Facelift methods for facelifting? Questions to PD Tremp

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

During a SMAS lift, the facial contours are lifted and redynamized. This restores the original, natural appearance of the face. Frequently, the simultaneous combined own fat treatment.

Read also: Plastic and aesthetic facial treatments, plastic facial surgery

What's the point of a facelift?

With face lifting, flabby tissue can be corrected and lifted throughout the face. In doing so, the lost harmonies in the face can be balanced and the face rejuvenated.

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

Incisions and extent of dissections

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

Causes of slack skin on the face

The processes in the skin slow down with increasing age, which contributes to the general skin aging. In addition to biologically induced aging, internal and external factors support the skin sagging.

Hormonal changes are an essential factor for sagging skin. Lifestyle and too much time in the sun can contribute to collagen damage and accelerating damage to the skin structure.

Facelift for facelift

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

Modern surgical techniques allow a gentle and safe treatment without large conspicuous scars. The downtimes are also comparatively short. Naturalness should always have top priority during a facelift.

SMAS Plication as facelift method

Until the 70s, facelifts tightened the superficial skin without the SMAS. In 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. In doing so, the face does not collapse, but retains its dynamism and natural tension over the years. The mask-like tightening of the face is thereby prevented.

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

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

MACS Lift for face lifting

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

Tightening is achieved by sutures that lift the sunken tissue vertically. This mainly lifts the midface and the eye area, rather than the neck. The advantage is a small incision line and low risk of injury to the facial nerves.

With the Simple MACS Lift the lower third of the face can be corrected. It can be used to treat the neck and cheeks as well as the angle between the neck and chin. The Extended MACS Lift also allows the nasolabial wrinkles and the midface to be influenced.

Deep plane facelift to tighten the midface

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

The advantage of this 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 nerve injury.

Advanced SMAS facelift

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 pulling direction is more vertical than the skin flap. A portion of the SMAS flap can also be repositioned retroauricularly to tighten the neck and cheek region. A disadvantage is the long duration of the operation. In addition, there is the risk of nerve injury and possible disturbance of blood circulation in the skin.

Lateral SMAectomy

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

This technique is simpler than DPFL or composite facelifts and the results are predictable.

What are the possible risks with a facelift?

Possible problems are secondary bleeding and the blood pressure should remain within the normal range after the operation. In rare cases, other risks include excessive scarring, infections, disturbances of blood circulation in the skin or nerve damage.

Can the facelift be combined with other treatments?

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

Possible methods of treatment are: Radiofrequency and ultrasound, liposuction, lipolytic injections. As well as fractional laser treatments, platelet-rich plasma injections (own blood) or chemical peelings. Neuromodulators (botulinum) or different types of fillers are ideal supplements.

Do you have questions about facelifting and plastic facial surgery?

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

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