Face Lift Surgery
Traditional Facelift
The surgeon begins the incision in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.
After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips, which permit surgery without shaving hair from the incision site. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia, the patient will experience little discomfort. Some surgeons prefer to use general anesthesia for facelifts. Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.
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SMAS (superficial musculoaponeurotic system) Lift
The "SMAS lift" is an emergent and highly effective approach to the traditional facelift. The fanlike superficial fascia (connective tissue) of the face and neck overlying the parotid and cheek area is referred to as the SMAS (superficial musculoaponeurotic system.) By partially mobilizing, redraping and reattaching the SMAS layer, the underlying structures are suspended back to where they were prior to the onset of the aging process. This technique has been shown to produce significant cheek elevation besides reducing sagging in the lower face and neck.
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Mini-Lifts
The development of minimally invasive techniques using small "puncture" incisions and sutures to reposition sagging and jowling have gained recent popularity and have proven to be reliable and effective for certain patients. The mini-lift techniques developed by Dr. Maas and his associates include the mini-facelift, the mini-neck lift, and the mini-cheeklift.
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The mini-facelift uses smaller incisions in the natural creases in front of the ear to tighten the cheeks, jawline and sagging folds around the mid-face. Similarly, the mini-necklift uses incisions behind the ears to tighten loose skin or the 'waddle' under the chin. Most of these procedures can be performed under local anesthesia and have quick recovery times.
The mini-cheek lift or "Percutaneous Midface Lift" resuspends sagging tissue in the midface region. This technique is done with the aid of a special suture and anchor system. Tiny incisions are made over the sagging areas of the face. Then thin needles are passed sequentially through these punch incisions and exit via a small incision behind the hairline. The proper tension is applied and suture is contoured to make the surface smooth and nicely repositioned. When applied properly, this technique has shown to be effective in suspension of the tissue for up to 7 years of follow-up.
Excerpts from Dr. Maas' most recent research and clinical papers:
Extrinsically, one of the main factors in facial aging is from actinic damage. In a process called elastosis, collagen is degraded and elastin is increased. The dermis becomes thickened and poorly organized. Fine-skin wrinkling from sun-damaged epidermis also occurs. Along with fat atrophy in the subcutaneous tissue, there is a general redistribution of tissue due to gravitational effects. The sagging of tissue leads to the loss of the cervicomental angle and mandibular definition. All these factors contribute to the aging face. Read More.
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