FACE Lift surgery
FACE lift surgery is an exciting facial rejuvenative procedure, wherein we attempt to improve the aftereffects of nature beating on ones skin. The ravaging effects of sunlight, gravity, ageing take a massive toll on the skin of the face and lead to drooping jowles, hollowness in the cheek region, eyelid sagging etc, making one older than one really is.
A short tour
A number of face lift procedures are available for different indications. some surgeons perform skin only procedures, some perform SMAS resection procedrues, other plicate the SMAS, and some surgeons perform the sub periosteal procedures. Thread Lift procedures are also becoming common due to their relative ease and low post operative morbidity.
Procedures
Thread Lift (for face lift procedures)
This involves passing of barbed, silhoutte, or ribbons in a subcutaneous plane and providing a cephalic traction on the face skin to elevate in upwards. Since this is a skin only procedure, it applies only to early age related face changes, and practically the effects would last for 1-2 years only, though some surgeons claim effects to be lasting for 8-10 years. This is arguable since SMAS is not worked upon and skin is also not being resected, so it is bound to fall back
Similary skin only procedures produce limited results for a short period, as SMAS is not being operated upon. There is a higher rate of redo procedures in skn only face lift
MACS Lift
A excellent operative procedure with very early return to work and low morbidity. The simplicity of the procedure and the very predictive results make this procedure easier to learn and practice. The trichophytic closure allows the scar to be hidden and no disturbance of hair growth in the temple region. No posterior scar allows no disturbance of the hair line, and the stratgic location of the incision near the ear allows good tragus position, preventing any of the stigma of surgery from occuring.
However MACS lift is not a good procedure if one is dealing with a very heavy neck, and in addition the MACS produces a bulge near the malar region, because of the vertical direction of the pull of SMAS. Now this bulge can be a bit troublesome for those who never had a bulk cheek / malar region. Thus it is very important to look at previous photographs of the patient before suggesting the procedure to avoid dissapointments
SMAS resection
Many surgeons claim this to be best procedure since this would procedure the best SMAS traction. However this procedure requires the highest training since SMAS resection is a difficult procedure and one needs to be very exact. Any faulty plane of resection will lead to a facial nerve injury, which can be disastrous.
SMAS plication
This is the most common procedure, Most surgeons perform an oblique vertical pull on the SMAS, the plication of course adds a bit of bulk on the skin , and again good pre operative discussions are requires to understand the requirements of the patient. However the Plication procedures are very flexible and specific areas can be pulled up to effect the required changes. These and the previous procedures also allow good neck control, since the platysma is also manipulated. It is important to make sure that the hair line is not disturbed and there is no ear deformity.
