Face and neck lift

Facelift is the procedure used to correct signs of sagging of facial and neck tissues by repositioning them in the most natural way in order to recover the time lived.
The face shows signs of ageing due to volume loss related to tissue atrophy and signs of sagging with more obvious effects like wrinkles, blemishes, folding and hollowing .
The neck may suffers dramatically from ageing showing sagging defects already at a relatively young age with patterns of skin flaccidity, wrinkles and sagging, and with time, the impression of transience and senescence of the neck gets worse and worse .

Aesthetic defects and causes of Facial ageing

At the level of the face, the passage of time causes adipose atrophy and bone reabsorption with consequent emptying of the supporting tissues responsible for a sagging appearance.
Mimic facial muscles that describe our character with their continuous activity cause wrinkles and furrows. That is why botox injection that relaxing these muscles can delay the appearance of ageing.

Neck imperfections

Regarding the neck we must remember that its skin is extremely thin and has a rather poor micro circulation. Moreover, the neck, particularly in women, has fewer sebaceous glands and less adipose tissue than the face, as a result, drier skin tends to age earlier. Another reason concerns the muscle structure of the neck that is not anchored to any bony structure so are more prone to drooping.
Also, unlike the face that is constantly being taken on care by women, neck skin and décolleté are more neglected event though they would need the use of creams and ointments to bolster hydratation and improve elasticity.
Environmental factors such as sun exposure on a fair skin that has less melanine defences cause damage to elastin and collagen fibres producing wrinkles, spots and loss of elasticity.
Especially in men, the major muscle of the neck aka platysma tends to collapse over time and at the same time the adipose tissue under the chin tends to increase, creating disagreeable skin laxity typical of the double chin.

Surgical solutions

To firm up the sagging and relaxed skin of the neck of man and woman, to remove the so-called vertical platysma bands or to cure wrinkled and folded skin you can resort to cosmetic surgery.
Drop of the cheeks
It is corrected by a facial lift and the repositioning of the SMAS in front of the ear and on the sideburn.

Double chin

A direct liposuction is performed with mini cannula that allows the removal and formation of new adhesions on the sagging skin.
Laxity of the neck
The solution consists of lifting the neck by repositioning the platysma, that is, the mimic muscle to which the skin of the whole neck is attached by hooking it to the ligament region of the ear auricle.
weak chin

Causes the undefined neck for which the solution could be a chin implant or fat transfer so to increase the projection of the chin and improve the jawline.

Specialist examination

It is essential to study the type of intervention based on each patient. The deep knowledge of the physiology of the mimic facial muscles that give uniqueness to an individual’s facial expressions, allows to customize the result for each patient.
The neck is the basis on which the face of the individual rests and therefore affects to outline the somatic traits of the patient and his appearance.

Dr. Tommaso Savoia analyses the anatomical part and customizes the most suitable surgery for each patient.
The doctor won’t always suggest a surgical option as a first choice since he could advice ancillary treatments like fillers, Botox, lasers and more.

Preparation for intervention

The exams required before a surgery are:
– Preoperative blood tests: blood counting formula leukocyte, blood glucose, creatinine, blood urea, plasmatic electrolytes (chlorine, calcium, potassium, sodium), total proteins, liver function (ast, alt), coagulation (PT, PTT).

– Electrocardiogram.
Surgery
To effectively lift and fix the neck and eliminate skin laxity the most suitable intervention is the neck lifting.
The surgery lasts from 2 to 4 hours depending on whether the facelift involves also malar and temporal region of the face or not and
may be performed under local (sedated) or general anaesthesia.
A night in the hospital is advisable but, in cases of minor lifting with slight extent of surgery, it can also be carried out in an outpatient basis.
The procedure is not recommended for heavy smokers. In any case, it is necessary for the patient to abstain completely from smoking at least 14 days before surgery.
The neck is made more tonic not only through the elimination of skin excesses, but above all thanks to the lifting and repositioning of the muscular portion of the area. The incisions are made in front of the ear (orthogonal under the sideburn) and, in the case of cervicofacial lift, along the line of the ear (longitudinal) and retroauricular.
In some cases it is also necessary to cute under the chin to have better access to muscle bands. The relaxed skin is released in the front part of the cheeks and the bottom part, on the neck. Thereafter, the deep tissue, known as SMAS (superficial aponeurotic musculoskeletal system), to which all the muscles that give expression to the face connect, is lifted and repositioned following two vectors that go upwards and backwards.
This technique allows to give a more natural look to the face, because it does not leave surface tension. The face takes on a fresher appearance, without presenting the imperfections of a “pulled” face with a “frozen” appearance, as the surgery maintains the mimicry capacity of the muscles unchanged.
In case of liposculpture of the neck, we proceed under local anesthesia , practising a small hole to pass a thin cannula. Scars are almost invisible and recovery times very fast. The procedure is performed by making a small incision in front of the line of the ear through which tissues are pulled and repositioned back like they where years ago.
Another possible intervention is lipostructure or fat transfer. A technique that allows the extraction of fat by liposuction with small hand guided cannulas from places that has excess fat (abdomen or lower extremities) and, after having cleaned it, to reintroduce it to the places of the face that need filling. The transferred fat is absolutely biocompatible because it comes from the patient himself: it is integrated into the receiving tissue and acts partly as a definitive volumetric structure and partly as a carrier of growth factors and new stem cells that rejuvenate the host tissue.
Post-operative
Stitches removed after 7 days, healing takes 15 days.
In the post-operative period it will be advisable simply to wash gently with a neutral soap. You can make a daily shampoo taking care to dry and disinfect the wounds well immediately after. It will be good to use a moisturizer cream on the skin, without applying it on the wounds with the stitches. Stitches can be removed from day eight and you can resume makeup. Starting from the fifteenth day it will be possible to start lymphatic drainage massages.
The scars will be in front of the ear, under the sideburn and along a retroauricular line.
There are some risks such as bleeding during hospitalization (5% cases): blood clots under the skin are eliminated with small drains. Other risks include infections, redness or delays in healing. All complications that can be solved by the care of the doctor. Facial paralysis is very rare, but regresses spontaneously within 3-6 weeks.

Prices for Face lift

The costs are extremely variable according to the intervention performed, but they must be oriented in a range from 500 € for a medical lifting or liquid lifting up to 9000 € for a surgicale facelift.