When skin over the sides of the nose and mouth start to gather and fold, then it may be time to consider a facelift procedure. Facelift or Rhytidectomy involves pulling up or cutting out a part of the underlying tissue of the face called the SMAS, to tighten it and subsequently pull up or firm up the skin of the face. The SMAS, which supports the skin of the face, is much like the lining of a flimsy blouse. Pulling the lining of a blouse in one direction will surely make the blouse move towards the direction of the pull. Since the effect of gravity manifests itself on the face in the form of more “skin folds” along the sides of the nose and mouth, pulling the SMAS in the opposite direction rejuvenates the face by repositioning the skin back to its previous youthful location. An additional benefit noted is the pull on the skin of the neck; wherein some, if not most, of the bands on the neck are eliminated and creates an angle between the neck and the chin.

There are different techniques that can be done in a facelift. Traditionally, the lines of the cut run along the temple of the head, within the thickness of the hair, down towards the front of the ear, around the ear lobe, to the back of the ear, then to the back of the head. The direction of the pull on the SMAS is slightly inclined upward and towards the back. Any excess skin due to the pull of the SMAS is cut away and the wound edges are approximated and closed. Now a days, with the trend towards the minimally invasive procedures, the lines of incision are shorter: running a little back to the hairline of the temple, down the front of the ear (but partly hidden), and ends at the back of the ear lobe. I employ the short scar with the use of the Minimal Access Cranial Suspension (MACS) lift technique; wherein, the direction of the pull on the SMAS is vertically upwards. This technique also gives some volume to the face.

In some patients, replacement of the volume of the face through Autologous Fat Grafts maybe all that is needed. The process involves getting some fat from your belly through a liposuction procedure, processing the fat, then, re-injecting the processed fat back into areas in your face that appears lacking in volume. This technique of Autologous Fat Grafting may be combined with the MACS Lift for optimal results.

For others, a Thread Lift may work wonders for them. The procedure involves inserting “barbed” threads in strategic places of the face and bunching up the skin while the thread is being pulled. This procedure provides a “lift” effect on the face with the barbs on the thread “holding” the tissues in position and the bunching of the skin providing volume to the face.

At times, the facelift may be combined with a blepharoplasty, for a more “refreshed” appearance of the face, or with a forehead lift to remove the remaining tell tale sign of aging. The technique to be used is individualized from person –to-person, as no one technique is applicable or suitable to all patients. A face-to-face consultation is advised for proper evaluation and understanding on the application of a specific technique.

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