Synonymous to : Facelift, Rhytidectomy, Facial Rejuvenation
Ptosis, wrinkling or fine lines of the face, is largely the result of aging, massive weight loss, actinic damage, or genetic disorder acting singly or in combination with one another. The aged look of the face results from the gradual reduction of facial soft tissue volume.
To better analyze the face and the changes that it sustained through time, it is divided into three regions. The forehead is observed for dynamic and static transverse lines, ptosis of the brow, and vertical glabelar lines between the brow. The mid-face is noted for hollowing of the cheek; deep nasojugal, nasolabial, and labiomental furrow; and hooding of the upper eyelid skin and lower eyelid bags. Poor jawline definition is accompanied by laxity of the neck skin with vertical lines and is often seen at the lower third of the face.
These significant changes can be addressed by rhytidectomy, or commonly known as face lift. There are two general types of face lift procedure: the open or surgical face lift, and the 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 jawline, thus restoring a youthful appearance. A face lift procedure addresses only the sagging and atrophic facial tissues. It has no effect on the quality of facial skin. It is also not a treatment for irregular skin pigmentation which can be addressed by a 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 the ear and turns back at the ear lobule going to the posterior hair line, thus making it very inconspicuous. Majority of patients who seek facial rejuvenation often have a simultaneous concern with the appearance of their eyelids. Most would complain of hooding and fullness of the upper eyelid skin with baggy lower eyelids. This can be addressed through upper and lower blepharoplasty. It's very common for patients consulting for a face lift procedure to also need a blephraoplasty surgery and vice versa. The results of both procedures are very complementary and they maximize the individual effect.
Facial rejuvenation can also be attained through a minimally invasive procedure without any surgical incision. This procedure, called thread lift surgery, involves inserting non-absorbable barbed sutures under the skin to lift the soft facial tissues and attain a more youthful look. This procedure results in less swelling compared to the traditional open face lift. The result may only last for two to three years.
Thread lift surgery is performed as an out-patient procedure in a fully-equipped ambulatory surgical facility. Patients may also be admitted to a hospital for a day or two if they prefer to have more comfort and relaxation immediately after the surgery. Whether performed as an out-patient or as a hospital procedure, pre-operative laboratory and medical clearance is required. This is done a day before the surgery. The procedure will last for three to four 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 garments for one week to help the skin redrape to the muscles of the face, control swelling, and prevent fluid accumulation under the skin flap. There will be some swelling and mild bruising of the face that will last for several days or weeks. Sutures are usually removed seven days after the surgery.
Patients planning to have this procedure will be required to allot ten to 14 days for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, the patient is safe to travel since wounds would have dried and healed.
Possible risks and complications:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor wound healing
- Anesthesia risks
- Correctible 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 requires removal
- Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, and unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve the results.)
- Deep vein thrombosis, cardiac and pulmonary complications
- Possibility of revisional surgery