Face & Neck Lifting

In the seventies of the twentieth century, the process of tightening the face was reduced to tightening the skin and removing excess skin and fixation. Skin or skin lifting without subcutaneous treatment.

Officially, the first skin tightening in history was performed by Dr. Eugen Holländer, back in 1901 in Berlin. The idea for this intervention came from an elderly aristocrat, who asked Hollander to “lift her cheeks and the ends of her lips”.

Shortly afterwards, in 1924, the first book on facial cosmetic surgery was written by Dr. Charles Conrad Miller, USA “The correction of Featural imperfections”.

During the following years, the interest in this aesthetic procedure grew, so already during the First World War, the Dutch surgeon Dr. Johannes Esser discovered a new technique of skin transplantation.

Since 1920, cosmetic surgery in general has gained new momentum in development, and at that time the first female surgeon, the French Dr. Suzanne Gross Noel, made a huge contribution to cosmetic surgery.

Face and Neck lifting with SMAS from 1970-1980 (SMAS) During this period, the concept of “subfacial dissection” was introduced, which means the separation of the deeper part of the skin, the so-called subcutaneously, in contrast to the previous exclusive reliance on skin tightening.

Soon there was a better understanding of the importance of the superficial subcutaneous layer of muscles and the lining of the face and neck (SMAS acronym “Sub Muscular Aponeurotic System”), which further improved the surgical technique of face lifting. It thus becomes the standard as a facelift technique and represents the first innovative change in facial tightening surgery in the past 50 years!

Face and Neck lift of the 80s (SMAS extended and superextended) In the 1980s, Dr. Paul Tessier, a surgeon, maxillofacial surgeon, used his extensive experience in reconstructive surgery, used autologous bone grafts and made additional corrections in facelifts, demonstrating the incision of certain parts of the facial skin that had not been used before, raising eyebrows and soft tissue, which further emphasized the youthful appearance of the patients. This has drastically changed the approach and possibilities in facial skin tightening surgery.

Face and Neck Lifting of the 90s of them until today (volumetric period with the aim of lifting the subcutaneous tissue and achieving youthful fullness after face lift) The beginning of this period is characterized by new thinking and innovative approaches to tightening the skin and subcutaneous tissue of the face and neck, which primarily achieve an antigravity effect and youthful vitality, leaving minimal scars whenever possible. Moderate dissection and tightening of the skin and skin with transplantation of own fat or the use of dermal fillers.

Modern facelift implies the use of modern techniques of tightening and volumizing the face with minimal scars.

Although modern surgery offers several facelift techniques, the three basic components of surgery are very important for achieving optimal results.

1. Facelift by removing fat from unwonted areas. The disappearance of a clear definition of the lower jaw is a very common sign of aging. This is caused by a decrease in facial muscle tone and the creation of a larger amount of fatty tissue on the neck and below the lower jaw (chin). This facelift technique necessarily involves the use of specially made cannulas that are used to remove adipose tissue, in order to emphasize the contours of the lower jaw.
2. Tighten facial muscles! There are several names for this procedure, but certainly the work process is the same regardless of the name of the procedure. Tightening the muscles means preparing one layer of the facial muscles and tightening it vertically, upwards. This corrects the contours of the cheek region. Tightening upwards fixes the cheeks, cheekbones and neck. Tightening of the facial muscles is done with plications, twists and a gentle resection of the facial tissue called “SMAS”. Some surgeons achieve this by using special filaments (sutures) with which this layer is fixed to the fascia of the temple muscle, for example.
3. Repositioning and tightening tightens and minimal tension-free tightening of facial skin! By tightening the neck and middle third of the face, the excess skin that appears after tightening and firming the subcutaneous tissue is removed. Hiding scars is the focus after this phase and that is why incisions are used right in front of or in the hair itself, in front of the ear shell or around it. The goal is to effectively cover the scars.

OVERVIEW OF METHODS

Once and now popular, according to the indications, reasonably used complete and shortened methods of overall tightening and lifting of the skin and subcutaneous tissue of the face and neck:

• Full Face and Neck Lift with SMAS (complete lifting of skin and subcutaneous skin of face and neck) • S Lifting (S form of scar in front of the earlobe)
• Mid Face Lifting (extended access to the cheek region or from the position of lower eyelid tightening or temporal access)
• Temporal lifting (temporal lifting in addition to raising the corners of the eyebrows in the eye, if necessary extended to the cheekbone region (Alan Fogli), modifications with fat grafting (own fat transplantation)

Minimal Undermining Suspension Technique (MUST) Combined Eyebrow and Mid-face lift via Temporal Access

• The Super – High SMAS Face and Neck lift Technique with Tailor Tack Plication (Bruce F. Connell)
• Full Face Lipotransfer (transplantation of own fat from an unwanted region of the body into the subcutaneous tissue of the face)
• Neck Lifting (Plastismaplasty) Lifting and tightening the neck improves the appearance of the neck by tightening the skin and core muscles of the neck and improving the contour of the jaw line. This procedure is often performed in conjunction with liposuction, facelift or cheek lift, but can also be performed as a stand-alone procedure.
• Neck Liposuction (Ultrasound assisted lipo, Vaser lipo and Laser lipo)
• Minimal Undermining Suspension Technique (MUST) Combined Eyebrow and Mid-face lift via Temporal Access
• The Super-High SMAS Face and Neck lift Technique with Tailor Tack Plication (Bruce F. Connell)
• Full Face Lipotransfer (transplantation of own fat from an unwanted region of the body into the subcutaneous tissue of the face)
• Neck Lifting (Plastismaplasty) Lifting and tightening the neck improves the appearance of the neck by tightening the skin and core muscles of the neck and improving the contour of the jaw line. This procedure is often performed in conjunction with liposuction, facelift or cheek lift, but can also be performed as a stand-alone procedure.
• Neck Liposuction (Ultrasound assisted lipo, Vaser lipo and Laser lipo)
• MACS – Mini Laser Face Lifting – Lifting and Tightening the Cheek

Laser Full Face and Neck Lift with SMAS

The term facelift usually means tightening the subcutaneous tissue of the whole face and neck. Volimenization and sagging of the face is achieved by applying its own fat or hyaluronic fillers.

Laser eyelid correction (laser blepharoplasty) is often offered and recommended on its own as an additional refreshment and rejuvenation in the aesthetic correction of appearance that complements facelift.

MACS – Mini Laser Face Lift – Lifting and Tightening of the Cheek

Face Lifting procedures with Minimal Access Cranial Suspension (MACS) provide the potential advantage of less invasiveness with faster recovery. Post-auricular tightening is not used and thus eliminates the often conspicuous healing of scars behind the ear after rejuvenation of the whole face and neck

However, there is insufficient practice in the literature documenting its usefulness and limitations.

MACS-lift is a lifting of a face with a short scar with lifting and tightening of deep tissues and skin and using only a vertical vector.

The MACS lift lengthens and tightens the relaxed soft tissues of the face with permanent or slowly resorptive sutures of the bag.

• The MACS lift is efficient, providing a high level of patient satisfaction due to aesthetic results, combined with a quick recovery and return to normal activities.
• Compared to conventional full face-lift, reduced operative time makes simultaneous non-facial procedures more feasible.
• Efficacy is limited in those with marked sagging skin and / or marked cervical (cervical).
• As the shortened method of Face lifting does not include an incision behind the ear, there is no potentially more difficult healing of the post-auricular scar ( mastoid) as after rejuvenation of the whole face and neck.

Picture of MACS – Mini Laser Face Lift – lifting and tightening the cheeks