Our Summary

This research paper focuses on different techniques used for facelifts, specifically looking at how much risk is involved with each one. The methods they focused on involve manipulating a layer of tissue under the skin called the SMAS (sub-superficial musculo-aponeurotic system).

Researchers analyzed data from 183 different studies to understand which techniques had the highest and lowest rates of complications like nerve injuries, hematomas (collections of blood outside of blood vessels), skin death (necrosis), and infections.

They found that two techniques, the “high lateral SMAS” and “composite rhytidectomy,” were more likely to result in temporary nerve damage. However, none of the techniques were associated with a higher risk of permanent nerve damage.

The “deep plane” and “SMAS imbrication” techniques were more likely to result in major hematomas. Skin necrosis was more common with the “SMAS flap” technique.

The researchers concluded that while some techniques do have a higher risk profile, choosing a technique should be based more on the quality of results it can achieve rather than its complication risk.

FAQs

  1. What is the SMAS and how is it relevant to facelift techniques?
  2. Which facelift techniques were found to have a higher risk for temporary nerve damage and major hematomas?
  3. How did the researchers suggest choosing a facelift technique, considering the risk of complications?

Doctor’s Tip

A helpful tip a doctor might give a patient considering a facelift is to carefully discuss with their surgeon the specific technique that will be used and the potential risks associated with it. It’s important for the patient to understand the pros and cons of each technique in order to make an informed decision about their procedure. Additionally, following all pre and post-operative instructions, such as avoiding smoking and certain medications, can help reduce the risk of complications and promote optimal healing.

Suitable For

Facelift surgery is typically recommended for patients who are experiencing signs of aging in the face and neck, such as sagging skin, deep wrinkles, and loss of facial volume. Ideal candidates for facelift surgery are generally in good overall health, do not smoke, have realistic expectations for the outcome of the procedure, and have a strong desire to improve their appearance.

Patients who are not good candidates for facelift surgery include those with certain medical conditions that may increase the risk of complications, such as uncontrolled high blood pressure, diabetes, or a history of blood clotting disorders. Additionally, patients who are heavy smokers or who have unrealistic expectations for the results of the procedure may not be suitable candidates for facelift surgery.

Ultimately, the decision to undergo facelift surgery should be made in consultation with a board-certified plastic surgeon who can assess the patient’s individual needs and goals, and recommend the most appropriate treatment plan.

Timeline

Before a facelift, a patient typically undergoes a consultation with a plastic surgeon to discuss their goals and expectations. They may also undergo pre-operative tests and evaluations to ensure they are healthy enough for surgery. On the day of the surgery, the patient will be administered anesthesia before the procedure begins.

During the facelift surgery, the plastic surgeon will make incisions in strategic locations to access the underlying facial tissues. The SMAS layer will be lifted and repositioned to create a more youthful appearance. Excess skin will be removed, and the incisions will be closed with sutures.

After the surgery, the patient will experience some swelling, bruising, and discomfort. They will be given post-operative instructions on how to care for their incisions, manage pain, and reduce swelling. Follow-up appointments will be scheduled to monitor the healing process and remove any sutures.

Over the following weeks and months, the patient will gradually see the full results of their facelift as the swelling subsides and the tissues settle into their new position. They may also undergo additional treatments or procedures to enhance the results, such as laser resurfacing or injectable fillers.

Overall, the timeline for a facelift can vary depending on the individual patient and the techniques used during the surgery. It is important for patients to follow their plastic surgeon’s recommendations for a successful recovery and optimal results.

What to Ask Your Doctor

Some questions a patient should ask their doctor about facelift techniques include:

  1. What technique do you recommend for my specific needs and desired results?
  2. What are the potential risks and complications associated with the recommended technique?
  3. How common are complications such as nerve injuries, hematomas, skin necrosis, and infections with this technique?
  4. How experienced are you in performing this specific technique?
  5. What can I do to minimize the risk of complications during and after the facelift procedure?
  6. How long is the recovery time for this specific technique?
  7. What kind of results can I expect from this technique in terms of natural-looking outcomes and longevity?
  8. Are there any alternative techniques that may be better suited for me?
  9. Can you provide before and after photos of patients who have undergone this technique?
  10. What is the cost associated with this specific technique, and does it include any potential revisions or touch-ups if needed?

Reference

Authors: Jacono AA, Alemi AS, Russell JL. Journal: Aesthet Surg J. 2019 Aug 22;39(9):927-942. doi: 10.1093/asj/sjz045. PMID: 30768122