By Robert M. Lowen, MD
Published on August 01, 2006
Would you like a facelift that didn't show any scars? A facelift that left you looking younger and more refreshed, without any of that pulled, unnatural look that you've seen? A facelift subtle enough to be useful for the early signs of aging in your thirties, yet powerful enough to be used in your fifties, and still avoid visible scars in front of the ears? Well, there is such a facelift. Its medical title is the "subperiosteal endoscopic facelift," but we'll just call it the "high-tech" or "scarless" facelift for short.
How can this kind of result be accomplished? And is it too good to be true? Here's how it works. The procedure is sophisticated, yet simple in concept. Since the main signs of aging, particularly the ones that concern you from your thirties to fifties, are in the "mid-face," it is this area--the cheeks, eyes, and brows--that is restored to the fullness of youth. Using non-visible incisions of less than an inch, behind the hairline of the forehead and temple, and a hidden incision inside the mouth, specially designed instruments are introduced right against the facial bone to gently elevate the tissues of the cheek, temple area, forehead, and brows. Visibility is provided under high-magnification by a light-conducting glass rod called an "endoscope," which is connected to a digital chip camera. The plastic surgeon sees a magnified image of the surgical field on a TV monitor.
When the tissues are freed, sutures are placed on the underside of the cheek, passed up to the temple area, and tied under appropriate tension to the deep connective tissue that covers the muscle of the temple region. By placing the sutures in the right place, the cheek is gently folded on itself at the deepest level. This maneuver elevates the cheek not only in a vertical dimension but also in the third dimension of outward fullness.
Because the earliest signs of aging are the sagging of the lateral and central brow, followed by the lower lid and cheek area, the "high-tech" facelift corrects these areas long before the need for a traditional facelift with incisions in front of the ears is needed. In fact, it is only when significant excess of skin and sagging in the jowl and neck area occur that any incision in front of the ears is needed. Many people, even into their fifties, find that they can have a high-tech facelift as the main procedure, and if they are developing neck laxity they can have a necklift through a small incision under the chin, further postponing any need for the traditional incisions in front of the ear for several more years.
Finally, if the total program of rejuvenation includes a sensible program of sun protection and a medically supervised regimen of retin-a and alpha-hydroxy acids and anti-oxidants, a person can stay looking younger and better at any age. With today's more gentle Erbium lasers, which allow rapid recovery and limited duration of redness, the circle of high-tech facial rejuvenation is complete. They can be used at the same as the high-tech facelift for that extra touch to soften fine wrinkles around the eyes or upper lip.
To understand better the logic behind the high-tech facelift, observe your face carefully in the mirror and instead of pulling up and out, just gently elevate the cheek and corner of the eye and brow. If you find these changes pleasing and want to avoid scars in front of your ears, perhaps the "high-tech" facelift is for you.