Rhytidectomy

Rhytidectomy or face lift (also erroneously facelift, Latin technical term: rhytidectomy ) denotes a procedure of plastic and aesthetic surgery ( cosmetic surgery ) on the face of a man. The aim of such a procedure is to tighten the facial skin and the underlying tissue and to give it a higher voltage. Often this operation is carried out so that the patient's face looks younger. The first documented facelift apparently made ​​at the beginning of the 20th century. Reports from ancient civilizations of the Egyptians show that they have already performed cosmetic surgeries. A facelift is one of today the expanded repertoire of surgeons specializing in aesthetics.

Lack of medical standards

In Germany, plastic surgeons, otolaryngologists, ophthalmologists, oral and maxillofacial surgeons, dermatologists and other medical specialists perform facelift surgery. In the training guidelines of the individual specialists ( even for plastic and aesthetic surgeon ) does not list the implementation of facelifts as binding for the specialist title. In addition, the public display of image material is prohibited since 1 April 2006 by the amendment of the Medicines Act or drug advertising law and is therefore no longer displayed on the websites of the relevant practices or clinics. Therefore, the customer may be the choice of the surgeon only on the basis of word of mouth or counseling sessions, there are no protected Specialist designation, which guarantees a specific training or experience of the surgeon.

Principle

A facelift usually takes place in the depths of the skin. For a cheek lift can be penetrated through the cheekbone to the periosteum. In the neck area or if particularly long-term effects to be achieved, structures below the subcutaneous tissue such as the platysma (skin muscle of the neck ) to be streamlined.

For lifts of an area already mentioned skin and muscle structures are tightened using sutures and anchored again on solid structures. The streamlining of different areas of this layer is carried out in different directions. Finally, the resulting excess skin is removed and sutured the skin as inconspicuous as possible and free of stress. There are both absorbable and non- absorbable sutures are used.

Facelifts can be performed either endoscopically or with several centimeter-long sections. Although the smaller cuts of minimally invasive technology mean smaller scars. However, with this technique no excess skin can be removed, which is why it is only used when liftings in the area of ​​the forehead.

Methods that do not involve cuts, such as the so-called thread - lifting with gold thread or threads of plastic with or without barbs, the basic problem underlying that excess skin can not be removed and the applicability to young people should be limited. The effectiveness is assessed very differently.

Techniques

• SMAS lift: SMAS stands for Superficial Muscular System aponeurosis. In a SMAS lift Particular attention is paid to this structure. There is broad consensus among experts that this layer of tissue must undergo a tightening in order to achieve long-lasting and effective results. There are many different methods here, as this structure ultimately prepared, repositioned, reduced and / or doubled and will ultimately tightened with sutures. Depending on erzielendem effect undergoes surgical dissection and reattachment of an individual adaptation va by an individual adjustment of the direction in which the tissue is re- attached.

• Mini -Lift: Only the skin is tightened. It consists in the professional world wide consensus that the result of such a lift usually does not last long.

• Liquid Lift: This term refers to process in which various liquid ( " liquid" ), partially resorbable filler injections materials used. These placeholders fill lost volume and thus minimize the

Folds of the large static facial lines ( nasolabial folds, marionette fold, ...). The biological effects of the incorporated fillers are not fully understood. Ultimately, the injected material has a dead volume, which often also binds water and so makes a volume effect. Also inflammatory processes for the local volume gain be held responsible. Typical resorbable fillers are, for example, hyaluronic acid, collagen, calcium hydroxyapatite and autologous fat. They are degraded by different more or less long time and without residue from the body. Documentation of complications and resulting histological studies indicate this to the fact that the tissue composition after such interventions sometimes significantly different from untreated tissue. The Liquid -lift technique has a shorter duration as operational facelifts, since the fabric is only populated and not mechanically streamlined. In individual cases, but also areas of age-related volume loss can be compensated, which is not achieved by facelift methods sometimes ( perioral area around the mouth, temples, etc.)

In addition to liquid placeholders also comes Botulinum toxin A are used to reduce wrinkles, caused by the activity of the facial muscles.

A further possibility consists in the implantation of usually silicone-based solid implants to model a face. These are used V.A. with receding chin, in the absence of projection in the cheek bones and the mandibular angle.

Abheilzeiten

The healing time is individual and depends inter alia on the size of the operated areas and the operation method. A company 's ability i.d.R. given after 1-8 weeks. The restriction on the ability of society is mainly due to swelling and discoloration caused by blood components.

Combination operations

As part of a facelift is often at the same time tightening the upper and lower eyelids to be impaired ( blepharoplasty ), so that these areas also show reduced aging effects. Also, liposuction of the neck is often performed in combination with a facelift in order to intensify the effect to the neck or jaw line. In order to improve the skin appearance in addition, cosmetic skin treatments such as chemical peels, dermabrasion and laser therapies can be combined with surgery.

Anesthesia method

A facelift is performed under local anesthesia with or without concomitant general anesthesia. The actions of the local injection of numbing liquid serves in general anesthesia both for ease and safe handling of the different tissue layers during preparation, as well as to avoid perioperative pain. The injected liquid ( per page 10-50 ml) is already over, and finally absorbed completely by the body after surgery.

Risks

The complications that may occur in addition under any operation should be mentioned also in the operation of a face. This is generally the swelling, bruising, infection, and wound healing to name a prolonged healing phase and possibly unsightly scarring. The latter is V.A. by careful incision to facilitate tension-free adaptation of the wound margins and sterile precautions. With a known tendency to hypertrophic scarring, such as keloids postoperative local treatment with scar ointment usually is an accepted procedure. Specific risks of facial surgery consist mainly in the training of asymmetries. Since each face has imbalances to some extent, to these after an intervention balanced or even represent emphasized. The thoroughness of the implementation and experience of the surgeon are essential for avoiding this aspect.

A specific complication would be the breach of nerve branches of the so-called facial nerve. This nerve is the nerve that innervates the facial muscles and is so necessary for the facial expressions, among the various ramifications has several cross connections and can be faster than compensate for it so even with irritation or injury of smaller nerve branches This would reduce the function of a specific muscle group with nerve transections otherwise the case. Violation of a Endastes the function of a particular muscle group may be temporarily (until about 6 months) or permanently prevent their function. Then it comes V.A. while laughing to warping in the face. Avoidance of this complication is essential and is flanked by many anatomical studies to provide the surgeon with the necessary knowledge about this.

Also, there may be numbness in the area of the operating field through the separation of small sensory cutaneous nerves (especially the trigeminal nerve ), characterized by swelling, bruising, tissue tension or train of seams. V.A. the area around the incision around the earlobe and the area in front of the ear may be effected temporarily affected.