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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">plasur</journal-id><journal-title-group><journal-title xml:lang="ru">Вопросы реконструктивной и пластической хирургии</journal-title><trans-title-group xml:lang="en"><trans-title>Issues of Reconstructive and Plastic Surgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-1471</issn><publisher><publisher-name>АНО "НИИ микрохирургии"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.52581/1814-1471/93/03</article-id><article-id custom-type="elpub" pub-id-type="custom">plasur-364</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКАЯ АНАТОМИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL ANATOMY</subject></subj-group></article-categories><title-group><article-title>Анатомия старения: углубленный анализ зон лица</article-title><trans-title-group xml:lang="en"><trans-title>Anatomy of aging: in-depth analysis of facial zones</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0222-2910</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Истранов</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Istranov</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Истранов Андрей Леонидович – д-р мед. наук, профессор кафедры онкологии, радиотерапии и реконструктивной хирургии</p><p>119992, г. Москва, ул. Большая Пироговская, д. 6, стр. 1</p></bio><bio xml:lang="en"><p>Andrey L. Istranov, Dr. Med. sci., Professor, the Department of Oncology, Radiotherapy and Reconstructive Surgery</p><p>6-1, Bolshaya Pirogovskaya st., Moscow, 119992</p></bio><email xlink:type="simple">plasticsurgeon@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1867-7074</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шабалин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shabalin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шабалин Алексей Александрович – аспирант кафедры онкологии, радиотерапии и реконструктивной хирургии</p><p>119992, г. Москва, ул. Большая Пироговская, д. 6, стр. 1</p></bio><bio xml:lang="en"><p>Alexey A. Shabalin, postgraduate student, the Department of Oncology, Radiotherapy and Reconstructive Surgery</p><p>6-1, Bolshaya Pirogovskaya st., Moscow, 119992</p></bio><email xlink:type="simple">alexshabalin001@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-9335-2635</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Диомидов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Diomidov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Диомидов Илья Андреевич – канд. мед. наук, ассистент кафедры хирургических болезней Института хирургии </p><p>620028, г. Екатеринбург, ул. Репина, д. 3</p></bio><bio xml:lang="en"><p>Ilya A. Diomidov, Cand. Med. sci., Assistant, the Department of Surgical Diseases at the Institute of Surgery</p><p>3, Repin st., Ekaterinburg, 620028</p></bio><email xlink:type="simple">diomidovilya@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0909-6278</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Решетов</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Reshetov</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Решетов Игорь Владимирович – д-р мед. наук, профессор, академик РАН, зав. кафедрой онкологии, радиотерапии и реконструктивной хирургии Института клинической медицины им. Н.В. Склифосовского </p><p>119991, Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>Igor V. Reshetov, Dr. Med. sci., Professor, Academician of RAS, head of the Department of Oncology, Radiotherapy and Plastic Surgery, the Institute of Clinical Medicine named after the N.V. Sklifosovsky</p><p>bld. 2, 8, Trubetskaya st., Moscow, 119991</p></bio><email xlink:type="simple">reshetov_i_v@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. SechenovFirst Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Уральский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ural State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>07</day><month>08</month><year>2025</year></pub-date><volume>28</volume><issue>2</issue><fpage>30</fpage><lpage>39</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Истранов А.Л., Шабалин А.А., Диомидов И.А., Решетов И.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Истранов А.Л., Шабалин А.А., Диомидов И.А., Решетов И.В.</copyright-holder><copyright-holder xml:lang="en">Istranov A.L., Shabalin A.A., Diomidov I.A., Reshetov I.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://plasur.elpub.ru/jour/article/view/364">https://plasur.elpub.ru/jour/article/view/364</self-uri><abstract><p>Процесс старения оказывает значительное воздействие на гармоничность и симметрию черт лица, наблюдаемые в молодом возрасте. Эффективной стратегией для оценки морфологических изменений, связанных со старением, является деление лица на три ключевые зоны: верхнюю треть (лоб и область бровей), среднюю (центральная часть и нос) и нижнюю треть (подбородок, линия челюсти), а также шею. Анализ процессов старения представляет собой важную область исследования в пластической хирургии. Средняя часть лица играет определяющую роль в формировании эстетического восприятия человека, поскольку привлекательность часто определяется совокупностью глаз, носа, губ и скул, составляющих так называемый центральный лицевой треугольник. При рассмотрении этой области необходимо применять трехмерный подход, поскольку лишь такой анализ позволяет точно оценить возрастные изменения и воссоздать молодую топографию лица. В данной работе представлен всесторонний анализ актуальных исследований, посвященных этиологии и механизмам старения лица по анатомическим третям. Глубокое изучение физиологических изменений, происходящих в каждом из указанных уровней, может значительно облегчить понимание процессов старения и способствовать улучшению стратегий коррекции, направленных на омоложение лица, что очень важно для выбора более эффективного способа хирургической коррекции возрастных изменений.</p><p>В открытых базах данных с использованием поисковых систем: PubMed, Web of Science, Scopus, Google Scholar, eLibrary и Cyberleninka был проведен поиск публикаций по теме нашего исследования. По ключевым словам и их комбинациям: «aging» (старение), «age-related facial changes» (возрастные изменения лица), «facial aging» (старение лица), «neck aging» (старение шеи), «facial thirds» (трети лица) и «rejuvenation» (омоложение) была выявлена 1351 статья. Из анализа исключались статьи, посвященные возрастным изменениям органов зрения, ротовой и носовой полостей; статьи с давностью публикации более 25 лет; статьи, не касающиеся эстетических изменений кожи и функциональных изменений мягких тканей и лицевого скелета; статьи, в которых рассматривались только косметологические процедуры; публикации, находящиеся вне рамок изучения лицевой анатомии и физиологии; статьи, в которых присутствует реклама медицинских несертифицированных препаратов. В результате применения этих критериев были отобраны 211 статей, из которых соответствующие полнотекстовые материалы были извлечены, проанализированы и обобщены на основе информации из базы данных. Выполнен анализ анатомии старения лица по третям для дальнейшего исследования и разработок эффективных коррекционных комплексных методик.</p></abstract><trans-abstract xml:lang="en"><p>The aging process has a significant impact on the harmony and symmetry of facial features observed at a young age. An effective strategy for assessing morphological changes associated with aging is to divide the face into three key zones: the upper third (forehead and eyebrow area), the middle (central part and nose) and the lower third (chin, jaw line), as well as the neck. The analysis of aging processes is an important area of research in plastic surgery. The middle part of the face plays a crucial role in shaping a person's aesthetic perception, since attractiveness is often determined by the combination of eyes, nose, lips, and cheekbones that make up the so-called central facial triangle. When considering this area, it is necessary to apply a three-dimensional approach, since only such an analysis allows you to accurately assess age-related changes and recreate the youthful topography of the face. This paper presents a comprehensive analysis of current research on the etiology and mechanisms of facial aging by anatomical thirds. An in-depth study of the physiological changes occurring at each of these levels can greatly facilitate the understanding of aging processes and help improve correction strategies aimed at rejuvenating the face, which is very important for choosing a more effective method of surgical correction of age-related changes.</p><p>A search for publications on the topic of our research was conducted in open databases using search engines: PubMed, Web of Science, Scopus, Google Scholar, eLibrary, Cyberleninka. By keywords and their combinations: “aging”, “age-related facial changes”, “facial aging”, “neck aging”, “facial thirds” and “rejuvenation” 1,351 articles were identified. Articles devoted to age-related changes in the organs of vision, oral and nasal cavities were excluded from the analysis.; articles with a publication date of more than 25 years; articles that do not relate to aesthetic changes in the skin and functional changes in soft tissues and the facial skeleton; articles that dealt only with cosmetic procedures; publications that are outside the scope of the study of facial anatomy and physiology; articles that advertise medical non-certified drugs. As a result of applying these criteria, 211 articles were selected, from which the relevant full-text materials were extracted, analyzed and summarized based on information from the database. The anatomy of facial aging was analyzed in thirds for further research and development of effective corrective complex techniques.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>старение</kwd><kwd>возрастные изменения</kwd><kwd>старение лица</kwd><kwd>старение шеи</kwd><kwd>трети лица</kwd><kwd>омоложение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>aging</kwd><kwd>age-related changes</kwd><kwd>facial aging</kwd><kwd>aging neck</kwd><kwd>facial thirds</kwd><kwd>rejuvenation</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">никто из авторов не имеет финансовой заинтересованности в представленных материалах или методах.</funding-statement><funding-statement xml:lang="en">no author has a financial or property interest in any material or method metioned.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Tiryaki K.T., Canikyan S., Woods J., Sterodimas A., Gentile P., Cohen S., Andjelkov K., Schlaudraff K.U., Siolo E., Kul Y., Duyan C. 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