CLINICAL ANALYSIS OF THE DETERMINANTS OF SEVERITY OF INVOLUTIONAL CHANGES OF THE FACE AND NECK

Abstract. Introduction. In the past few years, there has been a notable resurgence of research on human facial aging, facial attractiveness, facial recognition, and facial skin rejuvenation. Facial aging is a dynamic process that involves the aging of soft tissues, including skin laxity and bone structures. Each person has their own individual aging patterns, which are determined by genetic factors and the influence of external determinants. Aim. To analyze the main determinants that potentially accelerate involutional changes in the skin of the face and neck. Materials and methods. The study included 210 female patients with involutional changes of the face and neck. Metabolic (biological) and behavioral (patient-dependent) determinants were analyzed. Results. The biological determinants of the severity of involutional changes in the face and neck with a high degree of association were: Fitzpatrick 1-2 facial phototype (OR 1.93, 95%, CI 1.07-3.47); overweight (BMI over 30. 0) (OR 1.54, 95%, CI 0.79-2.58, p=0.268); early menopause (OR 2.63, 95%, CI 1.50-4.59, p=0.001); diabetes mellitus (OR 2.29, 95%, CI 0.41-12.81, p=0.577); hypothyroidism (OR 1.70, 95%, CI 0.21-10.41, p=0.896); skin hyperelasticity (OR 1. 83, 95%, CI 1.06-3.16, p=0.043); presence of concomitant ventral hernias (OR 1.91, 95%, CI 0.45-8.27, p=0.598); hemorrhagic syndrome (OR 1.98, 95%, CI 0.94-4.12, p=0.096); varicose veins of the lower extremities (OR 1.54, 95%, CI 0. 72-3.29, p=0.353); abdominal ptosis (OR 2.27, 95%, CI 0.20-10.00, p=0.920); mitral valve prolapse (OR 2.41, 95%, CI 0.87-6.21, p=0.136) and concomitant chronic hemorrhoids (OR 2.27, 95%, CI 0.20-10.00, p=0.920). The biological determinants of the severity of involutional changes of the face and neck with low connectivity were: Fitzpatrick phototype 3-4 (OR 1.26, 95%, CI 0.70-2.25, p=0.536); body mass index below 18.5 (OR 1.25, 95%, CI 0.54-2. 88, p=0.760); normal body weight (18.5-24.9) (OR 0.62, 95%, CI 0.34-1.11, p=0.138); moderate fatness (OR 1.05, 95%, CI 0. 59-1.85, p=0.993); hypertension (OR 1.24, 95%, CI 0.72-2.14, p=0.514); allergy (OR 1.15, 95%, CI 0.59-2.27, p=0.808). A clear relationship was found between skin aging, facial volume, and behavioral determinants such as smoking and alcohol consumption. The severity of involutional changes on the Merz scale increased with the amount and duration of tobacco exposure. Various aesthetic procedures in the history had a positive effect on the severity of involutional changes – the relationship was significant (p=0.038) and negative (OR 0.46, 95%, CI 0.23-0.92). Conclusion. The analysis of the main determinants that potentially accelerate involutional changes in the skin of the face and neck is necessary for an adequate assessment of the dermis and the development of individualized therapeutic approaches, which helps to improve the quality of life of patients and maintain their aesthetic well-being.