CHAPTER 48
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There is another advantage of facelifting at an ear- ly age: traces of age will take effect later in life. This is due to the fact that the deep level of the superficial musculo-aponeurotic system (SMAS) is lifted well and fixated with lasting effect. That is why this proce- dure could be considered as prophylactic preservation of youth or prevention of an ageing look.
The media often causes speculation about how long the effect of a certain method of plastic surgery will last: 3, 5, 10, 12, 15 years…? Robert Flowers from Hawaii had luck when he found two female twin sis- ters in the USA: one of them had undergone facelift- ing, the other – because of health, family, and finan- cial reasons – had not. Flowers organized a meeting between the two sisters, placed them on the couch, and took photographs: 10, 20, and even 30 years after When we have situation where the neck skin is not
very affected and the face could require some sup- port, then we take into account only preauricular ac- cess for a so-called minilift. The deep layer, however, should be done well. For decades the majority of plas- tic surgery patients were older; there is now an in- creasing number of younger patients in their mid-40s, sometimes even in their early 30s.
The question occurs whether facelifting at such an early age is at all reasonable? If we conduct facelift surgery on a 60-year-old or on a 70-year-old, the sur- gery can cause a rejuvenation effect of 15–20 years.
The younger our patients are, the smaller the effect of rejuvenation will be. There are not many traces of age to be modified on a 30-year-old. Yet her/his features can be beautified and harmonized.
Mini Facelift as Prophylactic Preservation of Youth
Dimitrije E. Panfilov
Fig. 48.1. a Our youngest patient, 28 years of age. b One week after sur- gery she does not look much younger, but harmonized and beautified
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plastic surgery the differences between the two sisters were still visible. One could easily tell which one looked younger, which one had undergone plastic surgery.
The effects of facelifting last forever. The skin and SMAS layers, parts of which we remove, do not grow back nor do they regenerate. The time lapse our pa- tient has gained has everlasting effects. Yet we have to warn our patients: we can turn back time on the bio- logical clock but we cannot stop it, it will go on. A 60-year-old woman can be made to look 45 again, but 15 years on she will not look 45 anymore, rather 60.
Providing there is sufficient zest for life and health,
Fig. 48.2. a Preauricular, retrotragal incision with radiosur- gery. b Skin flap preparation till the midline of the neck. c After the superficial musculo-aponeurotic system (SMAS) layer has
been tightened well; skin excess to be removed. d To achieve a harmonious result, we avoid too much tension of the skin
we can conduct a second facelift surgery, which is a completely new operation, not a correction of the first.
In secondary procedures, we only have to respect the previous scars and, if necessary and possible, to correct them, to make them less obvious.
Bibliography
Please see the general bibliography at the end of this
book.
357 48 Mini Facelift as Prophylactic Preservation of Youth
Fig. 48.3. a Male patient, 40 of age, with dermographic markings for a minilift. b The same patient 1 day postoperatively. Comparison c before and d after 7 days: intradermal sutures to be removed, hair-wash allowed, he is resocialized
Fig. 48.4. A 33-year-old patient a before and b 2 weeks after mini facelift and upper and lower blepharoplasty
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Fig. 48.5. a This 53-year-old patient had a facelift (somewhere else) 9 years ago. b Dermographic markings: notice the tempo- ral and frontal visible scars in the prehairline. c Six days after
mini facelifting, vertical simple snail SMAS flap and augmen- tation of the lower lip with a strip of the SMAS
Fig. 48.6. a A 60-year-old patient had a facelift elsewhere 8 years ago.
b A mini facelift was enough to refresh her appearance
