Facelift & Necklift
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Though there are other non-surgical procedures for facial rejuvenation such as radiofrequency, lasers, thread lifts, HIFU, etc these temporary procedures act on the superficial layers of the skin benefitting only 10 to 30 % of moderately aged skin.
Face Lift and Neck Lift
- Types of Facelift : Face and neck can be divided into upper, mid and lower face and the neck as Upper facelift or forehead- brow lift, mid facelift, lower facelift and neck lift.
- Upper Facelift : This involves taking care of the forehead and the eyebrows. In the upper facelift, the wrinkles of the forehead are corrected and eyebrows which tend to flatten with age are lifted. Depending on the amount of sagging and wrinkling, various methods have been devised including endoscopic methods with very small cuts. The cuts of upper facelifts are hidden in the hair.
- Mid Facelift : Midface lift tightens the cheek and the malar area. Of all the types of the facelift, this is the most commonly done. It can be done alone or as a part of a full facelift surgery. Different types of procedures and cuts have been described for mid facelift surgery. The approach is through the hair in the temporal area which is not seen. Endoscopes are used to reach down up to the cheek and pull the descending cheek from a hidden cut in the hairs, thus making the procedure “SCARLESS”. Mid facelift can correct the sagging of the lower part of the face also if the sagging is not too much.
- Lower Facelift : Lower facelift surgery tightens the skin in the lower part of the face, including the jowls. The cut for this type of facelift surgery is in the ear lobule crease and goes around the ear lobule to the back of the ear.
- Neck Lift: Through the cut of the lower facelift, the sagging skin of the neck can also be addressed. The neck skin can be redraped and the excess skin trimmed at the back of the ear.
- Neck Bands Correction : Often there are neck bands which are due to loose neck muscle called as Platysma. These bands are on the sides of the midline and are addressed by a small cut under the chin to tighten the skin.
- Assessment for Facelift : A detailed examination of face and neck is undertaken to understand which areas show maximum effects of aging. Very often surgical and non-surgical procedures are both combined to give the best results. One must understand that anyone procedure may not be the solution and a combination of treatments may be devised to correct the problem. For example, a facelift procedure can correct the sagging of the skin of the cheek but cannot correct the flatness of the cheek which happens due to the aging. An ancillary procedure may be required alongside for best results.
- Assessment of Eyes : The most important assessment after the assessment of the face is the assessment of the eyes. Under eye area show the signs of aging alongside that of the face like under eye bags and wrinkling of the skin. These changes cannot be corrected by facelift surgery and will require another type of surgery called blepharoplasty.
- Role of the Patient During a Facelift Consultation : All the areas of the face merge into one although it is often described in parts. Any change in one part of the face reflects in the other part and thus a bit of insight is expected from the patient. Also, the eyes, upper and lower eyelids, eyebrows and nose also show some effects of aging and the clinician may not be able to show or emulate all the corrections simultaneously.
- Morphing Software : Very often the patients expect the clinician to show the changes on the computer. In the opinion of Dr. Anshuman Manaswi, the changes in the computer act as guidelines only. Many times such changes, especially in the face is not possible or possible only to a limited extent because the face is three-dimensional structures and DOCTORS ARE NOT SOFTWARE EXPERTS.