Plastic surgery includes blepharoplasty, face and neck rhytidectomy, canthoplasty, neck lifting and earlobe reduction. Surgery can usually achieve initial satisfactory results, improve the appearance of premature aging, and relieve the symptoms such as visual impairment, dry eyes and chronic irritation caused by drooping upper and lower eyelids and excess wrinkles on the skin. However, surgery cannot prevent the recurrence of skin relaxation. Patients should be educated and informed that repeated operations are needed to obtain satisfactory results.
Wrinkle removal is usually the first operation. Nahas believes that SMAS fascia should be tightened during the first wrinkle removal, which is helpful for lifting and fixing the loose skin tissue. In the later repeated rhytidectomy, it is usually not necessary to tighten the SMAS fascia again, because SMAS can keep its position permanently, and only the skin and subcutaneous tissue need to be tightened repeatedly. Tamura reported the aging appearance of patients with early skin relaxation treated with botulinum toxin injection. He believes that botulinum toxin injection can be used as a conservative treatment for patients with mild skin relaxation and patients who are unwilling to undergo surgery. We also need to consider the timing of the operation. If the onset age is early and progressive, effective surgical treatment before admission can be beneficial to patients' mental health and social adaptability. For patients with systemic complications, the decision of operation is also influenced by factors such as operation tolerance, anesthesia risk and life prognosis. The prognosis of this disease depends on the genetic type. The dominant genetic type is skin damage, and the prognosis is good. The life span of such patients is generally normal. However, recessive inheritance is often accompanied by cardiovascular system damage, and those involved often die in childhood. Many scholars believe that with the growth of patients' age and physique, the progress of skin relaxation will gradually decrease and the facial appearance will tend to be stable. In addition, hereditary skin relaxation can be avoided by genetic diagnosis and prenatal diagnosis.
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