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how much facial rejuvenation do you think is possible in a patient with this severity of facial aging lets find out today on aesthetic minutes clinical vignettes hi welcome to aesthetic minutes clinical vignettes on todays case we have a 69 year old female with severe facial aging interested in total facial rejuvenation lets begin with our clinical assessment of two of the major facial aging components in this patient loss of skin quality and severe tissue laxity in terms of skin quality on immediate analysis its clear that this patient has severe aging of the face with docHub dermatoheliosis or photo aging of the skin due to the effects of chronic sun exposure as well as intrinsic hereditary aging due to genetics the underlying process responsible for these skin changes is known as actinic dermal elastosis and its characterized by degenerative changes in the skin structure in which an erratic jumble deposition of a large amount of elastic fibers and glycosaminoglycans occur