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| The treatment is specific for each patient.
It doesn't always correspond with the person's age and depends on the affected
areas, degree of sagging and types of wrinkles. The photograph on the left shows
the extent of the lifting on the skin of face and neck, as well as the incision
sites. The photograph on the right highlights the endoscopic incisions (red, in
the hair) and the separated areas as needed: A: mid face, B: eyebrow, C: end of
the eyebrow, D: malar fat. (Photographs by Man Ray, 1931) |
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Facial lifting, rhytidoplasty or lifting, are the different names given to
the procedure used to remove the signs of aging from the face. The name itself
explains the procedure: skin smoothing, wrinkle treatment (Rhytid) and lifting
of fallen structures (Lifting).
The different sagging areas of face and neck, as well as the design of the
scar, can be seen on the photograph. In endoscopic treatment, minimal incisions
are made in the frontal and temporal region.
Rhytidoplasty requires all the sophistication and cares of plastic surgery,
but, above all, it requires absolute attention to the detail.
Surgical technique is not sufficient to achieve the best result. It is necessary
to join it with the surgeon's sensibility so that together, they might provide
a greater level of satisfaction to the patient.
The saying "A picture is worth a thousand words" helps to understand
the Face Lift procedure: imagine whity-brown paper, wrinkle it in such a way that
parallel folds predominate, as if it were an accordion. Use glue to stick it by
the lower end to a board. Once it's dry, try to stretch it and you'll notice that
it's impossible and that the paper can even tear. Now partially unstick the paper,
stretch it and you'll see how the paper smoothens out.
There's just one more detail, skin is elastic. Stretching it does not correct
wrinkles. It is necessary that fat, muscle and other underlying tissues maintain
the shape. For this, it is necessary to tighten a very thin structure, like a
mesh, called SMAS (Superficial musculoaponeurotic system).
Another important
feature is that skin is peeled and elevated, followed by a layer of fat through
which the flap's blood vessels run. This delicate blood circulation is compromised
in smokers, people suffering diabetes, arteriosclerosis, etc., which makes it
necessary to take special precautions and limitations with this type of patients.
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Vigo. Suplemento dominical: sección Salud. 09.12.1990.
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Tratamento de las estruturas músculo-aponeuróticas na cirurgia do
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• Conway H:
The surgical face lift-rhytidectomy. Plast Reconstr Surg 1970; 45:124.
• González-Ulloa,
M.: Anatomy and surgical conclusions concerning the aging face. Abstract Book
I Internat.Cong. I.S.A. P.S.,4 (1972).
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sugery of the face. in Gibson, T., Editor: modern trends in Plastic Surgery, Washington,
D.C., 1964, Butterworths & Co.
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Rejuvenecimiento Facial. Editorial Jims. Buenos Aires,1994.
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Cansancao A. Direcao de Tracao em Ritidoplastias Revista Brasileira de Cirugia
Agosto, 1971Rees TD, Wood-Smith D: Cosmetic Facial Surgery. Philadelphia, WB Saunders,
1973.
•Quetglas Moll J. Breve manual de cirugía plástica
y estética de la cara. Publicaciones Controladas. Madrid, 1971.
• Rees
TD, Aston SJ, Thorne CHM. Blefaroplastia y plástica facial. In : McCarthy
JG. Cirugía Plástica: II. La cara. Panamericana, Buenos Aires,1992,
1419-1513.
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