The tension and elasticity of facial skin, which has been continuously explored and refined, is an important issue in cosmetics. Along with the unceasing progress in surgical science and technology, the overall concept of facelifts has developed from the traditional horizontal superficial “lift” to a longitudinal vertical “lift” accommodating esthetically good and long-lasting effects. Other advances include “short scars,” “minimal invasiveness,” “multiple layers,” and “regional units,” which offer patients a more natural effect and quick recovery. As more options become available and more devices can be obtained, modern facelift is no longer a prerogative demand in the elderly. An increasing number of mature as well as young people have begun to consider facelift as a shortcut to sustain skin tension or to delay aging. Moreover, it has become an unspoken secret of numerous people who remain young forever.
Patients usually have an inexplicable fear of traditional facelift because the procedure involves the face; thus, they often consider facelift as the last treatment resort. However, they often overlook the potential effects of skin age on postoperative recovery and the longevity of results and miss the potential of rapid rejuvenation offered by facelift. Many patients have incorrect information about these so-called “rejuvenation” treatments. They try undertested or prematurely developed light therapies and injection treatments, while ignoring possible risks and uncertainties. This is particularly due to the prevalence of mini-invasive procedures and injections, or laser and light therapy with dazzling sugar-coated advertisements. Furthermore, poor results and unexpected injuries are a risk when undergoing a procedure by a non-specialized physician, where often the results are quite regrettable. Based on his numerous years of experience in skin treatment, Dr. Chuang has estimated that more than 80% of patients previously exposed to esthetic medical treatment found the final results to be unsatisfactory or that they desired further improvement. Approximately 60% of them had to undergo facelift to resolve facial sagging. Esthetic medicine features “formulaic” treatments via devices or injections and fails to “differentiate” patients according to their age, skin conditions, and other influential factors. Physicians proceed with treatment depending only on treatment parameters provided by manufacturers or according to their own experience; thus, the results would definitely not meet the requirements of patients with different skin conditions and ages. In contrast, facelift can be performed using various methods depending on patients’ skin elasticity and is conducted by a professional plastic surgeon who can make adjustments and revisions in light of patients’ skin elasticity during the operation. Therefore, a facelift presents unrivaled results compared with those by micro-invasive or non-surgical therapy.
Facelifts are conducted in the deep layer of the skin to completely improve skin laxity or sagging from the structural plane, with the surgical results lasting from 3–5 years to over 10 years. This not only produces rapid results but also alleviates the concern about the potential of persistent skin sagging in a short time after the surgery. Furthermore, facelift saves one the budget and trouble of regular skin care or repetitive injections, which enables patients to enjoy a stable and long-term result.
Many patients are concerned about the safety of a facelift. However, there are now new surgical concepts and techniques to be applied. Presently Dr. Chuang provides two major trends in facelifts. One is a kind of distant facelift, where the incision is hidden at a site such as the scalp and the procedure is performed using an endoscope. It requires distal skin dissection and elevation, which reduces the possibility of nerve and blood vessel injury and leaves no visible incision scars on the face. The other utilizes temporary biodegradable fixation devices (such as Endotine forehead, midface, or Endotine Ribbon implants) or a new design facelift thread (such as Quills or Silhouette suture) to achieve solid fixation of the skin to deeper tissues. This not only effectively enhances the tension and stability of a facelift but also provides a longer result. This is a radical subversion over the traditional concept that the skin should be pulled tight as much as possible to achieve prolonged effects. In addition, Dr. Chuang is specialized in regional facelifts at local sites such as a lift of the brow end, midface, or jaw line, which relies on the tension and fixation of the superficial fascia to achieve the lifting result. This procedure, which boasts of a shorter recovery period and more efficacy than non-surgical Ulthera or Thermage therapy, or even an embedding thread lift, is suitable for young patients and gives patients quick results and a natural appearance.
Dr. Chuang considers that a “facelift” aims to “tighten” and “lift” and will simultaneously address facial skin “laxity” and “sagging.” This illustrates the primary difference between real surgery and micro-invasive or non-surgical procedure as well as its significance. Varied and diverse modern facelifts have revolutionized the traditional concepts. This allows patients to determine the necessity of operations from “requirements” and “objectives” and no longer by the “aging” stereotype. Regardless of which of the two common methods of facelift is selected, surgical safety is guaranteed as long as the aforementioned two objectives are met and newer advanced devices are utilized. Patients will comfortably enjoy an instant, obvious improvement; furthermore, they will have a stable, long-lasting rejuvenated appearance.
Various types and lengths of Endotine devices provide temporal but strong fixation in facelift surgery.