Total Face Lift (Rhytidoplasty) Surgery
The correction surgery of removing of excess and wrinkle of the face (forehead-face-neck) skin and subcutaneous soft tissue laxity is called facelift surgery. Only facial skin lifting surgeries are no longer accepted as facelift surgery.
There are three basic changes on the face that come with age.
– facial skin becomes thinner, wrinkles and becomes loose (facial wrinkles),
– subcutaneous soft tissues get saggy (face sagging),
– face fat tissue and facial bones lose volume (face becomes empty).
For an ideal face lift, it is necessary to intervene in all three of these cases.
In other words, the excess skin should be removed, the sagging soft tissues should be returned to their place and the emptied parts should be filled with fat -tissue injection.
Our preferred method of surgery is deep two-layer lifting. Between the facial skin and the facial muscles, there is a hard layer rich of fat, called SMAS-platysma. Essentially, this SMAS layer forms the saggy image on the human face. Therefore, face lifting methods which do not intervene with SMAS tissue can not have a natural and lasting effect. In the deep two-layer method we apply, the face-neck skin and the SMAS-platysma layer are abraded separately, stretched to different directions and returned to their original location. Thus, the ideal rejuvenation is achieved. In most cases, upper and lower eyelids should also be intervened.
The advantages of the method are: sagging tissues are drawn to their ideal place, it is possible to establish the fullness on the under the eye –cheekbones which were not provided by old, classical methods.
The tension is loaded into the SMAS layer instead of the skin. In this way, after the operation, people do not appear tense face expression. Because there is no excessive tension in the skin, the scars will heal in much better quality. 15-20 days after surgery, even people who know the patient will have difficulty to understand that he/she had this operation.
In the old, classical method, because the tension obtained by surgery is loaded on the skin, old problems reappear shortly after the surgery. However, by the method we described, the patient will live without any problems after surgery for a period of 10-15 years. That is, the effect of the surgery is permanent.
Where are the surgery scars?
The skin incision made for face lift starts in the temple area through the hair, goes down in front of the ear, turns to the back of the ear and ends on the neck. The incision method we describe is enough to lift the face and partially the neck. The incision on the scalp and under the chin is often necessary. A large part of the forehead lifting and neck lifting are performed from here.
The incisions scars are not seen directly in the hair and under the chin zones. The incision behind the ear is also hidden by the auricle. The only problem is a scar which is in front of the ear. This can be easily concealed if scar placed in the folds of the ears. In the early period after surgery, the scar is visible while it is red.
What is the best age for surgery?
Depending on the facial structure, this surgery is often performed around 50-60 years of age. However, light-skinned men and women who have recently experienced significant weight changes can be made to full face lift at earlier ages.
The sagging of facial skin and soft fat tissues under the skin is very evident at these ages. However, facial aging symptoms usually begin in the 40s, but patients often expect the subsidence of this image.
In recent years it is seen that plastic surgeons in many places of the world are in an effort to retreat the total face lifting surgery age to much earlier periods. In other words, when the signs of old age appear on the patient’s face (around 40 years of age), they tell the patient; ‘let’s do these surgeries’ so that the effect of the surgery lasts much longer. According to the surgeons defending this idea, thus the younger patient will have more flexible and stretched tissues, that longer will be the tension effect that obtained on the surgery. Thus, the effect will continue for much longer.
What is the preparation phase?
As with other aesthetic surgeries, the face lift candidate should not have serious health problems. Generally, in this age group, high blood pressure and smoking cause problems in terms of surgery. Excessive smoking causes wounds that do not close at the incision zones, while high blood pressure is the cause of bleeding under the facial skin in the postoperative period. It is necessary to keep blood pressure at normal levels with drugs. The use of the blood thinners drugs such as Aspirin, vitamin E, blood coagulant drugs such as birth control pills should be on hold, the nutrient intake with unknown contents and of herbal origin should be stopped. Prescription drug users should contact their physicians.
Where should the surgery be performed?
Face lift operations should be performed in a full-fledged hospital. Although general anesthesia is the most appropriate option, it can be performed under sedation with local anesthesia. My operations last for 5-7 hours depending on additional procedures. It is appropriate to stay in the hospital for one or two days after the surgery. In particular, patients with high blood pressure should remain in the hospital until their blood pressure is controlled. Drains placed under skin flaps are taken before discharge from the hospital. On the first night, however, a light bandage will be applied. Despite having such an extensive area of operation, there is no pain in the total face lift operation. General swelling that occurs in the entire face reduced tremendously at the end of the second week, it takes 2-3 months to fully return to normal. The 15-20 day leave of absence duration is sufficient for almost all patients. At the early day’s after surgery incision places are reddened, the skin scar increasingly fades and disappear within a few months depending on the skin structure.
Postoperative problems and complications
Following facial lifting, the infection occurs almost entirely in a blood-degrading zone. Treatment is applied by use of intensive antibiotics and daily medical dressings. Bleeding presents a special condition for facelift patients. When the age group is taken into consideration, high tension is frequently observed in face lift patients. In these patients, blood pressure is not regular in the early hours after the surgery and this may cause bleeding under the facial skin within the first day. Although different figures are given in different series, this problem is seen in 2-4 of every 100 patients in general. The treatment is to determine and stop the location of the bleeding in the operating room.
The problems associated with facial nerves are those that lead to distress in the long term. The most serious complication of facelift surgery is facial paralysis due to damage to the nerves that stimulate the facial muscles. This situation may be common, limited, permanent or temporary.
The temporary, limited to a certain area, muscle weakness is rarely seen, but this case is eliminated within a few weeks postoperatively. There may be cases that extend up to 2-3 months. It is necessary to explain the detailed situation and support the patient.
Permanent facial paralysis (in a certain area of the face or widespread), rarely seen, is the most serious complication of facelift surgery. It is not a case experienced surgeons encounter.
In addition, displacement of the hairline, hair loss around the incision, enlarged scars, pulling down of the earlobe, inability to correct the bands on the neck, a taut and pressed facial expression are results of inappropriate surgical techniques rather than post-operative surgery. Although these conditions are uncomfortable for the patient, the patient accepts this condition for a long time because the correction requires a new operation.
Frequently Asked Questions
Why do the friends from my surroundings who have had this operation come to me like a stranger?
Face lift surgery is done to rejuvenate, not to differentiate one’s face. The main objective is to reverse the changes that have occurred in the last 10-15 years. If these procedures are made insufficient or incorrect, this operation, which claims to rejuvenate the person, unfortunately, goes away from its goal and that person is no longer your usual friend. Thanks to deep two-layer lifting method that we apply, the problem of this metamorphosis that we have been using as “stranger” has been eliminated.
Can I have this surgery again in later years?
Depending on the duration of action of the first surgery, the second or even the third face lift operations can be performed. However, it is often sufficient for the patient to make lipofilling supplements to the face.