From the aesthetic point of view, the face can be divided into upper, middle and lower zones. Upper zone comprises forehead, periorbital area and the brow. The middle zone refers to the cheek, jowl, nasolabial fold,lips and chin. Lower zone includes the jawline, submental area and neck. Signs of upper zone aging are brow ptosis, wrinkles around the forehead and angle of the eye and droopy upper eyelid. Aging of the middle zone will show eyebag, deepening of the nasolabial fold and marionette line, presence of jowl, upper lip lengthening, chin ptosis and crease. In the lower zone, excess neck skin, vertical platysma bands, horizontal neck creases, poorly-defined neck-jaw angle and bulging of submental fat are seen.
The spectrum of facial rejuvenation is wide, ranging from the most minor to the most invasive. There are numerous non-surgical methods for facial rejuvenation. Botox, filler, laser treatment and many other skincare products are available to produce a more youthful face. While in many cases these non-surgical methods are able to produce satisfactory results, in advanced cases of facial aging, these may not be effective enough.
Surgical intervention in facial rejuvenation can be divided into upper face lift, midface lift and lower face lift. Upper face lift generally is referred to forehead lift or brow lift. Midface lift involves lifting of the cheek and jowl areas. Lower face lift deals with the lifting of the saggy skin around the jaw and neck. Often different surgical procedures are combined together to produce a optimal wholesome result.
A forehead lift or brow lift is procedure performed to revitalize the upper face. The procedure corrects the aged look of the lined forehead, elevates the saggy eyebrow to give the patient a more youthful and energetic look, as well as eliminates the frown lines that make the patient appears tired, angry and sad. Elevation of the saggy eyebrow also indirectly improve the droopy appearance of the aging upper eyelid.
Brow lift or forehead lift is performed as a daycare procedure. The procedure is done under general anaesthesia but in selected cases local anaesthesia and sedation can also be considered. The procedure is done through small incisions made just behind the hairline, with or without the use of endoscopy. Fixation of the elevated forehead skin can be done with the use of Endotine device. Brow lift can also be performed by direct excision of skin just above the eyebrow. Forehead lift or brow lift can be combined with a facelift to provide full facial rejuvenation. Often a eyelid surgery is done concomitantly to address the problem of droopy eyelid skin.
Facelift is a surgical procedure designed to effectively deal with facial aging and produce a long-lasting result. Facelift is usually performed under general anaesthesia even though in selected cases the procedure also can be done under local anaesthesia and sedation. Many variants of facelift exist, each with different technique and objective in dealing with the aging face. In many cases, an incision starts from the temporal hairline, continues in a natural crease in front of the ear, turns around the ear lobule and ends around the hairline behind the ear. Skin and the underlying soft tissue is elevated. The underlying soft tissue is tightened to produce a desirable facial shape and contour and the excess skin is removed. The loose excess skin in the neck is dealt with at the same time. The objective is to produce a natural -looking and youthful face. Depends on the condition of the patient, facelift can be combined a brow lift and eyelid surgery as indicated
Patient can either go back on the same day or stay one or two nights in the hospital. Stitches are removed after 5 days. Some degree of swelling and bruising may occur within the first week but usually that will subside gradually. Scar from facelift usually fade within a few months and is generally heals very well.