16 Aug Face to Face – Dr Terrence Scamp
Dr Scamp takes a look at the modern face lift.
The term “face lift” is in such common use that it may refer to a major building project or the release of a new software programme. It is similarly commonly misused in reference to facial cosmetic surgery. A face lift per se would refer anatomically to a procedure designed to improve the jowl. That is, to elevate the lower cheek tissues and improve the upper border of the jaw line.
Most commonly, people refer to a face lift expecting a rejuvenation to the neck as well and it is uncommon to lift the jowl without returning the tissues of the neck to their original position as these two areas commonly descend together.
In addition, rejuvenation of the brow is commonly performed at the same time. This is now done with a key-hole technique but the same principles of elevating the lateral portion of the brow which can look sad and heavy and weakening of the central frowning muscles remains. Use of the endoscope however has meant that the long scar in the hair from ear to ear is rarely employed these days although there are still some variations of scar design used to allow for high hairlines or long foreheads.
S lift procedure
‘S lift’ The term “S lift” is also commonly used these days. It is very much a trip into the past as the original face lifts were done in this way. That is, an incision was made, the skin was mobilized and pulled tight.
Plastic surgeons progressed away from this technique as they discovered that skin is designed to stretch, and it does exactly that, meaning that the improvement from a skin-only lift is limited in extent and short-lived. Some erroneously tried to overcome this by placing extra tension on the skin but this only resulted in an abnormally stretched “wind tunnel” look that was most undesirable.
The modern face lift shifts the power of the lift onto the stronger deeper tissues consisting of muscle and sheath. Strong sutures are used to elevate and secure these and as the deeper tissues are elevated the skin simply “goes along for the ride”. Excess skin can then be removed and the scars hidden around the ear with minimal tension. This combination resulted in finer scars, a much more natural look and a longer lasting rejuvenation.
However ageing consists of more than just sag. If you lift tired, sun damaged, Queensland skin you will end up with a better shaped face with tired, sun damaged Queensland skin. For that reason, a lot of emphasis is placed on rejuvenating the skin as it adds the “gloss” to the “bricks and mortar” of the face lifting procedure. Rejuvenating the skin can consist of simply a skincare programme using topical anti-oxidants and retinoids and specific factors to fade the discolourations on the skin. In many cases however it may extend into no downtime procedures such as IPL or all the way through to a full facial laser resurfacing.
Laser resurfacing became something of a dirty word in the late 90’s due to complications associated with widespread use of the Carbon Dioxide laser. Facial scarring was a rare complication but could be severe. Much more common was the loss of the natural colour of the skin.
Advances in laser technology over the last ten years have been remarkable. With the finer control of the modern devices and the introduction of concepts such as fractional resurfacing the healing times of previous laser resurfacings have been markedly reduced and the complication rate has also dwindled.
Apart from the sag and sun damage, the aging face also shows a deflation. The full round cheek and strong jawline of youth empty and drop and the round rosebud lip of the young becomes a thin irregular line. The popularity of injectables demonstrates the widespread awareness of these changes and the desire to counter them.
Thus the modern facial rejuvenation also addresses the loss of volume of the face using such various methods as fat grafting or injections. These very safe procedures enhance greatly the improvement that is seen from rejuvenating the skin and returning tissues to their original position.
But just in the same way as a good session at the dentist doesn’t mean you can throw away your toothbrush, such rejuvenative surgery is not meant to be the last word. An ongoing skincare programme and judicious use of injectables can help the rejuvenated face hang on to the blush of youth for years to come.
The consultation process for facial rejuvenation includes a thorough examination of the face with regards to tissue sag, volume loss and skin aging and then a discussion with regards to the individual’s aims and desires. From this, a rejuvenation programme consisting of non-surgical techniques or surgery, or a combination of both, can be selected to suit both the individual’s face and their lifestyle.
And for those of you fortunate to be young enough to not worry about facial rejuvenation a good skincare programme can help you stay that way for longer.
So get to know your face and take the best care of it you can. It’s all the face you have!