Facelift - Rhytidectomy

With aging, tissue degeneration causes a loosening of the skin and muscle components, leading to the formation of wrinkles, folds, or creases that give a senescent appearance to the person. Naturally, not all cases are the same; factors such as heredity, general conditions, the structure of the skin and subcutaneous tissue, dietary habits, quality of life, smoking dependency, and exposure to sunlight all play a role.

The quality of the result obtained will also depend on the initial conditions. Sometimes, this process mainly affects the upper third of the face, other times the mouth region or the neck; in more evident cases, aging affects the face and neck as a whole. The purpose of this procedure is to remove excess skin from the affected area and also address the subcutaneous structures to counteract the force of gravity, achieving rejuvenation of approximately ten years.

The combination of aesthetic medicine techniques now allows for a more comprehensive approach to patient care, implementing a true global rejuvenation program. For example, peels can be performed to improve skin texture, renew the epidermis, and activate the dermis. Alternatively, hyaluronic acid can be implanted beneath wrinkles, or CO2 laser photorejuvenation can be utilized.

Preoperative Evaluation:

An essential and indispensable part of the procedure, the preoperative evaluation determines which areas of the face need to be addressed. Facelifts can involve the entire face or only specific regions such as the middle third or upper third. Distinctions are made between the classic cervicofacial lift, temporal lift, midface lift, cheek lift or mini-lift, and neck lift.

Surgical Technique:

The incisions will naturally vary in location and extension, depending on the type of facelift. However, efforts will be made to position them in a way that remains as hidden as possible, such as within the hairline and behind the ear. An incision in front of the ear is also necessary but tends to become invisible after a short period of time.

The procedure begins with the infusion of a solution containing an anesthetic and adrenaline, which helps to separate the planes and facilitate subsequent dissection. If necessary, liposuction can be performed in areas with excess fat. Next, the skin is incised and detached from the deep planes, and the important ligaments are sectioned to achieve complete mobility of the skin envelope. The most challenging yet crucial phase is the dissection of the deep muscular plane, which must be repositioned by pulling it upwards according to well-defined vectors. This is the key point of the procedure, necessary to ensure a successful outcome and long-lasting results. Finally, drains are placed, and the wounds are sutured with very fine sutures to minimize scarring.

Additional Information:

The procedure is performed under general anesthesia and can last up to three or four hours. The surgery can be carried out on an inpatient or day hospital basis, depending on the type of procedure.

Postoperative Recovery:

Bruising may be present for several days but will gradually fade over time. The stitches in front of the ear are removed after four or five days, while for the others, a few more days may be required. The recovery period varies from ten days to a month, depending on the extent of the procedure.



Complications:

Due to the use of drains, hematomas are not particularly common.

The quality of the scar largely depends on the patient's individual response, but it is advisable to avoid sun exposure for a few months after the procedure.

If the patient is a smoker, they should be informed of the increased risk of skin suffering, including the possibility of variable extent necrosis.

The most concerning complication is injury to branches of the facial nerve. Often, these are only stretching injuries that cause temporary disturbances and are expected to recover spontaneously. However, in rare cases, complete lesions can occur, resulting in permanent deficits.