Who are the best candidates?

Man or woman whose hairs and face has commenced to fall or get loosen, because the skin has lost its elasticity, or there is an atrophy of the osseous structure which is no longer so defined, or when the muscles get loose. Forehead’s coronal Lifting or endoscopic Lifting can be performed combining the traditional facial lifting and eyelid esthetic surgery, being the best for the patient with great cutaneous laxity, loosen muscles, and large marked wrinkles.

LIFTING OR CONVENTIONAL RHYTIDOPLASTY

It does not work as a correction of the center-facial and chin-orificial wrinkles, as crow’s feet, space between eyes, and superior lips wrinkles; the mentioned zones require the use of other techniques such as botulinum toxin (Dysport or Botox), resurfacing laser, eyelid surgery, etc.

Generally the cuts are realized at a posterior or anterior level to the ear (preauricular and retroauricular) and they extend upwards and backwards, on the scalp. The largest the quantity of the skin to take out is, the biggest the scars will be. If the neck needs to be treated too, an incision under the chin is performed.

Sometimes a liposculture is needed to reduce the fats from the neck (double chin) and the muscles. Later a dissection of the muscles and fascias of the face is made, taking care of the facial nerve, to correct what had fallen due to ageing. Thus, the divulsion and the advance of the aponeurotic superficial muscular system (SMAS) are carried out and the excess of the skin is retired.

Some doctors leave drainage if necessary and later the zone treated is compressed for 24 hours approximately.

It is important to state that the swelling or edema’s period takes 7 to 15 days for the social/labor reintegration, depending on the magnitude of the surgery.

THREE-DIMENSIONAL OR COMPOSED LIFTING

Described in 1991 by the Dr. Sam Hamra and improved during 1997 to 1999, it allows correcting the old structures from a deeper plain with more lasting effects.

The incisions or cuts are similar, what changes is the space between the muscles and the malar fat with a wider dissection of the tissues and the SMAS.

Nowadays this is the most utilized technique for facial liftings. The durability of the results made this technique superior when compared to the conventional ones.

The recovery takes 15 days since there exists more swelling due to the greater aggressiveness to the tissues for just one objective, to make the result last.

MINI LIFTING

It is not very used these days, since non-surgical techniques exist.

The treatment consists of a surgery that leaves one scar in front of the ear, does not extend to the back, and has a minimum dislocation since it is applied to patients between 35 to 45 years old. Non surgical processes are currently utilized; some of them are the Russian Sustentation Threads, Lifting without surgery, ThermaCool, Botox, and others.

ENDOSCOPIC LIFTING

This process is done with microsurgical incisions in the scalp where lenses and television cameras are inserted. The surgery is visualized through a screen similar to a vesicular videolaparoscopy. In a second incision, the instruments to implement the surgery are introduced.

This method provides an excellent vision with a great zoom, and allows a stricter management of the muscles under treatment: from the end of the eyebrow to lift them, the muscles that produce wrinkles, thus being as less aggressive as possible.

Three to five cuts are need with this method; each of them is from 1.5 to 2.00 cm and can be closed with one or two stitches.

The postoperatory is not painful, but produces some minor disturbs, that can be relieved by oral medication. In some areas the patient could experiment reduced sensibility, a sensation that disappears in a few weeks or along the month.

Observation: The consult is necessary so that the doctor chooses the best option for each patient.