Procedure
As a rule, a surgical facelift is performed starting from the deep layers of the subcutis. The most commonly chosen approach of a pure cheek lift is immediately above the zygomatic arch and extends to the periosteum. In patients in whom, in addition to a face lift of the cheek region, the neck region is to be tightened and/or a particularly long-term effect is to be achieved, the large skin muscle of the neck (platysma) can be remodulated.
The actual tightening of the epidermis is usually achieved during the surgical procedure by inserting sutures into the skin and muscle structures. In this way, areas that have become too unstable can be reanchored without sufficient inherent elasticity. In cases where several areas of the face are to be lifted at the same time, it may be necessary to apply these tightening sutures in opposite directions.
In this way, even pronounced losses of elasticity can be compensated. In most cases, the fixation of the tissue is followed by the surgical removal of excess skin areas and the closure of the surgical field with as little tension as possible. In the case of less pronounced wrinkles, under certain circumstances the facelift can be performed in a so-called “minimally invasive procedure” without large scars.
Theoretically, there are also methods of face-lifting that can be performed completely without surgical incisions. The face lift with gold threads or threads made of plastic compounds is one of the most common procedures. The problem with these methods, however, is that excess skin lobes cannot be removed and should therefore mostly only be used on relatively young patients.
Methods
A surgical facelift can be performed in different ways. The choice of the most appropriate method of facelift depends on the doctor in charge of the procedure as well as the extent of the lift.SMAS-LIFTThe abbreviation “SMAS” in this context stands for Superficial muscular aponeurosis system. This name was chosen because special attention should be paid to the structures (muscles and aponeurosis) contained in it during surgical facelifts.
Within the plastic and aesthetic community, there is a consensus that an effective facelift can only be achieved by tightening these tissue layers. Long-lasting results are therefore only possible with an exact muscle and soft tissue lift. The SMAS lift, which is frequently used in Germany, is further divided into different techniques.
The surgical modulation and reattachment is individually adapted depending on the effect to be achieved in the respective patient. The rough procedure of the SMAS lift begins with an arch-shaped incision in the scalp area. In most cases, an incision must be made from one ear to the other ear.
The surgeon must then carefully remove the scalp and mobilize it in this way. The facelift of the forehead and eyebrows can now be performed simply by pulling and fixing. Mini-LiftWith this method of facelifting, only the actual skin is tightened.
For this reason, the mini-lift is only useful in cases of slight wrinkles. In addition, the durability of this form of facelifting is very limited. Liquid-Lift In this form of facelift, various liquids are used to inject into the wrinkles.
With the selected substances, a distinction must be made between absorbable and non-absorbable liquids. By injecting the liquid, existing wrinkles can be lifted and thus compensated. Furthermore, in plastic-aesthetic surgery, a distinction is made between upper and lower face lifting.
While the upper facelift mainly involves the correction of the forehead, the temple region and the eyebrows, the lower facelift is used to treat the cheeks and neck. In addition, fatty tissue can be used as an insert material. Since a facelift is usually performed under general anesthesia, some rules of conduct must be followed urgently before the surgical procedure is performed.
On the evening before the operation date, food intake should be stopped urgently. Failure to follow these rules of conduct can lead to vomiting during the anesthesia and, in this context, to aspiration (inhalation) of residual food. As a rule, drinking need not be stopped until the evening before the operation.
However, the patient should refrain from drinking in the morning before the facelift is performed. It should also be noted that the consumption of alcohol and/or tobacco products can have a negative effect on wound healing. For this reason, any consumption should be discontinued days before the planned date of surgery.
After the facelift, nicotine and alcohol should be avoided for at least 14 days. Furthermore, the head should be kept high while lying down within the first weeks after the surgical facelift. In this way, the risk of secondary bleeding can be significantly reduced, especially in the first few days after the operation.
