Facelift and facelift: types, results, rehabilitation, reviews

Facelift is an operative or non-operative correction of the face and neck by affecting soft tissues, the so-called facelift. Facelift allows you to get rid of wrinkles and sagging skin, which are often a consequence of aging.

Facelifting for the face was first mentioned in 1906 in the context of discussing surgical intervention in correcting age-related facial transformations. Later, various methods of soft tissue correction in the facial area were developed. In 1976, the term “subcutaneous muscular-aponeurotic system” was introduced under the abbreviation SMAS. In 1982, a technique for SMAS resection and fixation was developed. Since this period, new facelifting techniques have begun to appear, which are currently widely used in plastic surgery. Nowadays, it can be said that with proper preparation and the operation performed by an experienced specialist, facelifting will not have complications.

Prevalence of facelifts

The human body inevitably undergoes a number of age-related changes, among which the most obvious is the age-related change of soft tissues and facial skin. This is due to the effect of gravity. Due to this effect on collagen structures, the skin sags, deep furrows appear, especially in the area of the nose, lips and eyes. The aging process of the face accelerates depending on the presence of:

• bad habits;
• the detrimental influence of harmful external factors, including the unfavorable state of the ecosystem;
• somatic pathologies.

A combination of several or all factors leads to the appearance of wrinkles, including mimic wrinkles, sagging skin, and changes in the shape of the face. In the most unfavorable cases, the face may have all the signs of aging by the age of 35-40.

Due to the fact that appearance is an integral part of a person's social life, including career advancement, facelifting is one of the most popular plastic surgeries in the world, second only to mammoplasty, rhinoplasty and liposuction. Both women and men resort to surgical intervention.

Indications for the procedure

There are both surgical and non-surgical methods of face and neck correction. To perform a facelift procedure, it is enough to be critical about the condition of the skin of the face. Often, the operation is resorted to after 40 years, although there are cases of premature aging at about 35 years of age.

Non-surgical methods can affect the initial signs of skin aging. For surgical intervention, which is also used to completely eliminate the most difficult cases of age-related facial transformations, there are some indications for implementation:

• wrinkles and folds in the forehead, bridge of the nose, neck, temples and cheekbones;
• sagging skin;
• deep furrows in the cheek area;
• ptosis of the eyelids, cheeks in the area of the lower jaw;
• double chin;
• noticeable nasolabial folds;
• drooping of the outer corners of the eyes.

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Preparation

Surgical intervention requires some stages of preparation.

• 14 days before the procedure, it is prohibited to use drugs that have a direct effect on blood clotting, such as aspirin;
• 24 hours before the procedure, you should not eat heavy, fatty foods;
• The procedure should be carried out on an empty stomach, without drinking any water.

Technique facelift

There are many methods and techniques for performing facelift. Among them, the main ones are:

1. Endoscopic facelift

Endoscopic facelift is a surgical intervention that allows you to get rid of wrinkles, furrows and folds. Both lower facelift and upper and middle zone lifting are performed.

The operation lasts up to 2 hours. Several incisions of approximately 2 centimeters in length are made in the area of the head where the hair grows. Incisions can also be made in the temporal part to correct the middle third of the face, or under the upper lip to correct the lower part. With the help of an endoscope, which is inserted through the incisions made, and other devices, soft tissues are separated from the bones and fixed in the required manner. In this case, nerve endings, blood vessels and hair follicles are not injured.

This operation is performed under both local and general anesthesia. A special compression bandage should be worn for about 5 days after the operation. The patient fully recovers within a few weeks after this surgical intervention, usually within 14 days. Another advantage of this method is the absence of visible scars, unlike an open facelift.

2. Hardware facelift

One of the non-surgical methods is hardware facelift. This type of facelift does not involve invasion, but uses the developments of scientists in the form of devices that emit high-frequency radio waves. This method is called "Thermage" and is absolutely painless. The device for this method of lifting is equipped with various attachments that allow lifting not only the face, but also other parts of the body with different thicknesses of skin.

Hardware facelift is characterized by the thermal effect of radio frequencies on facial tissues. They penetrate the skin by a maximum of 0.5 cm, without causing discomfort to the patient. With this type of lifting, only a change in temperature effect on the face is felt. Connective fibers are compressed and compacted, which shows an almost instant effect in the form of the absence of wrinkles, furrows, folds and sagging.

3. Facelift with threads

The essence of thread injection is that they have notches and knots on the surface, with the help of which the facial tissues are fixed and a small frame is created under the skin. Thanks to them, the patient's skin is smoothed and becomes even, sagging and wrinkles disappear.

Facelift with Aptos threads is a rather painful procedure. The procedure lasts about half an hour. Local anesthesia is used to perform the operation. Anesthesia is administered in the form of injections into the places where the threads are supposed to be inserted. A small incision or puncture of the skin is made to inject the threads.

This type of lifting is recommended for patients aged 30-35. This procedure has a result comparable to the effect of plastic surgery. Rehabilitation usually takes 2 weeks, occasionally 4 weeks are required for recovery. The period depends on the individual characteristics of the patient, the adequacy of post-procedural care, the quality of the doctor's work and the threads used during the procedure. After the lifting, painkillers may be used.

4. Laser facelift

Laser facelifting uses a focused beam of light, which allows for tightening in the most inaccessible areas. This type of lifting is a non-surgical facelift and allows for tightening the skin of the face and neck without invasive intervention. With laser facelifting:

• the depth to which the laser beam penetrates during processing is controlled;
• at the same time, the condition of the skin improves due to the effect on collagen;
• there are no incisions that lead to scars and marks, there is no need to use anesthesia;
• the procedure is quite fast;
• rehabilitation occurs faster than with other methods.

Some complications may occur, such as:

• swelling of the face (disappears soon after the procedure);
• pigmentation in the affected areas (to avoid hyperpigmentation, avoid direct exposure of the facial skin to sunlight for 6 months).

There are also contraindications:

• pimples, acne;
• sensitive skin;
• dark skin;
• dermatological infectious diseases.

5. Short scar facelift

In short-scar facelift, also called “S-lifting”, the deep structures of facial tissues are surgically affected, thus leading to the maximum degree of skin rejuvenation. For this, the skin is cut in the area near the ear, due to which the scars after the operation are practically invisible. The effect of this procedure is quite long-lasting, since the deep structures of facial tissues are fixed.

Before the operation, anesthesia is used. Then, incisions are made (in front of the ear for male patients, behind the tragus for female patients.) Then, soft tissues are secured, sutures are applied to the tissues in the cheekbone area, after which additional intradermal sutures are applied, which are removed at least a week after the procedure.

For short-scar facelift:

• the smallest possible skin incision is made;
• the facial tissues are fixed in a strictly vertical manner, which avoids the effect of stretched skin and maintains this effect for a long time;
• the intervention is short-term, gentle local anesthesia and intravenous sedation are used, thus invasiveness is minimal;
• This operation fixes the muscular-aponeurotic system, which gives a long-lasting result;
• the possibility of damage to the facial nerve is minimal, complications, in particular in the form of hair loss, rarely occur;
• fast rehabilitation.

Some of the disadvantages include:

• Often there is a feeling of varying degrees of discomfort in the ears after a short-scar type facelift
• the maximum effect is achieved by lifting the two upper thirds of the face (upper and middle); to lift the lower third, a combination of procedures should be used

Short-scar lifting is indicated at the age of 40-50 years and is combined with other types of lifting and plastic surgery.

6. Vector facelift (bioreinforcement)

Vector facelift is also called bioreinforcement. This procedure is performed on patients aged 30 to 55 years.

Gels containing hyaluronic acid are invasively injected under the skin of the face. This creates a subcutaneous framework that resembles a natural framework made of collagen fibers. The introduction of the gel helps form a new framework that helps restore the natural one.

This procedure has many advantages:

• simultaneously with skin tightening, the processes of collagen production and biorevitalization are launched due to the sequential destruction of hyaluronic acid; after injection, the gel gradually disintegrates and dissolves;
• the created frame helps support the soft tissues of the face and prevents them from sagging in the future;
• a skin tightening effect is achieved on the face, as the skin is compressed in the direction from the edge to the center;
• the skin of the face becomes denser and more elastic and firm;
• the appearance of the skin also improves, the face acquires a clear shape, wrinkles disappear;
• no additional care is required after the procedure, since there is no rehabilitation as such;
• After the first procedure, the effect becomes noticeable; within 2 months after the vector lifting, the result is noticeably enhanced.

7. SMAS-lifting

SMAS lifting involves tightening the muscular-aponeurotic system, which consists of connective tissue. This type of lifting is an addition to other types of facial skin tightening. During this intervention, incisions are made in the temporal region above the hairline, after which the SMAS is lifted, excess tissue is cut off and everything is fixed. Most often, SMAS lifting is prescribed after 45 years of age.

8. Circular facelift

A circular facelift (rhytidectomy) is the most traditional procedure, performed under general anesthesia, with an incision made along the hairline in front of and behind the ears. The skin is then tightened by the doctor, excess tissue and skin are removed, and stitches are applied. They are removed 2 weeks after the operation.

Postoperative effect: facial rejuvenation for 10 years.

9. Acupuncture facelift

Acupuncture facelift is a facelift technique based on ancient Eastern acupuncture techniques. The needles act on the active biological points of the face. Acupuncture is combined with massage of active points and other physiological procedures.

In addition to the rejuvenating effect, there is a normalization of blood circulation and lymph flow throughout the body, which are also the cause of dullness of the skin color and the appearance of wrinkles and sagging on the face.

An individual scheme is created by a specialist for a specific patient. The points that are subject to acupuncture are located on the face, ears and other parts of the body. The needles promote tissue reaction, which helps in the production of collagen and elastin and in activating the reaction of blood vessels.

An acupuncture session lasts about an hour. The patient lies on a couch while the specialist punctures the skin with needles. The needles are always sterile and disposable, and the used material is disposed of.

For maximum effect, specialists recommend taking a course of several sessions, from 5 to 10 procedures with subsequent maintenance sessions once a month. The treatment regimen is prescribed individually, as a rule, it is carried out 3 times a week.

10. Total facelift

Total facelift is a combination of different lifts. As a rule, lifts of all parts of the face are combined: upper, middle and lower thirds. The procedures are performed using endoscopic and open methods, depending on the individual characteristics of the patients.

This method shows the maximum effect, which is observed due to the combination of different techniques and methods in one specific patient. This lifting is permanent.

11. Facial exercises (facelift yourself)

There are developments of exercises, during which facelifting occurs without surgery.

It is worth highlighting the facelift by Galina Dubinina. This non-surgical facelift is an original facelift system that combines exercises developed by the author, as well as existing elements of yoga, bodyflex and fitbuilding.

Galina Dubinina's method is multidirectional. Facelifting is performed using:

• eye exercises using a special technique;
• working on problem areas of the neck and face;
• fast charging;
• various manipulations aimed at working on the neck and face and intended to be performed in the morning and evening;
• bodyflex exercises for the skin;
• massage stimulation of bioenergetic areas of the skin;
• procedures designed for male facelift.

These procedures are divided into several courses.

Among the positive characteristics of this non-surgical facelift technique, the following can be highlighted:

• when performing the procedures consistently, an effect comparable to the result after a facelift operation is observed: a rejuvenating effect, the disappearance of wrinkles and folds, and smoothing of the skin;
• after completing all the manipulations, the face becomes fresher, a significant improvement in the skin condition is observed;
• thanks to the fact that the author uses elements of Bodyflex breathing exercises, the condition of the body's systems and the general well-being of the patient improves;
• there are no indications, including age and the presence of diseases in the patient's medical history;
• any complications that occur after surgical intervention are excluded.

Facelift areas

The face is visually divided into three parts. Facelifting can occur in:

• upper third (this type includes facelift for the eyes, the so-called temporal facelift, frontlift, tightening of the skin of the forehead and eyebrows);
• middle third (nasolabial fold facelift, cheek facelift);
• lower third (lip and chin facelifts; neck facelifts also fall into this category).

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Contraindications to the procedure

There are specific contraindications to different methods of facelift. However, there are general contraindications to surgical correction of the face:

• infectious pathologies in acute form;
• acute inflammations;
• severe diabetes;
• problems with blood clotting;
• oncology;
• cases where the patient's age exceeds 50 years;
• period of gestation (pregnancy) and lactation;
• thick skin;
• severe sagging or inflammation of facial skin tissue;
• hypersensitivity to anesthesia;
• severe dermatological pathologies;
• autoimmune diseases;
• problems with the heart and blood vessels.

Contraindications to some operations may include factors such as a tendency to form keloid scars, long-term smoking, etc.

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Consequences after the procedure

After the face and neck lifting procedure, a rejuvenating effect is observed,

• wrinkles and furrows;
• ptosis;
• folds;
• sagging;
• flews;
• and also significantly improves the general condition of the face. After surgical intervention, the final results are noticeable 2 months after the operation.

More specific consequences depend on what type of procedure was used.

Patient reviews are mostly positive. One of the important criteria is the qualification of the specialist who performed the operation or hardware manipulations, and the quality of the patient's preparation for the facelift.

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Complications after the procedure

After operations or hardware types of lifting, some complications occur. Thus, after face and neck lifting surgery, the most likely complications may be:

• Excessive pigmentation of the skin, which in most cases disappears on its own within 6 months after the intervention; a risk factor is delicate skin;
• swelling and bruising; swelling after a facelift is mostly mild and goes away after a while without any additional manipulation. The peak is considered to be the 3rd day, in the absence of other complications, the swelling disappears by the 7th day of the postoperative period;
• During operations that involve making incisions on the scalp, hair loss may occur without causing baldness (hair growth resumes after a while).

The following complications may occur infrequently:

• bleeding (after operations during the rehabilitation period);
• necrosis of the skin edges (in operations with incisions, the risk group includes old age and long-term smoking);
• formation of hypertrophic scars (in cases where the patient is prone to this consequence);
• weakening of the muscles responsible for facial expressions (passes without unnecessary interventions within six months);
• damage to the facial and ear nerves;
• development of infectious diseases through the entry of pathogenic microorganisms into the body through wounds (depends on the individual approach to wound care).

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Care after the procedure

Rehabilitation and recovery after a facelift depends on the type of procedure performed. Thus, after bioreinforcement and some non-surgical techniques (exercises, acupuncture) there is no rehabilitation, and with a laser facelift, rehabilitation occurs in a very short time. However, after a laser facelift, you should avoid sun rays for six months.

For most endoscopic or open surgeries, the following care guidelines apply:

• hospital stay up to 3 days;
• wearing a compression mask on the face for up to 7 days;
• facelift stitches are removed after the first week (for incisions in the ear area) or on the 10th day (for incisions in the hair growth area);
• washing your hair and applying makeup is allowed on the 7th day;
• you can return to work after 2 weeks;
• You cannot do a course of facial massage for 1 month, after this period it is recommended to do a lymphatic drainage massage;
• hair dyeing, sauna use and sunbathing are allowed after 1 month;
• You can start doing sports after 1.5-2 months.

Facelifting, performed by any method, will have the best effect if postoperative procedures are carried out correctly and adequate care is provided.

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