Facelift surgery

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Facelift surgery

The surgical procedure to correct the defects such as wrinkles and sagging in the neck and face due to aging is called “Face Lift” or “Ritidectomia” in the medical language. In this surgery, excessive sagging skin is removed, loose muscular and membranous tissues under the skin are tightened, the upper skin is placed on the shaped subcutaneous tissue. Non-surgical operations in facial aesthetics surgeries have become widespread nowadays. The treatments such as Botox, fillers, and laser-powered devices are applied. Thanks to these methods, the permanence of these surgeries can last for many years and it is possible to look youthful for a long time. Non-surgical operations in facial aesthetics surgeries have become widespread nowadays. The methods such as Botox, filling, and laser-powered devices are applied. Thanks to these methods, the duration of these surgeries can last for many years and it is possible to look youthful for a long time. Although it varies from person to person, the face can look young until the age of 50s. When these surgeries are continuously performed at certain intervals in certain periods of time, the period of this youthful appearance is prolonged.

What do we do in facelift surgery?

The most important factor in facelift surgery is to consider the face as a whole. In facelift surgeries, facial areas are all considered as a whole due to being interrelated to each other, rather than focusing on each separate part. Only if the face is proportioned completely, good results can be achieved. Facelift surgeries with minimal scars can now be performed more frequently in patients who have sagging in the middle face. However, a full facelift is necessary for the patients whose cheeks are sagging downwards to the double-chin. Neck lift can also be applied to these patients.

With a combination of neck lift, face and neck rejuvenation can be achieved. The experience of the doctor is very important in facelift surgeries. The protection of the anatomical structures and facial nerves during the surgery has great importance yet our patients have concerns and fears about this matter In facelift surgeries, we lift subcutaneous tissues, resulting in a facial rejuvenation. The other facial rejuvenation way is to combine facelift with the laser facial renewal procedure. With the application of the laser systems developed recently, including especially fractional lasers, the face can be rejuvenated, the outer part can look brighter and fine wrinkles can be eliminated. In this way, in the consideration of the face as a whole, the facial needs are determined and then a combination procedure is applied. As a result, our patients can achieve a completely new face structure in a period of 15-20 days. Endoscopic facelift can be added to facelift.

Especially in patients whose buccal fat pads and cheekbones sag down, having the flattened face called negative vector or disappearance of cheekbones; mid-face can be lifted up by inserting with a camera into an incision made at the temple. Of course, in these surgeries, it is possible to get a balanced and symmetric mid-face and to obtain a long-term result by stitching this area on the bone. With these procedures to be applied in this way, our patients can look 10-15 years younger, depending on their facial deformations. Of course, to perform the right surgery on the right patient is one of the most important factors affecting the permanence of rejuvenation. If we apply wrong facelift surgery to the wrong patient, we cannot obtain successful rejuvenation.

Besides, as I said in the postoperative period, it is possible to perform this facelift treatment perfectly by applying thermal procedures or stem cell applications. Facelift surgery is now one of the most important surgeries applied to individuals who want to look younger in social life, as a part of the highly safe and non-scary combinations.

Mid-face Lift Surgery

Mid-face lift has become very popular recently in particular because one of the most important complementary components of the golden triangle of the face is our mid-face. Our mid-face is the area lying between the lower eyelids and mouth. Especially in patients whose buccal fat pads and cheekbones sag down, having the flattened face called negative vector or disappearance of cheekbones; mid-face can be lifted up by inserting with a camera into an incision made at the temple. Of course, in these surgeries, it is possible to get a balanced and symmetric midface and to obtain a long-term result by stitching this area on the bone. Mid-face lift surgeries are performed by inserting an endoscope into incision from the temporal area, resulting in long-lasting rejuvenation. The lower eyelid and upper eyelid surgeries can be combined with this surgery.

Endoscopic mid-face lift

An important part of the face is the cheekbone. Since the buccal adipose tissue sags down, the cheeks can become indistinct, called the negative vector. In this case, we perform the endoscopic mid-face lift. It is based on the surgery performed by removing the fat pads after releasing mid-face areas with an incision made into the temporal area along the cheekbone. Rejuvenation of our patient is achieved especially by lifting up the adipose tissue that has sagged down. We are able to achieve a permanent mid-face rejuvenation by endoscopic mid-face lift, an operation applied by inserting into the temporal area via a camera, shifting all these tissues in place and lifting this area up. Of course, people who are not surgeons are trying to do this treatment with threads we call thread-lift. In fact, since they cannot perform endoscopic mid-face lift, they try to perform thread-lift, but the lifetime of these threads is very short; because we have many facial expressions. Even if thin threads with surgical sutures are used for lifting up, the face is going to return to its old form within 3-6 months due to mimic movements.

People who have experience of plastic surgery and knowledge about facial lift and mid-face lift plastic surgeries do not use and perform thread-lift, because its results last very short. Also, lower eyelid aesthetics and upper eyelid aesthetics can also be performed, if there is loosening in the lower eyelid of patients who have undergone mid-face lift. Of course, when we insert into the temporal area, an endoscopic forehead lift and eyebrow lift surgery can be combined for the patients who have a sad expression especially in the temporal area or in eyebrows or a drooping eyebrow expression; this surgery can be applied alone in the upper face rejuvenation. In facial rejuvenation, Botox applications are applied not only to lift eyebrows with the simplest technique, if requested a permanent brow lift, an endoscopic forehead lift or temporal lift procedures can also be performed. With this procedure, all tissues under the eyebrows are separated from the bone and released with an incision made at the temple line. The result of this surgery lasts so long because we can ultimately achieve a youthful upper area and eliminate crow’s feet. In addition to the endoscopic mid-face lift and forehead lift, I would like to mention eyelid aesthetics due to the drooping of upper eyelids.

In which cases is facelift performed?

  • If your face has significant sagging and drooping,
  • If there is a deep fold between the lip and cheek,
  • If the soft tissue has become distinct in the area between the cheek area and lower eyelid,
  • If the tear groove is deepened and sags down to the cheek,
  • If the subcutaneous soft tissue that gives fullness and vitality to the face has lost its volume, and if the remaining part has sagged,
  • If a double-chin occurs under the jaw after the lip corners and cheeks sag down,
  • If thin or thick lines occur on the facial skin,
  • If there are sagging and noticeable wrinkles on the neck skin,

If all these developments adversely affect the person both physically and psychologically,facelift can be applied.

Procedures to Carry Out in Addition to Facelift

One of the other factors that affect the success of facelift surgery is the complementary procedures combined with facelift. While face rejuvenation is usually achieved in the middle and lower face during facelift surgery, we can also perform the eyelid lower and upper eyelid aesthetics surgeries as a combination with this facelift in order to rejuvenate the upper face. Additionally, eyebrow lift, temple lift, eyebrow lift, forehead lift surgeries can be combined with facelift surgery. During facelift surgery, mid-face fat injections can also be applied or buccal fat pads of people who have a round and chubby face can be removed by inserting from the inside of the mouth. In other words, chubby cheeks are reduced by removing buccal fat pads or cheek fats that cause fullness in cheeks. As a combination of buccal fat removal with facelift, it is possible to achieve a triangular appearance on the face.

Who cannot have facelift?

  • For people who have serious health problems to prevent undergoing surgery and anaesthesia,
  • For smokers and/or people who have diseases that adversely affect the healing process and that disrupt the tissue nutrition like diabetes,
  • For people who have surreal expectations from the results of the surgery and who are not ready for this surgery physically and mentally,

Facelift surgeries should not be performed or should be performed cautiously.

How is facelift performed?

  • Depending on the course of treatment to be performed, partial sedation and local anaesthesia or general anaesthesia are used.
  • The surgery is performed with either traditional facelift incision that begins in the line at the temples, continues around the ear and ends in the lower scalp or with an incision that is made only in front of the earlobe. Depending on the course of the treatment in the neck, a second surgical incision can be made along the neckline under the chin.
  • After incisions are made, the skin and subcutaneous soft tissue are separated from each other in the planned area.
  • Underlying loose and sagging tissues and the membranous structures under the skin are tightened and lifted up and/or to the upper part in various ways.
  • Double-chin is corrected and tightened. If necessary, this area is reshaped by removing the subcutaneous adipose tissue with vacuumed liposuction.
  • The loose skin is placed again over the uplifted tissue; the excess skin is removed by lifting upwards and/or backwards.
  • The incision is properly sutured and a slightly pressed dressing is applied.

How is the postoperative period?

  • A mild pain can be controlled with medications after the surgery.
  • In order to facilitate the adhesion of the tissues to each other and to prevent fluid accumulation in the surgical site, a drain that absorbs fluid is placed and a slightly pressed dressing is applied.
  • Like all visible regional surgeries, a slight amount of swelling and bruising will occur.
  • Bed rest will be required by keeping the head in the upright position.
  • For a healthy follow-up and control, overnight hospitalization is needed.
  • At the end of the recovery period, the patients will have a vivid and rejuvenated face and neck appearance.

Facelift is one of the surgeries removing the signs of aging on the face. It is especially applied to lift sagging of cheeks, jawline, and neck. Facelift surgery is usually performed by using general anaesthesia and the surgery lasts for approximately 2,5-4 hours. In the full face and neck lift surgery, the skin of the cheek will be lifted up to a certain extent with an incision beginning from in front of ear lobe or in the hairline of the scalp, the sagging tissues are repositioned and fixed with sutures to new areas. Tissue and skin excesses are removed. In facelift surgery, a drain is placed to discharge the blood accumulated under the skin, and it is removed the next day.

  • Overnight hospitalization is required.
  • Sutures are removed within 5-7 days.
  • Oedema and bruises take 1-3 weeks to disappear.
  • In facelift surgery, the incision scars are easily hidden inside the hair.
  • Facelift surgery can be combined with surgeries such as facial fat injection, eyelid aesthetics, forehead lift, eyebrow lift.
  • At least 10 days before facelift surgery, blood thinners such as aspirin, vitamin E and medications should be discontinued.
  • Complications are more likely to occur in smokers.
  • Permanence of facelift surgery depends on the surgical technique used, the lifestyle of the patient and the nature of the skin.
  • Facelift surgery can be performed again after years.

What should be taken into consideration before facelift surgery?

Before facelift surgery, just like every preoperative period, the medications such as blood thinners should not be taken. Vitamin E and herbal teas should not be used. Smoking makes it more difficult for wounds to recover, especially in facelift surgeries. Therefore, smoking should be stopped approximately 3 weeks before facelift. Since the hair cannot be dyed 1 month after the surgery, the patient can make her hair dyed at least 1 week before the surgery. In addition, the long hair is useful to camouflage the dressings that will be used after the surgery.

What are the details of facelift surgery?

The facial skin is lifted with the surgical incision that begins from the scalp above the ear, continues in front of the earlobe and ends in the scalp beneath the ear. The soft tissue, which causes a facial sagging, is lifted by special stitches and the skin excess is removed. Thus, the loose skin in the cheek, jaw and temporal area disappears. Deep laugh lines at the mouth edges are corrected, resulting in a smoother appearance. Facelift is performed by applying general anaesthesia. Eyelid lift and neck lift aesthetics can be combined with facelift surgery, depending on the patient’s condition. If combined, the surgery process may be prolonged. Using the special suture and dressing materials, post-operative scars are minimized. As scars will be minimized on the scalp, they are not visible and do not cause a disturbing appearance from the outside. If the patient does not follow the necessary postoperative instructions, the problems such as bleeding, infection may occur, and the healing of the wounds may be delayed, resulting in the scars left in need of treatment.

What should be taken into consideration after facelift surgery?

On the next day after the surgery, the drain placed to prevent the accumulation of fluid behind the ear is removed. Postoperative ice application accelerates the recovery period. The patient may be discharged on the second day following the surgery. It may be recommended to wear sunglasses for a while after being discharged from the hospital. Sutures in the face and eyelids are removed within 1 week. On the 10th day, metal sutures inside the hair are removed. The patient can only take a bath 2 days after the surgery. The patient should act carefully while doing makeup and combing his/her hair. The patient can return to his/her normal life after the sutures have been removed. The patient should avoid activities such as the use of alcohol, steam bath and sauna for a few months and should protect the operated areas. The patient should use sunscreens regularly until 6 months. Swelling and bruises disappear within 3 weeks. Moreover, looks can be revitalized by applying Botox in the eye contour area and forehead area in order to enhance the effectiveness of facelift surgery. With the filling procedure applied around the mouth and lips, laugh lines can be reduced.

Author: Doç. Dr. Erdem Güven
We're writing about our patients.

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