Facelift

About Facelift

A facelift, or rhytidectomy, is a cosmetic operation that repositions sagging tissues of the lower face and neck to reduce visible signs of aging such as jowls and deep folds. Early facelifts in the early twentieth century simply removed and tightened skin. In the 1970s the Swedish surgeon Tord Skoog described lifting the deeper layer of the face, and the superficial musculoaponeurotic system, or SMAS, was characterized by Mitz and Peyronie in 1976. Lifting or folding this layer gives more natural and longer lasting results than skin tightening alone. Deep plane and composite techniques release and reposition the deeper tissues of the midface as a single unit. The incision usually begins in or along the temporal hairline, follows the natural crease in front of the ear, passes around the earlobe and ends behind the ear in the hairline. The skin is lifted, the SMAS is tightened by plication, imbrication or SMASectomy, excess skin is trimmed, and the incisions are closed carefully to minimize visible scarring. A neck lift with tightening of the platysma muscle is often combined, and fat grafting may restore lost volume. Bruising and swelling resolve gradually over the following weeks. The most common complication is a hematoma, a collection of blood under the skin, which may need prompt drainage; others include injury to branches of the facial nerve, which is usually temporary, skin loss at flap edges, particularly in smokers, hair loss near incisions, visible scars and asymmetry. The face continues to age after surgery. Nonsurgical treatments such as fillers, energy based devices and threads produce more limited changes.