A fiber mesh-work of protein consisting of collagen and elastin under our skin help to keep it firm. These proteins are what help the skin snap back into place when the skin is stretched.
This network of fibers weaken and causes the skin to sag as it loses the support structure as we age.
WHAT ARE SOME UNAVOIDABLE FORCES THAT ALSO CONTRIBUTE TO AGING SKIN?
- With age, the skin becomes thinner and loses fat. A much rougher texture replaces the youthful plump smoothness of our skin as we age.
- Gravity tugs on weakened skin creating the droop of jowls (chicken fat) under the arms.
- Our genes also contribute invisibly to the process. This leads to skin that appears 50 at 80 in some people and the unfortunate opposite in other people.
Visible signs of aging include wrinkles, age spots, dryness and sagging skin. Apart of changes in the skin, the whitening or graying of the hair is also another obvious sign of aging. You may also notice that healing time of the skin takes longer.
Factors such as gravity, the natural aging process, stress and sun exposure can negatively affect the skin. This leads to lax skin, deflated facial features, wrinkles and also fine lines.
Some of the most frequent aging signs that can be corrected are:
- Forehead lines
- Crow’s feet
- Sagging skin around the neck
- Wrinkling of the skin
- Loss of elasticity in skin
- Saggy of the skin
- Dullness of the skin
Face rejuvenation with fat grafting
Facelift surgery (rhytidectomy) is a procedure that reshapes the lower third of the face. Based on the amount of correction needed, surgery can be done either under local or general anaesthesia, on an outpatient basis. As for a traditional facelift, incisions are made along the hairline to make sure that they are not easily visible post-surgery.
Excess skin is removed from the face and neck, deep facial tissues are tightened, and volume is added to the cheeks and jawline during the procedure.
Presently there are newer, more advanced options. They include:
- Laser-assisted surgery: Technological advances have led to the development of laser-assisted face and neck lifts. These procedures utilize laser technology to tighten the skin by removing fatty tissue.
- Endoscopic surgery: The endoscope has also been incorporated into traditional facelift procedures, resulting in less trauma and reduced recovery time.
What TO expect after the procedure?
Some bruising and pain are common. They will normally subside within a few days. Most patients are very happy with the outcome of the procedure.
- Modified S Lift for the Lower Face: In the temple, a curved incisions is made. Similar to a midface lift, the incision continues downwards along the front of the ear (close to the edges of the ear cartilage) and around the earlobe. This is so that the surgical scar is less visible from a direct view.During this proceure, the skin is lifted from the underlying facial muscles in the lower face. Then, to lift the jowl and jawline areas, the muscles are tightened with special sutures sewn in a purse string pattern. Finally, excess skin is trimmed off before the wounds are sealed with fine sutures. This is a 3 hour procedure and can be performed under local anaesthesia or intravenous sedation. The recovery time is about 2 weeks.
- Endoscopic Browlift: A minimally invasive, keyhole procedure that’s performed through 5 small (2 cm) incisions in the scalp along the frontal hairline. This is so that all the scars will be well hidden. A high definition fiberoptic camera system is inserted through the incisions. This allows direct and magnified visualization of the relevant anatomical structures. The scalp is separated from the forehead bone, then deep tissues are carefully released along the brow bone area, identifying and protecting important sensory nerves in the vicinity, thus allowing the brow to be elevated to a higher position.The brow is then stabilized in this new position with a special device known as an Endotine. The scalp wounds are then closed using special skin staples. The Endotine device keeps the brow in the elevated position and dissolves and disappears in 6 to 12 months, by which time the brow has had time to set and stabilize in its new position. This procedure is usually completed in 1 to 1.5 hours under intravenous sedation. Recovery time is normally 7 to 10 days.
- Browlift: The brow is an extremely important structure because of it close relationship with the upper eyelid. Aging results in a descent of the brow. This in turn causes skin laxity in the upper eyelid region, which causes the upper eye lid to age. Patients invariably notice this problem and are frustrated by it, but often attribute it to loose and excess skin of the upper eyelid, when in fact the problem is caused by the sagging of the brow. To treat this problem effectively, a browlift is required, not an upper eyelid procedure such as an upper blepharoplasty.
- Direct Browpexy: This procedure involves making an incision just below the eyebrow. Excess skin is then removed and the lower wound edge is then stitched to the soft tissues overlying the brow bone above, thus elevating the brow. The wound is then closed with very fine sutures, so as to ensure the scar is inconspicuous. This simpler type of browlift is usually completed in about 2 hours under local anaesthesia, with a recovery time of about 10 days.
- Neck lift: A neck lift is usually performed alongside a lower facelift. The lower facelift incision is extended around the earlobe, along the back of the ear and into the hairline behind the ear. The skin is elevated from the neck muscles, the muscles are tightened with sutures in an upward direction. The excess skin is then removed and wounds are then closed with fine sutures. A neck lift takes about 3 hours to complete, and is usually done under intravenous sedation. Recovery time is about 2 weeks.
- Endoscopic Mid-face Lift: The mid-face refers to the middle portion of the face, and corresponds to the mid to upper cheek area. Endoscopic techniques are used when performing a mid-face lift. Firstly, a curved incision is made in the temple and the scalp in that area is elevated in a downward direction and over the cheekbone. The surgical dissection is completed from below through an intraoral incision on the inside of the upper cheek.The midfacial tissues are then lifted and stabilized using an Endotine device specially designed for the mid-face. Finally, the temple wound is closed with skin staples and the internal cheek wound is closed with dissolving stitches. Fortunately, this technique avoids visible scarring on the face, since they are hidden within the scalp of the temple and inside the mouth.The procedure takes about 3 hours and is usually done under intravenous sedation. Recovery time is roughly 2 to 3 weeks.
- The Silhouette Lift: Classified as a type of thread lift. A minimally invasive facelift technique that uses non-smooth threads to lift the facial tissues. There are multiple ways to make the threads non-smooth. One common method used is to create multiple pre-cut barbs into the thread. It will stick out at an angle along the length of the thread. The disadvantage is that they weaken the thread (thread is thinner) and therefore, it’s weaker at the area where a barb has been cut into the body of the thread. This may cause the thread to break more easily. The Silhouette thread does not have barbs. It has knots (that are tied) and cones (that are threaded). It’s inserted through the cheek tissues with a special needle. As the threads are not smooth, each knot and cone serves as a small anchorage point that catches some tissue. This gives a lifting effect to be created when the thread is pulled upwards. The top end of the Silhouette thread has a curved suture needle attached to it. It exits through a small (2 to 2.5 cm) incision made in the hair bearing temple. Then, the thread is stitched into the thick muscle in the temple known as the temporalis muscle to allow all the threads to be tied to each other in pairs. A firm suspension of the facial tissues with secure fixation into the temporalis muscle is created this way. Finally, the temple wound is closed with skin staples. The procedure takes approximately 1 to 1.5 hours and can be completed under local anaesthesia or intravenous sedation. Recovery time is 1 to 2 weeks.
- History taking and physical examination: Your doctor will discuss with you about your overall health, including any previous medical history as well as any complaints you have. He will carefully examine your skin, discuss with you the weak points and ask you about your desires and expectations, afterwards he or she will explain possible treatment options available for you.