they must be combined.
What chronic diseases should not be treated with fat injections?
Dr. Ton: Generally, there are very few contraindications, as it’s part of our own body. Certain underlying conditions, such as cancer, diabetes, and various immune disorders, can be treated. However, some conditions require temporary treatment interruption, such as fever, joint pain, or a rash, to allow the condition to settle. If the condition is still active, such as heart disease, diabetes, or poor blood circulation, the patient must be prepared. Fat grafting can also be used in treatment. For example, breast cancer patients who have had a mastectomy can have fat grafted to the affected area to address tightness, hardness, scarring, or hard skin.
How long does it last after refilling?
Dr. Ton: It can last for 10 years, or maybe even longer. Adding fat is like adding water to a glass; the water will gradually decrease. We just add it back in. Some people believe that as we age, it won’t be effective. But in reality, if we take good care of ourselves, sometimes older people will have better results than younger people. This is because some older people take good care of themselves. As they age, their cells may decrease. Therefore, when adding fat, we may need to leave a small amount to address the issue of cells being of lower quality than normal.
