Face lift

Not everyone accepts the signs of aging as something naturally associated with the passage of time. Thousands of people have reversed these visible signs of aging through a procedure commonly referred to as a "face lift." This name has become so popular that it has entered the dictionary as a synonym for rejuvenation and beautification. For most patients, a facelift is not only an improvement in physical appearance but also an enhancement of their well-being, making them feel psychologically rejuvenated and energized.

Many people in their forties opt for a facelift surgery to improve facial features and restore a youthful appearance. Currently, there is a trend among people in their thirties to undergo milder facial lifts. Gentler procedures include cheek lifting (mid-face lift) and less invasive temple lifting (lateral brow lift).

A facelift can either significantly rejuvenate the face or just subtly "refresh" it. You can choose between rejuvenation and altering appearance. A facelift won't change who you are, but it can restore a youthful appearance to a tired face. If you feel you look older than you feel, a facelift can match your youthful spirit with your appearance.

A facelift (rhytidectomy) is a surgical procedure aimed at reducing sagging and wrinkling tissue in the middle and lower parts of the face and neck. It does not address issues around the eyes or wrinkles around the mouth. Facelift surgery can be chosen for two reasons: to halt the progression of aging, i.e., to help relatively young patients (around 40 years old) maintain a youthful appearance or to assist those who already have extensive wrinkles and sagging facial skin in regaining a youthful look. The success of the operation depends on the amount of wrinkles and sagging tissue. If they are minimal, the results of the surgery may seem very subtle, but they largely halt the aging process. If the condition of the facial skin is worse, i.e., wrinkles cover large areas, then the results of the surgery are very noticeable. This procedure aims to rejuvenate the appearance of the face and neck by tightening and removing excess skin and fat tissue, often combined with repositioning sagging muscles to their proper place.

Best candidates:

•     Firstly, the person undergoing the procedure should be in good health, without any active diseases or pre-disease conditions, and should have realistic expectations regarding the results of the surgery. Good communication is crucial at this stage to express expectations so that the surgeon knows how to achieve the desired effect.
•     To undergo surgery, one should be in a stable emotional and mental state. This is a procedure that requires patience, especially regarding the wound healing process. It happens that after surgery, the patient is in a worse mental state, so it is important that the condition is good before the surgery. Please consider this before undergoing the surgery. If you meet the above requirements and want to get rid of sagging skin on your face and neck, you are a good candidate for a facelift.
•     If you plan to undergo weight loss treatment, you should refrain from a facelift until you reach your desired weight. After significant weight loss, you may need additional surgery to remove excess skin, which means that if you undergo a facelift earlier, you will lose money, time, and effort.
•     Face lifting is a very individual procedure. During the initial consultation, the condition of facial tissues, both skin and deeper layers - including bone structure, is evaluated. Overall health is assessed: hypertension, coagulation disorders, tendency to form abnormal scars, smoking, medication use - especially aspirin.

Types of facelifts:

•     There are several available facelift techniques. Some procedures correct the entire face or most areas, while others have been developed to improve specific areas only. Techniques also have their various variations, often combined - this depends on the surgeon.
•     Standard, conventional, or traditional facelift: Its goal is to lift sagging skin and (sometimes also) deeper structures. Incisions are made along or behind the hairline. Excess skin is excised, and the rest is stretched and stitched. Some surgeons only perform skin lifting, while others also include fatty tissue and muscles.
•     SMAS (superficial musculoaponeurotic system) lift: The SMAS is responsible for facial expressions. Without it, we wouldn't be able to smile, frown, etc. This area is lifted and stretched diagonally - this would be the best way to describe this technique. It can be performed together with a lift of the platysma muscle (wide neck muscle) to complement the rejuvenating effect.
•     Platysma muscle lift: Combined with SMAS lifting, it is considered by many surgeons to be the best procedure for sagging and flabby skin of the neck and chin. In this procedure, the platysma muscle is tightened, and then stitched, and sagging skin and excess fat tissue are removed. It is possible to undergo only a platysma muscle lift if only neck areas are a problem. Many young men undergo this procedure.
•     S-Lift: This procedure was invented in the 1960s and perfected by German surgeons before being used in the United States. The procedure can be performed on patients aged 40 to 80 and older. The incision is made precisely in front of the ear, and then layers are pulled to the side. The procedure improves the appearance of the lower third of the face. The jawline, chin, and neck can be significantly smoothed in this way.
•     Mini Lift: Some surgeons treat the above-described method as one of the variants of the Mini Lift. This procedure lifts the nasolabial folds. Many doctors offer patients a mid-face and cheek lift to tighten the middle part of the face vertically.
•     Mini Lift (with suspension): In this operation, stitches are anchored in the lower muscle tissue using surgical hooks. The muscles are stitched and attached using non-absorbable threads to the front. Another option is to insert a small screw into the skull and hang threads on it.
•     Temporal lift (side lift, lateral brow lift): It is a lateral-diagonal lift that can achieve an exotic appearance of the outer eyebrow arch and also an exotic cat-like appearance. Folds and small wrinkles on the forehead, in the area between the eyebrows, and crow's feet can also be removed. The temporal lift also lifts the cheek skin, allowing you to sharpen the cheekbone features, where the fatty tissue and skin have sagged. This lift is considered to be very tight, which can stretch and widen scars.

Surgery procedure:

Facelift surgery usually takes 3 to 6 hours. If the surgery also includes the platysma muscle, the time is closer to 6 hours.

•     The procedure is most often performed under local anesthesia combined with intravenous anesthesia (analgesia). For most of the surgery, the patient sleeps, feeling no discomfort. Details are determined during the preoperative consultation with the anesthesiologist.
•     The incision is made from the temple area, down just in front of the earlobes, under the earlobe, the surgeon bends the line, circling the ear and slightly upwards and backwards into the hair. If the neck is also operated on, a small incision may be made under the chin. Then, the surgeon detaches the tissues from the structures lining them, depending on the type of lift and desired results. This procedure involves detaching the skin and muscles from the skull. The surgeon then cuts off excess skin, removes excess fatty tissue, and possibly atrophied muscles. The lining structures are then suspended using non-absorbable sutures, of course if it is part of the technique you chose. Finally, the surgeon will stretch the skin to the appropriate degree and close the site with non-absorbable sutures and staples (the latter in the case of incisions on the scalp).
•     Drains are often placed behind the ear for a short period to collect and drain accumulating blood. The doctor also applies a dressing to protect the wounds, keep the tissue in place, and prevent swelling and displacement. This means that the dressing will extend from the top of the head to the chin, and often also behind the ears.

Postoperative course

•     You may feel numb due to anesthesia and medications, and you probably won't remember much for a day or two. You will need to rest. You will also need to keep your head elevated for about 14 days after surgery - depending on the surgeon's recommendation. REMEMBER TO KEEP YOUR HEAD STEADY. Do not turn your head from side to side - TURN YOUR WHOLE BODY. When you wake up, you may notice that your face is more swollen for the first three days. Swelling typically becomes more noticeable in the evening, and by the third day, it is usually at its peak. Over time, the swelling will subside. Bruises will also fade away. So mentally prepare yourself for your initial appearance - bruising and swelling are a normal part of most plastic surgeries. Don't worry, everything is part of the natural healing process. You shouldn't scrutinize yourself in the mirror but let the nurses take care of you.
•     Your back will hurt because you won't be able to lie completely straight. Some patients prefer warm compresses or hot water bottles.
•     Stitches will be removed after 5-7 days, and staples after about 10 days. The scalp skin takes longer to heal.
•     The scalp skin may be numb to the touch - you shouldn't worry about it. It's entirely normal because some nerves have been disconnected from their source. Give them time to regenerate; they need it just like you do. Try to rest and not do too much shortly after surgery. You should feel better within a few days of surgery, but if not, don't blame yourself.