Face Lift also written as facelift, is known medically as rhytidectomy. This is one of an important cosmetic surgery or procedure. It is about removal of excess facial skin and wrinkle with it, which brings about a younger rejuvenated looking face. Take an example of a temporal incision to expose the glistening deep temporal fascia for a mid-face lift. The plane is dissected by blunt dissection all the way down to the orbital rim where it is connected with the sub-periosteal fascia, and further through the sub labial incision assisted with incision through the lower eyelid.
There are many surgical techniques employed to remove the excess skin with or sometime without the tightening of underlying tissues. There are frequently combined with other surgery such as upper blepharoplasty and eye bag removal to further enhance the result. A top up of non-surgical face lift by using the thread, filler, anti-wrinkle, PRP rejuvenation or even a Vampire lift, of the part not covered by the full face lift, such as the forehead may be done together. This is one of our clinic hot selling service.
During the early 20th century, it was mostly lifting of the skin of the face. An elliptical shaped skin in-front of the ear is removed, skin pulled up and fixed. This is a very save procedure with short downtime. The only drawback is that it is not so lasting, for a year only.
Sub-facial dissection to free up the skin, superficial facia and muscle, mobilization, fixation and trimming. SMAS stand for Superficial Musculo-Aponeurotic System is the complex that is mobilized, fixed and trimmed for rejuvenation. The technique is less technically demanding, safe, minimal complication is seen. This becomes the gold standard of face lift.
Here, dissection goes deeper until it reached the sub-periostel tissue around the superior and lateral orbital rims allowing correction and elevation of soft tissue around the eye for better result. The objective is to lift up soft tissue and fixed to a higher location for a youthful rejuvenation.
Here, the surgeon have a change of concept of aging facial skin. They realized that aging is brought about by the loss of volume within the facial tissue. Therefore, it is best to restore back the volume rather than doing extensive incision for skin tightening. The trend going forward is to use own body tissue such as the fat as a natural filler to replace the lost volume due to aging face.
The facial nerve is the major motor nerve that innervate the facial muscles from the deep surface of the muscle. Hence, there is little chance to damage it. Hence, the dissection of the deep plane can be done very safely. This is except for muscle that lie deeper to the plane of the facial nerve, the mental nerve, levator anguli oris & the buccinator). The nerve ending medially becomes more superficial as we dissect towards the mid-line. Hence, the dissection towards the side, meaning nearer to the ear is the beginning point of the surgery. Then, it proceed toward the naso labial fold without risk of damaging the facial nerve.
Greater auricular nerve is the only major sensory nerve. Be careful for injury during elevation over the sternocleidomastoid muscle, as the terminal branches pass superficially to the earlobe.
The main function is to provide anchorage of surface structure to the bone beneath.
The last 3 are the most important. At the one end is attached to the skin, the other end to the bone. All these ligaments must be mobilized, freed and released to get a fully mobile tissue to be fixed at a higher position.
For a traditional face lift, incision is given in front of the ear, extending upward towards the hairline, down and backward around the ear and end into the hairline on the back of the neck. The skin is dissected from the deeper tissue using scissor by blunt dissection into the cheek and the neck. The deeper SMAS layer can be tightened by plication without removing excess tissues. After mobilization, the skin is re-positioned and fixed. Modification of this lead to Deep lane face lift.
The technique of a SMAS face lift, consisting of first mobilization, re-positioning and finally fixation. SMAS is better for positioning the platysma.
This is quite like SMAS, except that it goes deeper by freeing cheek fat and muscles from the cheek bone attachment, re-positioned and fixed.
This is quite like the deep plane face lift. The difference is that there is extra re-positioning of orbicularis oculi here. The malar crescent or the tear trough is due to the orbicularis oculi droop.
The mid face area between the 2 cheeks, flattens and makes a lady look more masculine. This face lift is suitable with people without neck droop or jowing. Ideal candidate is in the 40s. Several incisions are make along the hairline and inside the mouth. The fatty tissue layer can be lifted and re-positioned. Recovery time is short, usually is combined with eyelid surgery.
This is least invasive, and is similar to full face lift. This is also called S-lift due to the shape of the incision. The incision is make along the hairline around the ear. The soft tissue is mobilized, re-positioned and fixed.
Blue represent the incision in the skin only face lift. Green represent the S-lift. Red is the extensive undermining done in several face lift techniques.
Also called the feather lift is used for people seeking minor improvement to sagging face skin. The pull is dependent on the barbed hook that pulls on the skin. The thread can non-dissolvable or dissolvable.
This is done by mobilizing the soft tissue from the bone, re-positioned and fixed for a pleasing result.
Here, only the skin is lifted from beneath structure like the SMAS and beyond. It is mobilized, repositioned, and fixed. The drawback is that it last only a short time of a year.
Minimal Access Cranial Suspension lift allow elevation of soft tissue vertically and suspension from above through minimal small scar. The advantage over traditional face lift is that it is very natural than a “windswept” look of full face lift. It has very short downtime and no risk of complication.