FOURTH QUARTER 2003, VOLUME 17, NO 4

The many faces of a facelift… Which one is right for you

IN THIS ISSUE

Sleep helps fight the aging process

The many faces of a facelift… Which one is right for you

Ask the Surgeon / Health Tip / What’s New

Safety first: What you can do to mazimize your safety

Time, gravity, and the elements naturally take a toll on the appearance of your face. As we age, the skin begins to lose its elasticity and wrinkles start to appear. Fatty tissue tends to decrease in volume and in density causing the skin to sag and hang loosely. There are also changes in the bony facial structure that when combined with changes in muscular action and the effects of gravity, leads to more prominent skin folds. These changes are greatest under the chin, in the upper neck and at the skin folds near the corner of the mouth.

A common procedure designed to correct these facial conditions is the facelift, or rhtidectomy. The growing popularity of this procedure has precipitated advancement in techniques and in technology. Learn what is available and which type of facelift may meet your unique needs.

A Full Facelift

A full facelift is designed to lift and tighten sagging, primarily in the lower two-thirds of the face. It smoothes the neck area, reduces jowls, and refines the jaw line. The facelift procedure can improve wrinkled skin, but skin type and patient age are important factors in the final result.

Incisions are made around and behind each ear. The skin is raised, excess fat and skin are removed, the underlying connective tissue is lifted and repositioned, and permanent sutures are used to hold the skin in its new location. The surgery is typically performed taking two to four hours depending on the extent in an outpatient facility or in a hospital setting, and most patients go home the same day. The surgery may be done under twilight anesthesia; medication is given orally and intravenously, along with a local anesthetic. Swelling diminishes after one to two weeks.

Deep Plane Facelift

The deep-plane facelift involves elevating facial muscles and fat that lie below the SMAS layer (short for superficial musculoaponeurotic system) and securing the fat pads of the cheek and midface back to their natural position. While the deep-plane facelift allows more facial sculpturing to correct problems in the cheek and midface region e.g., reducing the appearance of deep creases between the nose and the mouth the procedure is more extensive and requires a longer recovery period.

Before and After PhotosThis is a young baby boomer professional who was seeking rejuvenation to further her career and to remain confidently youthful. The procedures employed included multifacted; multidiscipline minimal access facial plastic surgery under intravenous sedation in an accredited facility.

Key areas of evaluation included upper third facial issues including dermatochalsia of eyelid skin, lateral brow ptosis, and pseudoherniation of orbital fat, corrected by skin flap blepharoplasty, laser ablation blepharoplasty (tc) and suture suspension brow lift. In the midface and prejowl areas for correction of infrastructure shrinkage and hypoplasia the use of the Internal Face Lift (IFL) utilizing sub-periosteal fillers (malar/jowl) (alloplastic-silicone) and endoscopic assisted approach. To bring the periorofacial unit into balance the use of soft ePTFE (Advanta) provided an additional dramatic improvement. The final step employed the J-Lifta minimal vertical facelift with SMAS anchor to the zygomatic archand additional 45-degree vector plication and skin elevation with liposuction.

The results at one month depict the dramatic and youthful changes that can be achieved with new minimal access technology.

S-lift

This procedure derives its name from the shape of the excision that is used near the ear; it is shaped like an s. This procedure uses a technique involving suturing of the SMAS and the ESP (extension of the supraplatysmal plane) to the perosteum and zygomatic bone. This means that the fixation of the soft tissue to the cheek bones provides stability and also fullness to the area. The s-lift is not as invasive as the full facelift, therefore, there is less procedure time, lower cost, and quicker recovery. This lift is best for those who have early or minimal aging changes.

J-lift

The J-lift is a procedure that lifts and firms the lower one-third of the face and neck. Its name comes from the area that is corrected by the procedure: the jaw line or jowls. By repositioning of the muscle groups underneath the surface, the jowl is lifted to its natural best site for beauty. The incisions are hidden.

Midface Lift

A midface lift is performed through tiny incisions placed inconspicuously within the hairline and on the inside of the mouth. During the procedure, the fat pads of the cheeks are repositioned up and over the cheekbones where they belong. This redraping improves the nasal furrows and restores a more youthful appearance.