Facial ageing is a complex process, but the descent of facial fat from the midface into the lower face is particularly important. This operation is appropriately termed ‘facelift’ and not ‘face-tighten’ surgery. Our goal through surgery is not to create artificially tight skin, but rather to re-establish the proportions and tone of youth. We favour the “anterior SMAS plication technique” (initially described by Robbins in 1995), and our experience mirrors his description of a safe, effective, reliable procedure that provides a natural ‘non-operated’ appearance, 5-10 years of effect and allows our patients a rapid recovery to normal activities. We do not recommend thread lifts, but will do the S-lift for patients who do not have a significant problem with loose neck skin.
Rhytidectomy patient shown before surgery with deep cheek folds, jowls, ptotic soft tissues, and loose skin on the front and side of neck.
Incisions are variable, made on either side of the face from inside the hairline at the temples (see photo) or a trichophytic incision in front of the hairline, in front of or partially within the ear, around the earlobe, in the crease behind the ear and into the lower scalp.
The design of these incisions may vary from patient to patient and according to the surgeon’s personal technique.
Loose skin is pulled up and backward, and the excess is removed. In many patients, the underlying tissues are repositioned to restore volume from the lower face jowls to the mid-face cheeks, restoring more youthful facial contours.