Understanding the basic make-up of the human face helps you understand the rhyme and reason for the various restorative and cosmetic techniques we use at Revive. Face musculature is complex, which explains in part why we are capable of so many different facial expressions and why our emotions can be so apparent to others. It takes a lot of effort to maintain a “poker face”, because our thoughts and feelings are so intimately linked to our faces. So, without further adieu, here is a simple mnemonic we used in medical school:
S is for skin, including the epidermis and the dermis. The epidermis is what’s treated during a deep facial cleaning. The dermis is where fillers are injected, and where the Neogen regenerates connective tissue to restore the face’s youth.
C is for connective tissue. This is a sheet of thin, tough, often whitish tissue that serves as a basement for the skin (both epidermis and dermis). Injected cosmetic fillers inevitably end up, in part, in this layer and deep to this layer, but that’s not harmful and in its own way adds to reducing the lines, wrinkles, sags, etc
A is for aponeurosis. This is simply a “coming together” of bundles of very tough, white fibrous tissue that gives muscles anchor points to pull upon, holds down muscles so that they push/pull instead of just bulge out, etc. Much thicker and tougher than the C connective tissue, the A aponeurosis really adds to the shape of the face and links up muscles. In fact, it is the layer that contains the muscles. Botox, the botulinum brand most people know, does its work in this layer.
L is for loose areolar tissue. This stuff is not unlike the C and A tissues, but is much thinner, less tough, more cushion-like. Sort of like the rubber mat beneath indoor-outdoor carpet that sits on the hard surface being carpeted. Not much gets done in this layer with our treatments.
P is for periosteum. This is the bone’s outer coating. It contains the blood vessels that dive into the bone to keep it alive, the repair cells needed to build and rebuild bone, etc. If you look at a raw beef or hambone straight from the butcher, periosteum can be scraped off with the edge of a knife. It’s not unlike the very smooth bark on certain trees. The periosteum is not part of regenerative cosmetic work, but is very important if you suffer facial fractures and need bones repaired.
Most of the work we do at Revive takes place in the epidermis, the dermis, and the muscles living in the aponeurosis.
So now you know!!!
Dr. Thomas Basch