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Face Lift Article for Body Language

The number of patients undergoing facial rejuvenation continues to increase with a 44% increase in the last year alone (British Association of Plastic Surgeons audit figures 2006). Over 90% of these are performed on women. In recent years there has been a number of changes in facial rejuvenation surgery.

Older techniques can produce an unnatural ‘windblown’ appearance and were generally performed on patients in their fifties and sixties. More modern techniques produce less dramatic transformations and are often performed on patients in their forties. It is during this decade that many of the gravitational ageing changes occur and the emphasis has changed to maintaining a youthful fresh appearance rather than producing dramatic alterations later in life.

All patients undergoing facial rejuvenation procedures require thorough medical assessment. This will include cardiovascular and respiratory examination and appropriate tests. Approximately 10% of patients are unsuitable for operative treatment and are offered non-surgical options such as facial peels and dermal filler injections. These procedures can produce considerable improvement without surgery.

Common facial rejuvenation procedures include:

Eyelid surgery (Blepharoplasty) – this involves reducing the skin fold of the upper eyelid and leaves a scar concealed in the eyelid fold.

In a lower blepharoplasty and incision is made under the eyelashes extending out into a natural fold. Puffiness can be reduced by removing or redistributing the fat pads of the lower lid. Any skin excess is treated by direct skin excision. It is extremely important that this is performed judiciously as excess skin removal can pull the eyelid down away from the eye (ectropian).

Traditional face lift – this elevates the jowl and neck regions. They are best suited to patients over 40 who have significant laxity in the neck region. The incisions are located in the hair line of the temple, in the fold in front, in the sulcus behind the ear and backwards into the hairline.

A traditional face and neck lifts produce a dramatic change which is often hard to conceal. Because of this many people are now choosing to undergo less invasive procedures such as the MACS-lift at an earlier age. MACS stands for Minimal Access Cranial Suspension. The procedure is minimal access because in contrast to traditional face-lifts there is no incision behind the ear. The deep tissues of the face are returned to their original position with permanent stitches secured to the deep fascia of the temple region (cranial suspension).

During the forties and early fifties gravitational changes are usually confined to the cheek and jowl region and are often best treated with a MACS-lift. From the mid forties onwards laxity develops in the neck region and this is often best treated by a more conventional face and neck lifting procedure.

Facial rejuvenation surgery is a relatively specialised area of Plastic and Cosmetic Surgery and is not performed by all Plastic Surgeons. As with any surgical procedure the more experience the surgeon has in the particular field the better the results are likely to be. Most Surgeons who specialise in facial rejuvenation will be able to provide:

• Detailed information leaflets about the procedure.
• Before and after pictures of patients who have undergone surgery.
• Data on how many of each procedure they perform a year.
• Analysis of the outcome of these procedures.
• Contact information of previous patients who have recently undergone surgery.

I perform over 100 facial rejuvenation procedures per year. The majority of these patients also have one or more ancillary procedures which can include:

• Upper or lower blepharoplasty in which excessive skin or puffiness caused by fat pad herniation is reduced
• Brow lift procedures for patients with low lying eyebrows. Elevation of the eyebrows in these selected patients produces a rejuvenated fresh appearance.
• A glycolic or acetic acid peel which improves the condition of the skin and removes fine lines
• Liposculpture – in this procedure fat is removed by suction from either the flanks, abdomen of inner knee area. It is then injected under the skin in areas which have lost volume. These typically include the lips, naso-labial lines, marionette lines and the transverse fold above the chin. Fat transfer is considered a semi-permanent solution. In some patients the correction is permanent in others the fat slowly dissolves over the following year.

In recent years we have seen a dramatic increase in the number of people considering facial rejuvenation surgery. Each person ages differently and it is important to analyse the face thoroughly. The assessment should include:

1. The condition of the skin
2. Active lines caused by underlying muscle contraction
3. Gravitational lines caused by downwards migration of the facial structures

To achieve an harmonious appearance each of the above need to be addressed. The skin by chemical peels or laser treatment, active lines with muscle relaxing injections and gravitational changes with surgery. In many cases surgery is inappropriate and attention should be focused on the other areas.

Facial rejuvenation surgery is a very satisfying speciality and when performed for the right indications can produce very pleasing long term results and is associated with a high degree of patient satisfaction. It is however very important to stress to the patients that this is elective, non-life saving surgery that does have complications and should not be undertaken lightly.

About the Author

The Gatehouse Clinic combines the experience of specialist of Plastic Surgery, Nurses and specially trained beauty therapist to ensue you receive the best possible treatment and advice.