General information
Operational interventions for the purpose of face rejuvenation are being carried out for more than one hundred years. In the course of time face skin starts to change essentially, its cells divide slower, dermis (deeper layer of skin), becomes thinner. The dermis consists of several types of tissue, mostly elastin and collagen. Elastin gives to skin elasticity, and collagen keeps its flexible.
But sooner or later both components start to «grow old», forcing our skin to change as well. Loss of elasticity and decrease of flexibility create conditions for more intensive manifestation of aging effect on the entire depth of skin and muscular tissue of facial area. Wrinkles and deep folds start to appear on the skin, age changes of the entire shape of the face begin to form.
The face lifting is unable to eliminate all age changes of skin, but, at least, it can reverse many visible consequences of time. In 2005 only in Europe and the USA more than five hundred thousand people paid money for new youth, for new look and underwent procedure of face, forehead or neck lifting. The surgery of face lifting is developed and intended for recovery of younger look of the person, eliminating deep wrinkles and folds, supporting weakening skin and face muscles. The majority of people after procedure of a face lifting look 10 years younger, and the standard guaranteed result of a face lifting remains 7-10 years.
Surgery planning
Face skin reconstruction is a procedure that requires individual approach. Therefore at this stage detailed examination of the patient’s face, his personal anatomy and bone structures is extremely important. The plastic surgeon shall study in detail complete medical history of the patient, and the patient shall ask the doctor about expectations, possible concerns and chances to get desirable result.
After the analysis of photos and necessary number of consultations together with the plastic surgeon, patient’s expectations from the face uplift surgery are shaped up into an exact idea.
Preparation for surgery
Preparation for surgery begins with passing a full medical examination and ends with the complete list of surgeon’s recommendations for the postoperative period.
At preliminary examination all standard medical tests shall be undergone: general blood analysis, common urine analysis, biochemical blood assay, blood electrolytes, blood analysis for syphilis, HIV, hepatitis, ECG. In case of any counter-indications based upon tests, in-depth examination is carried out: full scale biochemical blood analysis, ultrasound examination of internal organs, supplementary consultations with specialists.
Serious attention shall be paid to general physical condition of the patient, particularly, the patient must quit smoking and alcohol consumption, stop taking hormonal and psychotropic medication. Special attention is paid to abstention within 10-14 days from taking medication, which increases the risk of postoperative hemorrhage. Hair shall be long enough to hide post-surgical hems. In case of necessity hair can be colored, as next such opportunity will occur one month after the surgery. At least two weeks prior to the operation it is necessary to stop getting sun tan. The surgery, preferably, shall be carried out in the beginning or in the middle of the menstrual cycle.
Preparation to the surgery also includes discussion of patient’s wishes and possibilities of their realization. For this purpose it is recommended to look at the photos of people taken after similar surgeries. On the day of surgery antibacterial and antiviral medication is prescribed, which shall be taken for necessary period of time in order to prevent viral and bacterial infection. No food shall be taken for 6-8 hours prior to the surgery, yet some anesthesiologists allow a few sips of water 2 hours prior to the surgery. It is vitally important to discuss and sign the medical services contract prior to the surgery.
The surgery
Face uplift plastic surgery is a rather complicated procedure. The surgery is carried out under general anesthesia.
The technique of the surgery is individual for each patient and is conditioned by personal plan of the surgery. Type of anesthesia also depends on individual peculiarities of the patient, as well as on the level of planes operative intervention. In any case, the anesthesiologist shall apply necessary medication, which allow not to feel any pain during the entire operation, thus guaranteeing full safety and minimal post-surgical discomfort. The entire procedure usually takes from 1 to 3 hours, depending on surgical technique applied, peculiarities of facial structure, tasks and objectives, defined before the surgery.
Each surgeon achieves specified goals by his own, the only correct in the particular case, method and technique of surgery. Depending on peculiarities of muscular structure and professional skills, the surgeon selects methodology of the surgery. The doctor may carry out manipulations on one side of the face and then go to the other side. Alternatively he can, in maximally coordinated manner, carry out the surgery on the entire face.
Location of sections is conditioned by the area of uplift of skin and muscular tissue. In case of chicks uplift the section is made from the temporal region, a bit above the hairline, along the ear contour; in case of surgeries on tissues of the lower thirds of the face — inside the mouth cavity, in case of forehead skin uplift – in parietal region; if the surgery is carried out on neck tissues – along the fold under the chin. In any case, the surgeon separates the skin from fat along the edges of the muscular tissue. Further, the superficial muscles are lifted and relocated. Then the surgeon clamps muscular and connecting tissues, draws the skin up and backwards, removes excess skin and puts required number of stitches. Excess fat is removed from the areas of neck, chin, and lower third of the face in order to improve its shape and contour. On flat skin zones of the head application of metallic clips is possible. For removal of lymph and remnants of blood a subcutaneous drain is placed behind the auricle. Necessary bandages are applied at the end of the surgery.
Presently, following main options and methods of face uplift exist:
- Mini lifting.
- S-lifting.
- SMAS-lifting .
- Week-end lifting or holiday lifting.
- Lifting with application of Aptos sutures.
- In-depth face lifting.
- Subperiosteal face lifting.
- Composite face lifting.
- Tumescent face lifting.
Postoperative period
Time of stay at the hospital usually is 1-2 days. After discharge the surgeon shall provide you with necessary recommendations for postoperative incremental recovery of usual lifestyle. They are as follows: during one week within the postoperative period it is necessary to wear a special compression mask.
In majority of cases the postoperative edema significantly rows on the second-third day after the surgery, dissipates by the end of the first week and completely disappears within three weeks. Often temporary reduction of skin sensitivity is observed. Period of recovery – from few weeks to several months. It is necessary to exercise caution, as reduction of skin sensitivity increases the risk of burns and other injuries.
Stitches are taken out after a week. From that moment on you should treat your new face with special care – its skin and subdermal muscles are not used to the new condition, shape and size. You can wash your hair after 7-10 days with moderately warm water; however, you cannot color it earlier than after one month. Use of makeup is allowed within a week after the surgery provided normal healing of stitches.
After the surgery:
- avoid intensive physical activity, including sexual.
- do not engage into heavy housework, at least for two weeks.
- set yourself for quiet walks, healthy food and tranquil, maximally ordered life.
- exclude alcohol, smoking, sauna for not less, than several months.
For some patients it is specific to experience undue fatigability and certain psychological oppression within the first two weeks after the surgery. Yet, already within a month after completion of recommended lymphatic drainage massage you will be able to value real results of the plastic surgery. The patient shall be happy and satisfied, it will only take him to get used to the new look, new haircut and new skin.