Facelift methods for face lifting? Questions for PD Tremp

There are different methods of face lifting to tighten the sagging parts of the face for a long time. The classic face lift can be divided into different layers. However, today's trend is towards the minimally invasive method with a short recovery time and low surgical risk.

During a SMAS lift, the facial contours are lifted and redynamised. Thus the original, natural appearance of the face is restored. Often the combined autologous fat treatment is performed at the same time.

Read also: Facial plastic and aesthetic treatments, Facial plastic surgery

What is the benefit of a facelift?

With a facelift, sagging tissues throughout the face can be corrected and lifted. In the process, the lost harmonies in the face can be balanced and the face can be rejuvenated.

The facelift allows for the tightening of the facial skin or also the lifting of lowered eyebrows, cheeks or a sagging facial contour.

Incisions (incisions) and extent of dissections

Short and long incisions in front of and behind the ear: A) Mini lift B) Short incision C) Traditional

Causes of sagging skin on the face

The processes in the skin slow down with age, which contributes to general skin ageing. In addition to biological ageing, internal and external factors support skin sagging.

A major factor in sagging skin is hormonal changes. Lifestyle and too much time in the sun can contribute to collagen damage and accelerate skin texture damage.

Facelift for face lifting

Very lasting results can be achieved with a facelift. A facelift is a complex procedure that often takes several hours. Existing excess skin and tissue is surgically removed. At the same time, the skin is tightened and the deeper structures repositioned.

Modern surgical techniques allow gentle and safe treatment without large noticeable scars. Downtime is also comparatively short. Naturalness should always be the top priority for a facelift.

SMAS plication as a facelift method

Until the 70s, a facelift tightened the superficial skin without the SMAS. With a SMAS lift (= superficial musculo-aponeurotic system) the facial contours (muscle / connective tissue plate) are lifted and supported.

The aim is to restore the original appearance of the face. The face does not collapse, but retains its dynamism and natural tension over the years. The mask-like tightening of the face is prevented.

The SMAS plication technique primarily treats the deeper, hanging structures. The preparation is above the SMAS. After the SMAS is exposed, the mobile to the non-mobile SMAS part is fixed by several sutures.

The excess SMAS can then be shortened. The procedure is relatively easy to perform and has low risks for the patient.

MACS Lift for face lifting

In the MACS lift, the incision is made in the area in front of the ear. The preparation is less extensive than with the classic face-neck lift.

The tightening is done via sutures that lift the sagging tissue vertically. The mid-face and the eye area are mainly tightened, less the neck. The advantage is a small incision line and low risk of injury to the facial nerves.

The Simple MACS Lift can be used to correct the lower third of the face. It can be used to treat the neck and facial cheeks as well as the angle between the neck and chin. The Extended MACS Lift additionally allows the nasolabial folds and the midface to be affected.

Deep plane facelift to tighten the midface

The Deep Plane Facelift is an option for sunken areas of the face. In a Deep Plane Lift, the layer of tissue under the SMAS is prepared. The skin does not have to be separated from the SMAS.

The advantage of the method is the low risk of superficial scarring of the skin. The natural facial expression is also preserved.

This technique is particularly suitable for older patients with changes in the midface and nasolabial fold. The results are long-lasting. However, there is an increased risk of injury to the nerves.

Advanced SMAS face lift

The sub-SMAS preparation is the basic principle to tighten the overlying skin structures for a long time.

The skin and the SMAS flap are prepared separately (lamellar). The SMAS flap has a different vector than the skin flap.

The direction of pull is more vertical than the skin flap. Part of the SMAS flap can also be moved retroauricularly to tighten the neck and cheek region. A disadvantage is the long duration of the operation. In addition, there is the risk of injury to the nerves and possible disturbance of the blood supply to the skin.

Lateral SMASectomy

With this very safe technique, only the outer part between the mobile and non-mobile SMAS is tightened. The vector is usually perpendicular to the nasolabial fold, but may vary depending on the shape of the face.

This technique is easier than DPFL or composite facelifts, and the results are highly predictable.

What are the possible risks of a face lift?

Possible problems are post-operative bleeding and blood pressure should remain in the normal range after the operation. In rare cases, other risks are excessive scarring, infections, disturbances of blood flow in the skin or nerve injuries.

Can the facelift be combined with other treatments?

In recent years, several non-surgical facial treatments have become increasingly popular that can be performed with a face lift.

Possible methods of treatment are: Radiofrequency and ultrasound, liposuction, lipolytic injections. Fractional laser treatments, platelet-rich plasma injections (autologous blood) or chemical peels. Neuromodulators (botulinum) or various types of fillers are ideal supplements.

Do you have questions about facelifts and facial plastic surgery?

Contact PD Dr. med. Mathias Tremp (specialist in plastic, reconstructive and aesthetic surgery) for a consultation.

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