Facelift, Neck and Brow Lifts
FACELIFT, NECK LIFT, FOREHEAD/BROW LIFT, SCARLESS LASER FACELIFT
A facelift, technically known as a rhytidectomy (literally, surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful appearance. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient’s face and neck. The technique has evolved from short incisions in front and behind the ears to longer incisions into the temple and neck hairline including elevating the muscle deep to the skin and the tissues overlying the facial bones. With the advancement of endoscopic techniques twenty years ago we are capable of performing face and brow lifts through shorter inconspicuous incisions in the hairline or inside the eyelids. The muscles and deeper tissues are thus elevated, stretched and sutured into position with special sutures. Not only does this decrease the visibility and shorten the scar, it also diminishes decreased sensitivity and swelling.
The NECK AND LOWER FACE LIFT are usually addressed from an incision behind the ear, extending just around and in front of the earlobe. Through this incision the skin and muscles are elevated and sutured back and up. Liposculpture of the jaw line provides additional improvement in contour and longevity of results. The upper and central face is approached by extending the incision in front of the ear for the central face or into the scalp to raise the outer brows and temples. Procedures last two to four hours depending on the areas addressed. In most cases they are performed under conscious sedation; general anesthesia is not necessary. Sutures are removed at one week at which time swelling and bruising have subsided enough to return to social situations.
PRECISION TX is a newer application of the Sidelaze by Cynosure. A one time internal Laser treatment of the neck and jowls now provides long lasting tightening and lift without the scars associated with the neck lift surgery. This procedure may be performed with a neck and jowl liposuction for individuals with more fat in the neck. Minimal downtime and scarring combined with lasting results make this an ideal treatment for the younger to middle age patient.
The THREAD LIFT incorporates using fine barbed sutures inserted through small incisions in the scalp to lift the brow or from behind the earl to below the chin to tighten the neck. Marked as a less invasive technique for face and brow lifting experience has shown that results are usually not long-lasting. This technique is useful to suspend the face and brow tissues once they have been dissected and elevated.
FAT INJECTIONS to the smile lines from the nose to the corner of the mouth, the lower chin, lips, eyelid/cheek grooves and overlying the cheek bones are growing in popularity. Natural looking, long-lasting results (they may be permanent) make this a hugely versatile result. Plumping of the cheeks, outer upper and lower eyelids and jaw line, smile lines and brows for many can rejuvenate the face as much as a facelift. Fat is harvested with a 2.5 mm cannulae using local anesthesia from most unwanted fatty areas. Injection of the fat with a small blunt cannulae makes this a safe and effective procedure with less risk, scarring and downtime. Patients usually leave the office after 2 hours looking better than when they arrived. Typically swelling and bruising resolve within days; pain is minimal to none. Facial fat injections are successful in 2/3 of the time. The remaining patients experience loss of the fat which may be irregular. This can be corrected by further injections. In any event injected fat stimulates new collagen formation resulting in smoother, more youthful appearing skin.
Non-invasive radio-frequency, IPL and infra-red light machines have to shown to tighten and smooth the skin by heating of the deeper tissues. Results may be short-lived, requiring repeat treatments. IPL, intense pulsed light is best suited for correction of uneven skin coloration, brown and red scars and redness due to inflammation in the skin. Three or more treatments are required to obtain significant results. E-light is a combination of IPL and radio-frequency. This combination of energies by heating the deeper skin and activating the more superficial layers tightens, smooths and evens out difference in skin color. Higher powered radio-frequency treatments will significantly tighten the skin by stimulating collagen production. This energy based tightening should be repeated two to three times followed by yearly maintenance.
Copyright © 2011, Luis A. Cenedese, M.D. F.A.C.S., Beaute des Arts Institute. All rights reserved.
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