What holds the face up
A young face has support. The cheeks sit high, the jawline is defined and the three thirds of the face keep a proportion between them. That design does not come from the skin: it comes from what lies beneath it.
Facial support is the set of structures that holds the face in place. Bone gives the shape, ligaments anchor, fat fills the spaces in organized compartments and muscles move all of it. The skin is the last layer, the one you see.
When the deep structure decreases, the soft tissues that rested on it no longer have anything to hold on to. They descend. That is why two faces with the same skin quality can look like different ages: one kept its support points, the other did not.
This reading changes the question you ask in the mirror. Instead of "what should be pulled", the question becomes "what has gone missing underneath".
What time changes, layer by layer
Facial aging happens in several layers at the same time, and each one contributes in its own way. Looking only at the surface explains little.
Bone
Over the years, gradual bone resorption occurs in the facial skeleton, in areas such as the eye socket, the cheekbone and the jaw. The foundation shrinks a little, and what rests on it loses height. It is like a tent whose poles get shorter: the fabric is still there, but it drops.
Fat and ligaments
Facial fat is not a single layer. It is organized into separate fat compartments that change in volume and position over time. Some deflate, others descend. The retaining ligaments, which attach the skin and the soft tissues to the deep planes, become more visible when the surrounding volume decreases, and creases and shadows appear.
Skin
At the surface, the skin produces less collagen and loses elasticity. It becomes thinner, holds less water and follows movement less well. Unprotected sun, smoking, poor sleep and large weight fluctuations speed up the process.
The skin is what you notice first, but it is rarely the main cause of a face that seems to have dropped. Understand this sequence in how the face changes over the years.
How loss of support shows up in the mirror
The change rarely starts in a single spot. One area loses support and drags the next one with it. That is why the face is read area by area, always looking at the whole.
Upper third
The temples lose volume and become hollow. The side of the face looks more marked, the support of the eyebrow changes and the gaze feels heavier, even when the eyelid is not the main problem.
Middle third
The malar region, the cheekbone area, is usually the first to lose support. When it deflates and descends, the midface flattens, under-eye hollows look deeper and the nasolabial fold becomes more evident. In many cases the fold is a consequence, not the origin.
Lower third
The weight goes down and reaches the lower third. The jawline contour loses definition, lines appear running down from the corners of the mouth and the area below the chin changes. The shadows created by all of this are what give the face the tired look people notice before they can name it.
What facial restructuring is
Facial restructuring means restoring support where it has been lost, instead of filling the line that appeared because of that loss. It is a change of target: from the surface to the foundation.
In Dr. Fred Fortes's work, restructuring is done only with hyaluronic acid, placed at the deep support points, next to the ligaments that hold the face. Structural replacement restores the volume that time has taken at those points. Then comes repositioning: with support underneath, what has descended goes back to a higher position.
And all of this is planned for the whole face. An area treated on its own changes the local design without considering the rest, and the whole loses proportion. The N3F® Protocol was born from this reasoning.
"My work is a technique of my own that I created for lifting, repositioning and restructuring. The whole face, with hyaluronic acid."
Dr. Fred Fortes
Why the order matters
In restructuring, what comes first is not what bothers you most. It is what holds the face up.
Hyaluronic acid goes first to the deep support points, close to the ligaments that hold the tissues. The lifting effect comes from that foundation, with no incisions. Only afterwards comes the fine design, which defines the features that have always been yours, a little sharper.
Reversing that order tends to cost a lot in the result. Volume placed at the surface, over a foundation that is still missing, leaves the area fuller and the face heavier. The proportion between areas is what guides every decision, and it only appears when the face is read as a whole. If your concern is a face that has dropped, see why the face sags and which treatments can help.
Restructuring is a plan, not a session
Support keeps changing after the first session, because the face keeps living. That is why restructuring is followed over the years.
- Assessment: photos, analysis of the thirds of the face, of what has lost structure and of what only looks tired. If it does not make sense to apply anything that day, nothing is applied.
- Individual plan: which areas are included, in what order and with how much product, considering your moment in health and in life.
- Restructuring of the whole face, in the same session, with the amount the face calls for.
- 60-day follow-up: once everything has settled, the fine adjustments. This is where the result comes together.
- Annual maintenance: about one third of the initial amount, adjusted to your moment. Some patients are in their ninth year of follow-up.
This is what Dr. Fred calls management of aging: looking after the face over time, with less product at each visit, because the foundation has already been built. The assessment takes place at N3F Clinic, in Brooklin, São Paulo, or during periodic appointments in Florianópolis.