Facelift is a plastic surgery aimed at eliminating wrinkles, sagging skin, nasolabial folds and other signs of aging by removing excess fat, tightening the underlying muscles and redistributing the skin of the face and neck with excision of excess.
A facelift is best done at the age of 40-60 years, when the face and neck just started to undergo the aging process, but in general, elasticity still remained, and the facial bone structures were not subjected to gross age changes. If necessary, the operation can be repeated after 7-10 years.
Following the manipulation of the wrinkles are smoothed out (mostly in the area of the cheeks and the neck), the contour of the jawline and chin-neck angle is reduced and lost facial contours.Description of the technique of subperiosteal lift of the forehead skin and middle third of the face appeared in 1970, and in 1982 the method of resection and fixation of SMAS (subcutaneous muscle-aponeurotic system) was scientifically grounded.
Indication for facelift is the presence of ptosis or sagging the soft tissues of the face under the influence of its own gravity due to a decrease in their tone, loss of elasticity and contractility. Manifestations of ptosis in different areas of the face:In the area of the forehead and temporal area:
- Low eyebrows and overhanging upper eyelids – “gloomy” look.
- The formation of a horizontal fold or wrinkles in the region of the nose.
- Omitted corners of the eyes and eyebrows.
Sagging of soft tissues in the middle third of the face:
- The formation of deep nasolabial folds and vertical folds or wrinkles on the cheeks.
- Due to the hyperextension of the skin of the lower eyelids, the formation of “bags” under the eyes.
- Deformation of the lower contour of the face due to the sagging of the skin of the cheeks with the formation of so-called “jowls” or “bulldog cheeks”.
Ptosis of soft tissues at the level of the chin and neck:
- The formation of a double chin with or without excess adipose tissue.
- Sagging tissue with the formation of skin folds in the form of a bag, smoothed and fuzzy chin-neck angle.The skin of the neck is flabby, atonic with a tendency to form folds, there is some “excess” skin on the neck.
Individual manifestations of ptosis of the soft tissues of the face are the following changes:
- Sagging of the soft tissues of the eyelids;
- Sagging of the forehead and eyebrows skin;
- Omitted corners of the eyes;
- Vertical wrinkles on cheeks;
- Deep nasolabial folds;
- “Double chin”;
- Ptosis of soft tissues of cheeks;
Contraindications for this operation are:
- infectious diseases;
- oncological diseases;
- blood clotting disorders;
Facelift (rhytidectomy) is a complex and lengthy operation, the duration of which depends on the surgical technique used and the scale of tasks facing the doctor. Surface and classical circular face lifts take an average of 1.5 – 2 hours; deep facelift can last up to 3-4 hours.In such cases, the doctor resorts to general anesthesia (inhalation anesthesia). Lifting of individual areas of the face can be carried out under local anesthesia.
Preparing for surgery.
Preoperative preparation includes analyzes, surveys and inspection specialists.
- Blood type and Rh factor
- General blood analysis
- Blood test for clotting (coagulogram)
- RW, HIV, the presence of antigens to hepatitis B and C viruses
- General urine analysis
- Blood glucose test
- Total protein
- Bilirubin, Alt, AsT
- Panoramic X-ray of the chest (or photofluorogram)
Inspection by specialists:
- According to the results of the examination, if necessary, the patient may be assigned additional examinations.
Types of facelift
Depending on the depth of lifting:
- Surface or classical circular facelift;
- SMAS-lift and mini-facelift;
- Deep lifting.
- With the combined application of different techniques, facelift is called combined.
Depending on the zone:
- Lifting of the upper third of the face – frontal and temporal zones – or frontlifting;
- Lifting of the middle third of the face or check-lifting;
- Lift the lower third of the face, chin and neck – S-lifting;
- The combination of these techniques.
According to the technique of implementation:Open methods: when a classic skin incision is performed and all subsequent operations are performed through it.
Endoscopic method: when access is limited to short skin incisions or punctures, and all further manipulations are performed through them using an endoscope.
The volume of the operation, the depth of the skin tightening, which method will be used in and in which zone are determined by very many factors: the patient’s age and tissue state, anatomical features, general health, patient’s wishes, and even the cost of the operation. The decision is made individually, jointly by a plastic surgeon and patient, after a thorough analysis of the situation.
Postoperative period and recoveryThe duration of any stage of the postoperative period, namely: inpatient treatment, suturing, restoration of working capacity, complete recovery, depends primarily on the volume, depth of surgical intervention, as well as on the individual characteristics of the patient (this includes age and the ability of tissues to regenerate and others).
- The stay in the hospital is from 1 to 5 days.
- The joints are removed from 4 to 12 days after the operation.
- Anesthesia and taking antibiotics about 1 to 7 days.
- Compression bandage and compression mask are worn from 1 day to 2 weeks.
- The decrease of edema and resorption of hematomas lasts from 2 to 4 weeks.
- Recovery of work capacity: from 3 to 20 days.
- Applying make-up and washing your head is allowed after 3 – 10 days.
- Restrictions on physical activity, visiting saunas and solariums is 2 – 3 months.
- Complete recovery, including the disappearance of bright scars, which become completely invisible is from 2 weeks to 6 months.
- The given intervals can vary significantly, more specifically, the recovery time is considered for each operation and for the specific patient.
In this topic we have prepared information about facelifting, collected on the sites of various plastic surgeons, as well as on the website realself.com.
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