Facelift

To counter the signs of ageing and restore a youthful appearance to the face, a comprehensive approach may be required. A facelift will treat the undesirable effects of the ageing process from the corner of the eyes down to the collarbone. Designed specifically for each patient, today’s facelift is a highly individualised procedure which involves repositioning of the underlying foundation and restoring tissues to their original position, without stretching the overlying skin.

The ageing process of the face is the combined result of several physiological processes and environmental influences. Many factors contribute to the structural changes of the ageing face, these include gravity, sun exposure and loss and redistribution of fat tissue (fat atrophy). Over time the face’s bony foundation which provides buttresses for the soft tissues weakens, this is particularly apparent around the jaw line.

Rejuvenation of the face

Facelifts, also known as rhytidectomy, are the most efficient method for reversing the effects of gravity and ageing in the mid and lower portions of the face. They raise the soft tissues in the cheek and mid-face, reduce jowls and provide a cleaner and more defined jawline. In combination with a neck lift, the contours in both the face and neck are smoothed, providing a fresher appearance all round.

Dr Sorensen specialises in facial rejuvenation and employs a three-dimensional approach to his facelift surgeries - always considering the restoration and recreation of volume - as opposed to the classical two-dimensional lift and skin tightening. This approach provides results that are natural-looking and will accommodate future ageing more gracefully.

Dr Sorensen typically uses a combination of adjustments, rather than a single ‘all-out’ procedure. For the finest contouring and aesthetics, he designs a facelift technique that will offer the individual the best outcome, and combines this procedure with autologous fat-transfer and skin restoration. This will provide a balanced, healthy and naturalistic rejuvenation.

Techniques

Numerous adaptations of facelift techniques have been devised, and each surgical approach has its own benefits. All of the conventionally accepted techniques achieve removal of redundant skin. However, it’s the variations in approach to the deeper soft-tissue structures that distinguish the many facelift procedures.

●  A skin-only facelift was the earliest form of surgical rhytidectomy. This involves undermining and tightening the skin in order to smooth out folds and lines and remove excess skin. This technique does not restore the facial contours (the deeper soft-tissue foundation) and often fails to achieve significant long-term benefits.

●  SMAS based facelifts (Superficial Musculo-Aponeurotic System): This refers to contemporary techniques to achieve long-lasting rejuvenation of the face. A SMAS facelift is a two-layer lift, in which the majority of the manipulation is provided to the underlying soft-tissue foundation, with fewer changes applied to the skin layer, avoiding the tendency to over-stretch skin. An important procedure is the SMASectomy, in which the SMAS layer is either resected and tightened over the parotid gland (lateral SMASectomy), dissected and elevated vertically as a flap towards the cheek-bones (conventional SMASectomy), above the cheek-bones (high SMAS facelift), or mobilized over a larger area towards the nasolabial fold to provide extended correction of the mid-face (extended SMASectomy). SMAS-plication is another technique in which the SMAS layer is folded on itself without undermining, a tissue-sparing technique suited to restore contours in faces with less fullness.

●  S-Lift, MACS-lift (Minimal Access Cranial Suspension) are facelift variants often referred to as ‘mini’ facelifts: Procedures are less invasive and were developed for patients with lesser requirements for facial rejuvenation. These approaches rely upon a limited facelift incision, conservative skin flap creation, and (MACS-lift) the use of sutures in a loop configuration (purse-string) to lift the deeper tissues. These techniques are less effective for patients with laxity or sagging skin in the neck.

●  Deep-plane facelift, or ‘composite rhytidectomy’: Sub-SMAS facelift technique in which facial soft-tissues, including skin, muscle and cheek fat, are dealt with as a single unit.

Recommended treatments

The majority of patients who desire long-term rejuvenation of the face and neck are likely to benefit from a SMAS facelift design as it will allow better customisation of a deeper lift and allows their restored skin to sit naturally on top. A SMAS facelift typically also involves a neck lift. Short-scar-lift techniques are suited for patients with lesser signs of facial aging and minimal requirements for neck restoration. Skin-only facelift are only indicated for patients in where lines and loose skin is the only matter of concern.

Facelifts are often combined with an endoscopic brow lift and eyelid surgery. The use of a chin implant may compensate for age-related bone reabsorption where indicated, and balance jawline aesthetics even further. Incisions are made in inconspicuous locations such as behind the hairline and in the natural folds of the face and ear. Incisions inside the ear (post-tragal) conceal scars completely. The scars are designed to fade in time to near invisibility.

A full facelift is most suitable for someone whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is well defined.