Japanese Society of Aesthetic Surgeons Specialist Specialist of Japan Society of Plastic and Reconstructive Surgery Regular member of the International Society of Aesthetic Surgery Japanese Society of Anti-Aging Medical Science Specialist Director of Japan Association of Aesthetic Medicine
Face lift is an operation that removes slack by making an incision in the skin from the ear to the inconspicuous area around the temple with a scalpel and pulling up the skin and subcutaneous tissue.
In addition to the face lift, as a lift-up treatment that leads to improvement of slack, a thread lift (thread lift) that pulls up the slack of the face and neck by inserting a special thread (thread) with a hook under the skin and high frequency There are irradiation treatments with machines such as HIFU (ultrasonic) and HIFU. Incision-type face lifts tend to have long downtime such as swelling and swelling after surgery, but they have a high lift-up effect and the effect lasts for a long time .
By knowing in advance the causes of sagging, the characteristics of facelift surgery methods and main surgical procedures, downtime and risks after surgery, and differences compared to other lift-up surgery, facelift surgery can be made more effective. You can receive it with confidence .
Table of contents
It is said that about one-third of the subcutaneous fat on the entire face is concentrated on the cheeks and around the cheeks, and one of the causes of sagging is the atrophy of the cheeks and the fat around them with aging. It is due to the fact that it hangs down (hanging) as it comes and loses gravity.
The facial muscles, the facial muscles, weaken with age because they are not used, and when the muscle mass decreases, the force to support the cheeks and the subcutaneous fat around the cheeks in their original positions weakens, causing drooping. Causes sagging. Therefore, it is said that those who originally have a lot of subcutaneous fat on the face tend to sag due to the drooping fat.
On the face, there are ligaments that connect the deep fascia, which covers the skin and bones or muscles deep under the skin, like an adductor muscle. Supporting ligaments are columnar or lattice-like fibrous tissue that firmly connects the skin of the face to the bones or deep fascia and helps prevent the skin and the underlying subcutaneous fat from dripping.
The supporting ligament is originally a tough and elastic fibrous tissue, but when it deteriorates mainly due to factors such as aging and swelling habit, it becomes thin and loosens and cannot support the skin and subcutaneous fat, causing sagging .
In addition, bone tissue constantly repeats the cycle of bone resorption in which old bone is destroyed and bone formation in which new bone is created, but as we get older, bone resorption exceeds bone formation and the bone gradually becomes thinner. , The supporting ligaments may loosen.
It is located under the skin, which has a three-layer structure of epidermis, dermis, and subcutaneous tissue (mainly fat) from the outside, covers the facial muscles, and exists over a wide area of the face from the temporal region above the ears to the face line. The thin, membranous tissue is called SMAS (superficial fascia).
SMAS, which is the foundation of the skin, is made of collagen, which is a strong fibrous protein, and does not loosen when young. However, when it loosens with age and hangs down, it cannot support the skin and causes sagging and wrinkles. It will cause the cause.
Facial sagging is manifested by drooping subcutaneous fat, loosening of supporting ligaments and SMAS, as well as a decrease in collagen and elastin, which help keep the skin firm and elastic.
Collagen, which is a fibrous protein, occupies about 70% of the dermis, which is the lower layer of the epidermis, and hyaluronic acid, which is a jelly-like substance, fills the space between them while holding water. Furthermore, in the dermis, a fibrous protein called elastin binds reticulated collagen to each other and maintains the firmness and elasticity of the skin with a spring-like structure.
However, when collagen and elastin deteriorate and decrease due to ultraviolet rays, stress, aging, hormonal imbalance, etc., the thickness of the dermis becomes thin, and the skin becomes less firm and elastic, and sagging is likely to occur .
Subcutaneous fat that hangs down due to aging, loosening supporting ligaments, SMAS, and other tissues that cause sagging are surgically returned to their original positions, and the skin is pulled up to improve sagging. Face lift is an operation that aims for a youthful contour.
The range of indications for face lift surgery is generally from the entire face (middle face) excluding the forehead, eyelids, nose, and mouth to the upper part of the neck including the face line. Since the surgery name and coverage may differ depending on the medical institution, please check the website of each medical institution or the contact information in advance when considering a face lift.
In addition, face lift is an operation that is said to have been reported in Europe and the United States for more than 100 years. Initially, the skin is incised from the sideburns or in front of the ears, and the skin is simply pulled up and sewn together. Was the mainstream. However, at present, not only simply pulling up the skin, but also adjusting the subcutaneous tissue such as supporting ligaments and SMAS according to the degree and cause of sagging that varies from person to person, and removing excess subcutaneous fat have been established. I will .
The main face lift surgical methods used in many medical institutions, their characteristics and surgical contents are as follows.
An incision was made in the skin around the ear, the thin membranous tissue SMAS was peeled off once, excess SMAS and skin were excised, and then the subcutaneous tissue including SMAS was pulled up so that the sagging was eliminated. The "SMAS method" is a face lift technique that is sewn and fixed in a state.
It is a face lift that tends to be selected for those who have severe slack from the cheeks to the vicinity of the face line, and it can be expected to improve the bulldog face by eliminating the slack, and it gives a youthful impression. You can aim for the line of the chin .
The face lift by the SMAS method has various treatment methods such as the range to peel off the SMAS, the shape when excising, the object to be sewn and fixed, etc., and the surgical content may differ depending on the medical institution, and the state of slack and the ideal finish The doctor chooses the best method. The general procedure for surgery is as follows.
(* ⑥ is not always done)
The "MACS method" is a face lift technique that aims to lift up the skin by making an incision in the skin around the ear and then pulling up and fixing the SMAS using medical sutures. Compared to the SMAS method, the area where the subcutaneous tissue is peeled off is smaller, so it is a surgical procedure that is said to be relatively less burdensome to the body.
Face lift by MACS method is suitable for those who want to aim for natural lift-up without severe loosening of the skin, and it is said that downtime is shorter than SMAS method. The MACS method, which raises SMAS at two points on the neck and cheeks, can be expected to improve slack on the face line and around the cheeks .
The surgical procedure, such as the method of treating the subcutaneous tissue and the method of stitching, may differ depending on the medical institution, but the general surgical procedure is as follows.
Since face lift is not an operation to stop aging itself, aging occurs over the years, but it is said that the progress of aging is slowed down by undergoing surgery.
It is said that the duration of the lift-up effect by the face lift varies greatly depending on the skill and knowledge of the doctor, and in the case of surgery where the area around the ear is simply incised and peeled off and only the skin is pulled up and sewn together to fix it. The duration may be less than 3 years.
Face lift is not a treatment that provides a permanent lift-up effect, but it lifts each subcutaneous tissue such as SMAS and fat in each part in addition to the skin with appropriate strength and orientation according to the degree and condition of ptosis that varies from person to person. If you have surgery under a doctor who can, you can expect a long-term effect of 10 years or more .
Therefore, in order to obtain long-term effects with face lift, it is necessary to confirm the details of surgery from the website of the medical institution considering surgery or contact information in advance.
Depending on the medical institution, you may be hospitalized on the day of face lift surgery, or you may wear a fixed band called facial garment for about two days to stabilize the surgical site. Five to ten days after the surgery is completed, the patient will return to the hospital to remove the suture.
Swelling and internal bleeding due to surgery tend to subside in about 2 to 4 weeks, and you may feel a tightness or swelling of the face for about 1 to 3 months. In addition, it is generally said that it takes about 3 to 6 months for the scar to become inconspicuous and finish naturally, and it is recommended to visit the hospital regularly to check the presence or absence of hematoma and the finish after surgery. It has been.
|Immediately after surgery (on the day) to 2 days later||Depending on the medical institution that underwent surgery, you may be hospitalized for one day or wear a fixed band for about two days.|
|5-10 days later||Remove the suture site|
|2-4 weeks||A guideline for swelling and internal bleeding to subside|
|1 to 3 months later||A guideline for calming the tightness and swelling of the face|
|3 to 6 months later||Estimated until the scar on the incision site becomes less noticeable and finishes naturally|
Post-surgery pain tends to be alleviated by taking painkillers prescribed as aftercare, with swelling peaking around the third day after surgery and large swelling subsided in about two weeks. The incision in the skin damages small blood vessels, and slight bleeding may cause the area around the incision to appear purple, but in most cases it becomes less noticeable after about 3 weeks.
In addition, since swelling occurs for about 3 months after surgery, you may not feel the effect of lift-up until you have settled down. It takes about 3 to 6 months for the scars on the incision site to become inconspicuous and finish naturally, but if you do not mind swelling or internal bleeding, you will return to your daily life such as work or housework within 2 weeks after surgery. It is also possible .
Hematomas may occur after surgery if you have high blood pressure or if you are taking a coagulant that prevents blood from clotting because it incises and peels off the skin and subcutaneous tissue. When a hematoma develops, it can be resolved by reopening the surgical site and removing it.
It is a post-surgery risk mainly in smokers (heavy smokers) , and in rare cases skin necrosis occurs around the ears due to the lack of blood flow caused by the shrinking blood vessels caused by smoking. In the unlikely event that skin necrosis occurs, the skin is regenerated by ointment treatment.
Since small nerves run in a complicated manner on the face, the skin and subcutaneous tissue are carefully peeled off so as not to damage the nerves in the face during face lift surgery. If the nerves in the face are damaged by surgery, paralysis may occur, but even if the paralysis does occur, it is temporary and it is usually said that the nerves recover and improve over the years.
The human face is not completely symmetrical in the first place, but if you have surgery under a doctor who has little track record of face lift, there is a risk that the finish will be different on the left and right after surgery.
In order to aim for a natural finish, a doctor who has abundant experience in face lift and can appropriately treat the range to peel off the skin tissue, the strength to pull up, and the object to be fixed for each case such as different skin and sagging conditions. It is important to have surgery at.
|By pulling up the tissue that has drooped or loosened, it can be expected to improve the sagging. By eliminating the sagging, the excess skin and subcutaneous tissue that can be expected to have the effect of making wrinkles less noticeable are removed, so aim for a firm impression. Ru||Scars are noticeable in the months after surgery due to skin incision. Temporary strong swelling and pain on the face after surgery. Very rarely, there is a risk of nerve paralysis.|
Face lift has a longer downtime than treatments that do not require an incision, but its high lift-up effect makes it suitable for severe sagging, and long-term effects can be expected.
There are various options for sagging treatment other than face lift, and the main treatments that do not make an incision in the skin are irradiation treatment with a thread lift or machine that pulls up sagging using a special thread with a catch as follows. However, in any case, the face lift is good for the duration of the effect.
|Treatment||Duration of effect|
|Thread lift||8 to 24 months (for absorbency)|
|Therma Cool||About half a year|
|HIFU machine (Ursera, Dubro, Ultraformer III, etc.)||About half a year|
Thread lift is a treatment that pulls up the slack on the face and neck by inserting a special thread (thread) with a catch under the skin . Since the skin that has lost its gravitational force is physically pulled up with a thread, you can expect a lift-up effect that is easy to understand.
There are various types of threads, such as those with thorn-shaped protrusions called cogs and barbs and conical protrusions called bio-cones, and the pulling force differs depending on the shape and number of protrusions. If the thread is an absorbent thread that breaks down over the years, the duration of the effect is about 8 to 24 months, and if the effect decreases, it can be re-treated to make up for it.
Thermacool is a machine that irradiates radio frequency (RF) energy, which is a type of electromagnetic wave . Radio frequency has the effect of tightening and promoting the production of proteins such as collagen by heat, giving the skin firmness and elasticity. It is an irradiation treatment that can be expected to have the effect of preventing and improving sagging.
Since the effect of Thermacool lasts for about half a year, it is recommended to receive the treatment once or twice a year. High frequencies do not damage the surface of the skin, so downtime is short and redness at the treatment site tends to be less noticeable within 24 hours. In rare cases, you may feel a slight twitch, but in most cases it will settle in 2 to 3 weeks.
Mr. Yoshiro Suzuki, who supervised the article, taught me about face lift.
Introduction of supervising doctor
Dr. Yoshiro Suzuki, the director of Doctor Spa Clinic, is attracting attention as the first doctor in Japan to perform the cable suture method, which is a rejuvenation operation for the middle face. We specialize in rejuvenation surgery such as face lift, pursue total anti-aging, and have abundant achievements and experience in eye plastic surgery and nasal plastic surgery. Leading aesthetic medicine.