Relaxation of the skin and recurrence of the laxity of the tissues in the neck and jowls after a face lift is inevitable and it is part of the continuing aging process and the effect of gravity.
Sometimes this occur after months from the procedure, more often after a few years, depending of the face lift technique and the type of skin of the patient, her/his racial and genetic back ground , diet, smoking habits and overall state of health.
At this time the only solution available to correct the recurrence is to perform another face lift with the same risks, chances of complications and down time of the first operation.
A new and revolutionary concept and technique has been developed by which not only the duration of the original face lift is longer but and fore most the need of a second face lift operation maybe obsolete: this is called the Adjustable face lift.
Traditionally, when a face lift is completed, the skin is pulled tight, the excess skin excised and the edges are sewn up in front and behind the ears. These may result of unsightly and hypertrophic scarring from the tension applied in the closure in the effort to create a tighter look. Later on, after the swelling has resolved, there may be a recurrence of the skin laxity which, unfortunately, may occur sooner then later.
The Adjustable Face lift is developed in a way by which at a later day when the skin laxity reoccurs, trough a small adjustment done under local anesthesia, the skin could be repositioned in a more youth full fashion, avoiding, therefore, the morbidity of a longer operation.
How It’s Performed
At the point of redraping the skin, at the completion of the face lift, the excess skin is marked in front and back of the ears. Traditionally this excess skin is simply excised and then the edges brought together with sutures. In this procedure, instead of the full skin, only the epidermis or top layer of the skin is excised, leaving the dermis and subcutaneous tissue fully intact, both in front and behind the ears. Two suspenders are, in fact, created, made not of suture material but of your own natural tissues. Then a few centimeters apart, in the scalp, two pockets are created trough two small incisions, small tunnels are developed, and the suspenders (or flaps) are inserted in to the tunnels and brought up at the level of the new pockets previously created.
Then two important steps follow: one non absorbable suture is placed trough the suspenders tissues and left in the pocket untied, another suture, this one absorbable, is used to anchor the suspenders in place to the fascia. The second suture along with the suspender carries all the tension of the procedure which is usually carried by the skin edges creating bad scarring, allowing the incision to heal with minimal scarring. Months or years from now the aging process and gravity is going to cause a recurrence of skin laxity and jowls (with this technique the recurrence is going to happened later then a traditional face lift), but nevertheless when it happens, all is need it to correct it is to open the scalp incision under local anesthesia and tie up the suture connected with the suspenders: this will correct the residual laxity in the face and neck. The down time is minimal and the need of a second face lift is avoided.
What this procedure accomplishes is, basically, put suspenders on a face lift: at a later date, when need it, these can be simply tight up therefore reversing the signs of aging by a quick, easy, no down time , local procedure.