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Facelift Surgery
A facelift, technically known as a rhytidectomy is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are multiple surgical techniques. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. Facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.
Rhytidectomy or face lift surgery was first performed by Eugen Hollander in 1901 and has since then undergone many changes to attain a cleaner surgery. Earlier the surgery would show scars, but nowadays with more consciousness towards external appearance, scars have become minimal and almost invisible.
Rhytidectomy or facelift procedure will not alter your appearance drastically. Instead it will help you look younger by diminishing the signs of aging like the sagging skin, loose fat around the neck and jaw, double chin, under eye lines, wrinkles on forehead and around the eyes. The procedure will not change the basic shape and contour of your face which is actually done in facial reconstruction surgery.
Eye brow lift to correct the shape of eyebrows and Eyelid surgery to tighten sagging eyelids, are rejuvenation procedures performed along with facelift surgery. The ideal age for surgery is younger than 50 years. The effects of surgery last for around 10 years but the aging process is not stopped by facelift surgery.
As the skin and muscles of the face lose their elasticity and muscle tone with age, additional procedures may be necessary to achieve better results.They include necklift, blepharoplasty (eyelid surgery), liposuction, autologous fat injection, Removal of buccal (cheek) fat pad, forehead lift, eye- browlift, chemical or laser peel, and malar (cheek), sub-malar or chin implants.
How is the surgery performed?
Each face has a unique shape and contour. So the surgical procedure will be slightly different for each patient.
Before the procedure, the doctor will evaluate the patient's skin consistency and explain the surgery. Smokers will be asked to stop at least a week or two before the surgery and stay off of cigarettes for a couple of weeks after the surgery, because smoking inhibits blood flow to the skin and can interfere with healing. Patients are also asked to avoid aspirin and other medications that can increase bleeding.
A facelift can be performed either in a plastic surgeon's office or in a hospital. Most patients are given a local anesthesia combined with a sedative, so that they are awake but unable to feel the procedure. Some doctors use general anesthesia, which puts the patient to sleep.
During a traditional facelift (SMAS lift), the doctor makes an incision that typically begins around the hairline from the temple and curves around the earlobe, ending at the bottom of the hairline. The surgeon may also make a small incision under the chin to specifically tighten the skin of the neck.
The doctor first separates the skin from the fat and muscle underneath. He or she may suction out (via liposuction) or trim excess fat to give the face a sleeker look. Underneath the skin is a layer of tissue called the SMAS (superficial musculoaponeurotic system). The doctor tightens this layer by folding it -- pulling it back over itself. Tightening the SMAS layer lifts the cheeks, gives the jawline more definition, and firms the neck.
Finally, the doctor pulls the skin back up over the area and removes any excess skin with a knife or laser, similar to the way that you would pull a carpet to tighten it over the floor and trim the excess. The incision is closed with stitches, sutures, or tissue glue. The stitches are usually placed within the hairline so they are hidden by the hair.
The surgery can take between two to four hours, depending on the extent of the tissue and muscle work, and the number of different procedures being performed.
Deep plane facelift is done to improve the wrinkles and skin folds around the nose that extend up to the lips and cheeks. It is a modification of the above SMAS procedure in which the skin is lifted and the underlying fat and small muscles are freed.
Composite facelift is another alteration of the SMAS procedure in which still deeper layers of fat and muscles are mobilised to correct the drooping eyelids and under eye bags (malar crescent). The ligaments anchoring the muscles around the eyes (orbicularis oculi) are tightened.
The Mid face lift surgery is performed to rejuvenate the area between the cheeks. There is flattening of the cheeks with age. This surgery requires small cuts on the cheeks and cheek bone to mobilise the fat in this area to give the face a fuller appearance. The surgery helps the face to look more delicate and soft as opposed to the hardness that comes with age.
Mini face lift or the ‘S’ procedure is similar to facelift procedure with the exception that the neck is not worked upon. This surgery is opted by women who have a sagging facial skin but a well-shaped firm neck. The surgery has a faster recovery time as it can be performed with the help of an endoscope. Women with premature aging signs generally go for this procedure.
Deep plane facelift is done to improve the wrinkles and skin folds around the nose that extend up to the lips and cheeks. It is a modification of the above SMAS procedure in which the skin is lifted and the underlying fat and small muscles are freed.
Thread Lift
The thread lift or feather lift is a less invasive surgical option, which is often used for people who seek minor improvements to treat sagging or laxity in the eye, forehead, and naso-labial fold areas. The lift can be performed under local anaesthesia.
Subperiosteal face lift
The subperiosteal facelift technique is done by vertically lifting the soft tissues of the face, completely separating it from the underlying facial bones and elevating it to a more esthetically pleasing position, correcting deep nasolabial folds and sagging cheeks. The technique is often combined with standard techniques, which provide a long-lasting rejuvenation of the face and is done in all age groups. The difference between this and other lifts is that the subperiosteal facelift has a longer period of facial swelling after the procedure.
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