(Facial rejuvenation surgery/ Rhytidectomy/ Rhytidoplasty/ Mid face lift/ Mini face lift/ S-lift/ SMAS lift/ High SMAS face lift/ Cheek lift/SOOF lift/ Deep plane face lift/ Sub periosteal face lift)
Face lift surgery is probably the most known cosmetic surgery procedure in India and worldwide. Because the face is the most visible part of our body and one that conveys a lot about our personality, improving facial appearance is of top priority when considering enhancement of appearance and self esteem.
Face lift surgery is performed to reverse the signs of ageing on the face and thereby create a youthful, well rested look. The result looks natural without a pulled look.
Most face lift surgeries in India are performed for men and women in the age group of 40-75 years. In the younger ages (close to 40) a mid face lift/ mini face lift/ short scar face lift surgery may be enough to provide a powerful rejuvenation. In the later decades a full face lift surgery may be combined with brow lift, eyelid surgery and neck lift depending on the extent of ageing signs.
The safety of face lift surgery has increased significantly over the decades along with our understanding of the micro anatomy of facial tissues. The longevity of results and technical variations are also much more now as there is a tremendous amount of clinical research into facial ageing and its treatment. Face lift surgery has evolved from a simple skin removal procedure in the early 1900's to completely anatomical based sophisticated plastic surgery procedure.
Reasons for ageing changes on face:
Ageing is multifactorial. Genetics and time related changes at the cellular level are the major factors that determine the rate and type of changes seen with age in an individual. Other important contributory factors include sun exposure, gravity, smoking, significant change in body weight, stress, lack of rest etc.
The changes seen with age are highly variable from person to person. Ethnicity also plays a role in the kind of changes seen.
Changes seen with the passing decades:
Ageing affects the entire face. The pattern and areas affected will vary from person to person. From aesthetic assessment and surgery, the face is divided into three equal parts- the upper face consisting of the forehead and eyes; the mid face from the lower lids to the corner of the mouth; the lower face and neck- from the lower lip to neck area.
The upper face- brows and eyelids show the initial signs of ageing- lowering of brows, forehead lines and eye lid bags. In the mid and lower face, the first change noticed is a deepening of the line by the side of the nose and mouth (naso labial line).
There is a reduction in the tone / tightness of the skin and some fine wrinkles start to appear. There is a progressive sagging of the facial skin and tissue underneath (SMAS) which leads on to jowls and neck bands along with deepening of the lines of expression and naso labial lines. Ageing also causes reduction in volume of tissues including fat and bone. The net effect of these changes is to have a tired, sometimes angry look on the face in addition to the ageing look.
Assessment and planning:
Facial rejuvenation is a customized procedure.
The most important aspect in planning is the patient's wishes and expectation. The surgeon will make a detailed assessment of the visible ageing changes and how to reverse them in a safe and predictable manner. A detailed discussion which should include your priority, the surgical possibilities and the time required for recovery will help in the surgical planning.
Face lift surgery is performed under local or general anesthesia depending on the extent, time required and medical status. Most face lifts in India are performed in GA.The procedure will begin with pre surgical photography followed by anesthesia. The incisions are placed in front of the ear and in the hair line, where scar visibility is minimal.
The surgery will involve exposure and rearrangement of the SMAS layer of tissue under the skin, thereby repositioning of the sagging areas in a normal position. The direction of pull- vector of movement- is selected in a manner that will lead to a natural looking result.
Ancillary procedures like fat grafting, lip plumping, chin augmentation, facial liposuction may be carried out as required. Meticulous control of bleeding points is achieved. Small drain tubes may be placed under the skin. The excess skin is trimmed and a fine closure is carried out. The surgical steps vary depending on the type of face lift surgery chosen- whether a traditional face lift, mini face lift, limited incision face lift or a face and neck lift.
Your surgeon will discuss with you the relevant details with you once the final surgical plan is made.
Post op recovery:
Recover following face lift surgery is pleasant and relatively pain free. Ice application and Arnica in prescribed dosage will help to reduce post surgery swelling.
There would be significant amount of swelling and some bruising which resolves completely in 2 -3 weeks. Sutures are removed on day 7. The surgical sites will be numb for many days and will slowly regain normal sensation.
Dressing on the face will be removed after 2-3 days. Elastic compression is advised for 2 weeks after surgery. Light activities like walking are allowed from day one. Heavy physical activities can be started after 4 weeks.
Risks of surgery:
Face lift surgery has evolved over the decades to become the most sought after cosmetic surgery procedure. The increased safety of the surgery has contributed to the rise in popularity for this aesthetic procedure. Any complication in face lift surgery would be of great concern given the elective nature of the surgery.
For this reason, it is important to choose a qualified and experienced plastic surgeon to perform your face lift surgery. Temporary weakness of the facial nerve can occur in a small minority of cases. The recovery of function in such cases occurs over a few days. Permanent damage to facial nerve branches is rare.
Other problems that can happen include bleeding, infection, unfavorable scarring and risks of anesthesia. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
Prepare for face lift surgery:
Quit smoking 3 weeks prior to surgery.
Stop aspirin and other blood thinners 10 days prior to surgery.
Inform your surgeon regarding medical conditions, medications and allergies that you may have.
Arrange for somebody to accompany you to and from the hospital.
Perform lab tests as advised by your surgeon well in advance.
Understand properly from your surgeon regarding pre and post op instructions.