Written on the face…
The human face is a very specific region of our body. A different type of musculature is present here. For the most part, all muscle attachments are located within the skeleton. This allows us to move freely. Facial muscles, as a feature, have attachments located in the skin or subcutaneous tissue. This guarantees us the ability to move the performance of the so-called. Facial movements that express our emotions.
What are muscles?
It is a special contractile tissue that, receiving the appropriate nerve impulse, contracts or relaxes – nothing but shortens its length and returns to its original length. The part of the muscle that is attached to the bone does not change its position, but the opposite part of the muscle is pulled, resulting in a change in the position of the skin where the muscle ends its course. We have different groups of expressive head muscles:
- muscles of the cranial vault
- muscles of the auricle
- muscles surrounding the eyelid crevice
- nostril muscles
- muscles surrounding the mouth gap
In each of these groups, we distinguish the muscles responsible for particular movements of facial structures.
Plug and socket
I explain to mypatients the principle of muscle function in a pictorial way. Suppose a muscle has a socket to which a plug – a nerve – is permanently connected. This allows for a steady flow of nerve impulses that generate the muscle’s contraction – its work. The principle is simple: a muscle that is intensively exercised grows in strength and significantly increases in mass, quite like the muscles of the body deliberately exercised in the gym. The facial muscles here are no different from the rest of our body muscles. Regular contractions of the same muscle parts cause hypertrophy of the muscle and excessive contractility – hypertrophy and hypertonia. The effect of such “exercises” is precisely our facial muscles. What do we need to do to break this vicious cycle? Well, nothing more than “unplugged”! How to do it? It’s very simple – temporarily and reversibly “injure” the muscle with btulin toxin (BTX-A).
Why do facial wrinkles form?
Even in fetal life we can observe the first grimaces on the faces of our yet unborn babies, thanks to the development of ultrasound imaging. Even then, this “game” begins. As long as our skin is strong and elastic it is able to resist the effects of facial expressions and immediately, when the muscle tissue relaxes, the skin becomes smooth and facial wrinkles disappear – according to the Glogau scale, this is type I in describing the condition of facial skin. This is followed by the appearance of fine wrinkles, which persist for a short time after facial movements cease but straighten out over time (type II Glogau, around age 25 – 35). A more advanced problem is facial wrinkles that are permanently visible on the face, more or less deep, and do not flatten out at all due to the cessation of facial muscle work (type III Glogau, about 35 – 65 years of age). The last type in this classification is the face, which shows numerous facial wrinkles, regardless of the state of muscle tone (Glogau type IV, approximately after the age of 65)
Resilient, elastic and smooth facial skin, no visible facial or static wrinkles
|up to approx. 25 years old||Topical therapy, such as mesotherapy, chemical peels, biostimulation lasers, etc.|
|II||“wrinkles while moving”
appearance of pronounced facial wrinkles due to muscle play, disappearing completely due to relaxation of facial muscles
|ca. 25. – 35. year of life||BTX-A plus topical therapy (as above)|
|III||“wrinkles at rest”
clear, permanently visible static wrinkles , remaining in place of wrinkles caused by facial movements
|ca. 35. – 65. year of life||BTX-A plus fillers|
|IV||“nothing but wrinkles”
numerous, deep wrinkles both static and facial, skin with poor elasticity
|m. w. 65 each. year old||BTX-A (preferably in the form of mesobotox) plus intensive resurfacing|
Tab. Glogau scale and its characteristics.
Curtain Fabric and Tightening Tape
In a conversation with Patients on the Glogau Scale, when we define the type and scale of the problem for a moment we move with our eyes to the sewing room of beautiful curtains. Even the most expensive, thick and beautiful fabrics are smooth as long as they are wound on display rollers. Once you decide on a particular design, the seamstress cuts off the selected piece of fabric and treats it, during which the crinkle tape is sewn in. The material will be our skin from now on, and the tape will be our muscle.
When the tape is sewn in, but not yet pulled down, the fabric is still smooth, without creases – type I Glogau. When you test any crease in the tape, then release it, the material still shows no creases after straightening – type II Glogau. On the other hand, once you have obtained the desired density of pleats of the fabric, sew the tape permanently and hang the curtain. The longer the fabric is left in the crease, the more creases are expected when the tape is stretched out – Glogau Type III. Unfortunately, these creases will no longer disappear on their own – after cutting the tape, you will most likely still need to iron the fabric additionally. If, on the other hand, this curtain is removed, without cutting the tape, haphazardly stuffed into the closet, years later we will pull out a fabric with numerous irregular creases and, unfortunately, we will have to put a lot of effort to iron this fabric – type IV Glogau.
In the next section, you will learn how to effectively fight the above types of wrinkles.