Face Lift

 

Rhytidectomy / Facelift

 

Ptosis, wrinkling or fine lines of the face is largely the result of aging, massive weight lost, actinic damage or genetic disorder acting singly or in combination with one another. The aged look of the face results from gradual reduction of facial soft tissue volume.

 

To better analyze the face and the changes that it sustained through time, this is divided in 3 regions. The forehead is observed for dynamic and static transverse lines, ptosis of the brow and vertical glabellar lines between the brow. The mid face is noted for hallowing of the cheek, deep nasojugal, nasolabial and labiomental furrow, hooding of the upper eye lid skin and lower eyelid bags. While poor jaw line definition is accompanied by laxity of the neck skin with vertical lines and is often seen at the lower 3rd of the face.

 

These significant changes can be addressed by Rhytidectomy or commonly known as face lift . There are 2 general types of face lift procedure. These are the open or surgical face lift and non surgical face lift which is also known as thread lift. Both the non-surgical and the surgical face lift reduce the sagging skin, soften the deep nasolabial folds, smoothen the sagging skin of the neck and improve the definition of the jaw line  thus, restoring a youthful appearance. Face lift procedure addresses only sagging and atrophic facial tissues. It has no effect on the quality of facial skin. And consequently, this is not a treatment for irregular skin pigmentation which can be address by resurfacing procedure.

 

This rejuvenation or restoration procedure is done by re-suspending the soft tissues of the face with placation sutures and removing or excising the excess, inelastic skin of the face. The resulting scar is oriented along the natural line of the face, this is placed along the anterior border of ear and turns back at the ear lobule going to posterior hair line, thus making it very inconspicuous. Majority of the patients that seek consult for facial rejuvenation often have simultaneous concern with the appearance of their eye lids. Most would complain of hooding and fullness of the upper eye lid skin with baggy lower eye lids. This can be deal with upper and lower blepharoplasty. It’s very common that patients consulting for face lift procedure will also need a blephraoplasty surgery and vise versa. The result of both procedures are very complementary and maximizes the result of  each procedure.

 

Facial rejuvenation can also be attained through a minimally invasive procedure without any surgical incision. This procedure is called Thread Lift Surgery, in which suspension, non absorbable barbed sutures are inserted under the skin to lift the facial soft tissues and attain a more youthful look. This procedure results to less swelling compared to traditional open face lift. However, the results may only last for 2 to 3 years.

 

This is performed as an out-patient procedure in a fully equipped ambulatory surgical facility or patients may be admitted for a day or two if they prefer to have more comfort and relaxation immediately after the surgery. Whether the procedure will be performed as an out-patient or as a hospital procedure, preoperative laboratory and medical clearance is required. This is done a day before the surgery. The procedure will last for 3 to 4 hours under deep sedation with local anesthesia or general anesthesia. This can be performed simultaneously with other cosmetic procedures for patients with good physical health. Patients are required to wear tight dressing or compression garment for 1 week,  this will help the skin to redrape to the muscles of the face, assists in controlling swelling and also prevent fluid to accumulate under the skin flap. There will be some swelling and mild bruising of the face that will last for several days to weeks. Sutures are usually removed 7 days after the surgery.

 

Patients planning to have this procedure will be required to allot 10 to 14 days for the initial consultation, laboratory, medical clearance, surgery, follow up, suture removal and early recuperation. After this the patient is safe to travel since wounds are already dried and healed.

 

Possible risks and complications:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anesthesia risks
• Correctable hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss
• Numbness or other changes in skin sensation
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications

• Possibility of revisional surgery

 

 

For more information on affordable cosmetic procedure, selecting qualified cosmetic plastic surgeon and to know all your options for the procedure you want to have you may visit www.philippinecosmetic.com/ or www.cosmeticplasticsurgeryphil.com . 

Not infrequently I get requests from patients for the desire to transform a round face into a more shapely appearance. One cause of a round face is that the patient is overweight. A full neck, round cheeks, and a lot of subcutaneous fat throughout the face creates a generalized fullness that creates a fat and round face. These patients know full well that they are overweight and some liposuction of the neck and buccal lipectomies may make some difference. But weight loss will probably make the most difference in these cases. And these procedures should not be performed until some weight loss has been achieved.

But the overweight patient is not what usually makes up the ’round face’ patient. Most commonly these are younger patients that are not significantly overweight and are usually closer to being more height and weight porportionate. They may have some mild fullness in the cheeks and neck but often their bony prominences (cheeks, chin, or jaw angles) may be somewhat deficient. The approach to these patients must deal with both hard and soft tissues issues to be effective at improving the face’s angularity and definition.

In addition to the fullness of the cheeks and neck, the next most important consideration in facial shape improvement should look at the chin. Often it may only be midly short in the horizontal dimension but the width of the chin is also important, particularly in the male patient. Chin implants today can provide more projection as well as width in many different sizes. Placed through a small incision under the chin bone, a chin implant can lend more definition and squareness to the lower face from subtle to dramatic results.

Upper facial fullness, more specifically midfacial fullness, can be achieved through cheek implants. Placed into position by incisions inside the mouth under the upper lip, cheek implants can provide good highlights through three-dimensional enhancement of the bone as it wraps around the area below the eye. An amazing aray of cheek and midface implants is available to provide a lot of enhancements around this important facial landmark. When paired cheek implants are combined with a chin implant, an upside down triangle of change is created that directly opposes a more round or oval facial shape.

Jaw angle implants are always a possibility but these are rarely needed in most really round faces. They can produce some lateral facial fullness but this is not usually helpful in ‘de-rounding’ the face in most patients.

The procedures of buccal lipectomies, neck and jowl liposuction, chin and cheel implants make up the usual plastic surgery tools for facial rehaping. Which one or a combination of procedures is most helpful for improving facial definition is best determined by careful computer imaging study during the consultation with your plastic surgeon.