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The art of facial sculpture
Last reviewed: 08.07.2025
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The goal of all forms of facial rejuvenation surgery, from brow lifts to simple liposuction, is to refresh the patient's appearance. The desire to look younger has its roots in the youthful features immortalized by ancient Greek and Roman sculptors. For example, when analyzing idealized sculptures of Venus and David, one notices the sharp angles and clear structure of the faces.
Surgeons have been working on ptotic orbicularis oculi muscles, holding down drooping cheek fat pads, and tightening hypertrophied and sagging platysma bands for many years. All of these interventions are an attempt to sharpen the facial angles by repositioning, fixing, or removing drooping or redundant soft tissue. Facial obesity is a significant problem that has prevented ideal surgical results for many years. In the early 1970s, Schrudde discussed the general principles of "lipoexeresis." Fat manipulations were first performed as an adjunct to facelifts and were intended to improve the aesthetic results of rejuvenation surgeries.
General provisions on fat removal were developed in the works of Fischer and Fischer, Kesselring, who proposed to introduce a tube connected to a suction device through small incisions to access fat deposits over a large area. Illouz described a lipolysis technique in which he introduced a hypotonic sodium chloride solution into the surgical area and then used a blunt-ended cannula to aspirate the fat. Today, liposuction is used on the face as a primary procedure for re-shaping and rejuvenation, as well as in combination with other local aesthetic procedures. Unlike earlier methods, vacuum lipectomy has such important advantages as minimization and concealment of postoperative scars, decreased tissue trauma, and a shorter recovery period. Some authors believe that liposuction has revolutionized aesthetic surgery. Recent advances in this area include the introduction of smaller cannulas, the use of hypotonic adipose tissue infiltration, the use of ultrasound techniques and the liposhaver.