Facelift or Rhytidectomy

With aging the skin becomes lax and the tissue sag giving the problem of brow droop, cheek sagging, prominent nasolabial folds, jowls and wrinkles and loose skin in the neck. Although various non-invasive, no surgical treatments using laser resurfacing, botulinium toxin treatment and intense pulsed light treatment can help the rejuvenate the face in milder cases, when the problem becomes more severe, generally surgical facelifts will be required. The ageing face has loose excess skin resulting in static wrinkles and sagging of the soft tissue resulting in cheek droop, jowls or neck bands.

What is Facelift Surgery?

The facelift surgery aims to rejuvenate the face by remove excess skin and reposition the sagging facial tissue. The facelift procedure targets 3 main areas:

  • Eye and Brow area or Upper Face,
  • Cheek or Midface
  • Jawline & Jowls or Lower Face and Neck.

Short Scar Facelift or Midface Facelift or Upper Rhytidectomy

Early signs of ageing usually appears around the eyes and cheek. The lateral brow starts to droop and the cheek complex starts to sag. There is associated anterior cheek flattening and appearance of the nasojugal groove. A cheek and temple lift is suitable to reposition the sagging cheek and periorbital tissue through a short scar in the hairline. The procedure is called a Short Scar Facelift or Midface Facelift in Singapore, or Upper Rhytidectomy.

SMAS Lift, Lower Facelift or Lower Rhytidectomy

The incision is made in the temple scalp extending down to the lobule. The skin flap is raised to expose the internal periorbital tissue and cheek tissue which are then suspended with internal sutures. The skin flap is lifted, tightened and excess skin removed before closure.

Short Scar Facelift or Midface Facelift or Upper Rhytidectomy

With further ageing there is more severe sagging of the cheek and facial tissue leading to the appearance of jowls and accentuation of the naso-labial groove. The sagging tissue is extended down to the lower face and jawline. To remove the jowls and improve the jawline, the SMAS fascia is tightened and lifted with a procedure called a SMAS Lift in Singapore or Lower Rhytidectomy

 

What is a SMAS lift procedure like?

 A similar pre-auricular incision extending from the temple scalp down to below and around the lobule is made. The cheek and lower face tissue, particularly the SMAS (submuscular aponeurotic system) or fascia, is exposed by lifting the skin flap. The sagging cheek and jowls are lifted by tightening the SMAS with plication and partial resection and transposition. The skin flap is redraped and repositioned and excess skin removed.

Neck Lift

Early signs of ageing in the neck is the appearance of wrinkles and excess skin. Further ageing leads to the appearance of platysmal bands or webbing due to platysma muscle in the neck. The platysma muscle is an extension of the SMAS fascia in the face. 

 

What is the neck lift procedure?

An extended incision from the lobule to the back of the back ear is made to expose and mobilize the skin and muscle bands in the neck. The neck is lifted by tightening the platysmal bands and removing excess skin.

How long is the Facelift procedure and the recovery time?

All the above surgical procedures may be done under local anaesthesia and sedation or with general anaesthesia as an option. The duration of surgery ranges from 4-6 hours depending on the extent of surgery required in one sitting. Head or neck bandage will be applied post-operatively and they can be removed after review the next day. The recovery period is about 1-2 weeks.

Supplementary Procedures for Facial Rejuvenation

Non-surgical or minimally invasive procedures like Laser Resurfacing or Micro Fat Grafting can be used to complement the facelift surgical procedures to improve the outcome of the surgery.

Laser Resurfacing

Fractional CO2 laser resurfacing with serum application is performed to stimulate collagen formation in the facial skin, giving it a clear and firm looking skin. It usually requires a series of 3-5 treatments at monthly intervals to see the improvement.

Micro-Fat Grafting

With ageing, the face has loss of volume due to atrophy of fat or soft tissue. Micro-fat grafting serves to improve the volume of the facial soft tissue. The procedure involves judicious harvesting of healthy fat cells and transferring them into the face to stimulate the regeneration of collagen and soft tissue.