The science of plastic surgery has developed the rhytidectomy or Face Lift technique, which consists of the reshaping of the face’s tissues trying to compensate for the effects of the passing of time and gravity.
In order to achieve best, durable results, the surgeon acts on both the skin and the deeper tissues of the Superficial Muscular-Aponeurotic System (SMAS)
Traditionally the face is divided in thirds: inferior, medial and superior (neck, face and eyebrow trail plus the forehead). Antiaging surgery can be independently applied to each area or in combination.
WHEN IS IT NEEDED?
This procedure is recommended for all men and women that show a loss of skin elasticity, flaccidity, sagging and wrinkles in certain places of the face, nasolabial furrow and neck.
Depending on the kind of intervention needed, the Face Lift covers a very wide range of patients: from those that are 35 or 40 years and wish to regain their skin tone (through a Weekend Lift) to those who are older and ask for a full Face Lift because aging is showing up in all thirds of the face. These people as a rule show too a photo-aged, dehydrated, stained skin, and a thick epidermis that require additional non-surgical treatments.
A Face Lift can be performed under local anaesthesia. Supplementing it with sedation or going straight to general anaesthesia is recommended.
Depending on the patient’s needs there are different types of lift procedures and areas to apply them to:
- Neck: excess skin and incisions are done behind the ears.
- Cheeks: the cheeks’s skin is pulled and the scars are situated in front of the bowl of the ear (behind the ear’s tragus).
- Eyebrow trail: the incisions are done in the temporal region.
- Forehead: the incision is in the shape of a diadem. This is the so-called coronal lift. Nowadays it has fallen into disuse as the effects it provides are too similar to those of the botulinum toxin (‘botox’).
The area to be intervened is marked with a dermographic marker. Incisions are done, the skin is detached, the superficial muscular-aponeurotic system (SMAS) is tractioned and then the skin is reattached. Once this step is done, excess skin is removed taking care to be exacting so as not to cause excessive tightness and achieve minimal, imperceptible scarring.
Drains and bandaging are applied next.
DURATION OF THE PROCEDURE
The operation lasts about three to four hours depending on the magnitude of the intervention.
A Face Lift requires 24 to 48 hours of hospitalization after which the patient can leave for home. Drainage is left for 24 hours, dressings are removed 48/72 hours later. Stitches are removed 8 to 10 days later.
In terms of recovery time, partial Face Lifts are very quick: 48/72 hours after surgery the patient shows an socially acceptable appearance.
On the other hand, patients subjected to a major Face Lift intervention will show swelling for 7 to 10 days and eccymosis (bruising) for a week.
For longer lasting results it is vital to take care of the skin, keeping it hydrated. Also, exposure to sunlight must be moderate and under the protection of a sunscreen product.
- Haematoma: is the abnormal accumulation of blood in the intervened area. To prevent it, a rigorous coagulation must be performed. If the haematoma is too large it can be evacuated through new surgery.
- Infection: the risk of infection is very low nowadays as it is prevented through the use of antibiotics. Its occurrence, depending on its intensity, could affect the results of the intervention.
- Hypertrophic scarring: la cicatriz puede resultar de ‘mala calidad’, es decir, extremadamente gruesa y lenta para blanquearse, circunstancia que depende de la naturaleza del paciente y de su edad.
- Keloid: is the pathological overgrowth of scar tissue, rare in white patients although less so in black patients.
- Scar hyperpigmentation: is due to the patient’s physical make-up, premature exposition to sunlight, or the use of certain medications. Its treatment consists of the application of creams, chemical peels or depigmenting laser therapy.
- Scar hypopigmentation: loss of colour in the scar tissue giving it a whitish appearance.
- Facial Paralysis: can be temporary or permanent, and is usually the result of poor surgical technique. Statistically its occurrence is lower than 1%.
- Necrosis and poor blood circulation-based alopecia: are usually due to the consumption of tobacco.