Facelift

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Hadrian Tran

All authors of this article

Last updated on: 08.04.2021

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Definition
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Synonym: Rhytidectomy

Surgical method for correcting the typical symptoms of aging or appearance of the face.

General definition
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  • Minilift: Advantages: Shorter healing time, reduced swelling or bruising. Disadvantages: Less durability. Unfavourable changes in facial proportions due to slackening of supporting, connective and retaining tissue or muscular structures are not sufficiently corrected during this procedure.
  • S-Lift (according to Ansari): Procedure with skin-muscle rotation in the facial area with good early and late results. Method of choice for neck and face lifting. Low risks and complication rates. Surgery is generally performed on an outpatient basis and under local anesthesia. The incision begins with an S-shaped upper part in the temporal region. The incision is continued vertically downward to the lower ear attachment point. The incision ends about 1 cm in the sulcus behind the earlobe. The skin is undermined by approx. 3 cm in the classic manner. Decisive for the extent and intensity of the tightening is the shape and angle of the lower S-loop and not, as with the conventional method, the width of the resected skin.
  • Bio-Lift: No special surgical technique. Rather, the use of a tissue or fibrin glue is the main focus. This protein adhesive is used to fix the layers of muscle, tendons and fat tissue that have been loosened in connection with a facelift and then brought to the desired state. Advantage: Small bleedings in the tissue are stopped early. The use of fibrin adhesives has no effect on the surgical result itself.
  • Composite Facelift/Hamra-Lift: Surgical method that involves the capture and repositioning of all soft tissue layers of the face (skin, subcutis, muscles, fascia) including the muscle plate located under the SMAS (superficial musculoaponeurotic system). The entire block is mobilised towards the upper edge of the cheek.
  • Mask Lift: Extensive surgical method with mobilization and repositioning of the entire soft tissue muscle block of the face. The procedure is usually performed from the inner cavity of the mouth and involves the entire lymphatic system. Advantage: Very good results, optimal modelling. Disadvantage: Long lasting postoperative swellings.
  • ESP-Lift (Extending Supraplatysmal Plane Lift): Extended facelift over the platysma muscle. Particularly suitable for deep nasolabial and eye wrinkles, for hanging cheek, lower jaw and neck wrinkles, as well as for extended and sagging fat deposits. During the operation, the surgeon remains above the muscle area, i.e. the surgeon does not constantly move in different planes with at least a conceivable increased risk of the operation. During the operation, preparations are made up to the eyes and the corner of the mouth, skin-muscle ligaments are loosened and reattached.

Implementation
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Before every surgical procedure, the origin of the optical disharmony must be checked in order to plan the optimal aesthetic procedure. The surgical procedure includes a tightening and lifting of the ptotic parts of the face. This repositions not only the skin, but mainly the subcutaneous fatty tissue, muscle and tendon tissue. Aim of the operation: reduction of the ptotic facial and cervical soft tissue by developing a large rotational flap. Creation of a natural-looking, rejuvenated face that looks as if it had never been operated on. Performing an atraumatic, low-risk operation to promote rapid wound healing.

Complication(s)
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Possible complications of any facial surgery are facial lesion, asymmetries, distortions, retroauricular scars.

A specific complication would be the injury of nerve branches of the so-called facial nerve (facial nerve paralysis). This nerve is the nerve that innervates the facial musculature and is thus necessary for facial expression. It has several cross-connections among the individual branches and can thus compensate for the restricted function of a certain muscle group faster than is otherwise the case with nerve cuts, even in the case of irritation or injury to smaller nerve branches.

In addition, numbness can occur in the area of the surgical site due to the severing of small sensitive skin nerves (especially the trigeminal nerve), swelling, bruising, tissue tension or pulling of sutures. Especially the area around the incision, the earlobe and the area in front of the ear can be temporarily affected.

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Last updated on: 08.04.2021