Facelift

Facelift in Yerevan, Armenia (rhytidectomy, facelifting) is a cosmetic rejuvenation procedure that smooths age-related wrinkles and creases. A neck lift (platysmaplasty) is often done alongside to reduce fat and sagging in the neck. However, it won’t eliminate fine lines or sun-induced aging—these require specialized beauty treatments.

As you age, facial changes include:

• Loss of skin elasticity
• Altered fat distribution (some areas lose fat, others gain)
• Skin flaps are lifted and underlying tissues repositioned to restore a youthful contour

Correctable signs:

• Sagging cheeks
• Loose skin along the jawline
• Deep nasolabial folds
• Neck skin laxity and fat (when combined with neck lift)

Note: Significant weight fluctuations may reduce longevity of the results.

Preparation

Consultation includes:

• Medical history and health check (smoking, alcohol, previous surgeries/complications)
• Medication review (prescription, OTC, supplements)
• Facial photography and assessment of bone structure, fat, skin quality
• Discussion of expectations and limitations (e.g., fine wrinkles, natural asymmetry)

Preoperative instructions:

• Stop blood thinners ≥ 2 weeks prior
• Use bactericidal facial wash on surgery day
• Fast for 8 hours before arrival; water and approved meds allowed

Surgery Overview

• Skin and underlying muscles (SMAS/platysma) are tightened
• Excess fat is removed or reshaped
• Skin is redraped; excess is removed; incisions are closed

Incision options:

• Traditional: hairline → front of ears → behind ears (optional chin incision)
• Limited: shorter incision around the ear
• Neck lift: around ear + optional chin incision

Duration: 2–4 hours (longer if combined with other procedures)

Postoperative Care

Immediate effects: mild pain, discharge, swelling, numbness
Urgent symptoms: severe unilateral pain, breathing difficulty, chest pain, irregular heartbeat
Day 1–3:

• Head elevated during sleep
• Pain control and cold packs to reduce swelling
  Follow-up visits:
• Day 1: dressing change
• Day 2–3: transition to elastic band
• Day 7: stitch removal and wound check
• Regular monitoring over 2 months

Self-care for 3 weeks:

• Clean and protect incisions
• Use front-fastening clothes
• Avoid pressure, makeup, strenuous or sun exposure
• Begin using SPF30+ sunscreen after 3 weeks
• Delay hair treatments for 6 weeks
• Schedule social events after full recovery

Results and Longevity

• A refreshed face and neck appearance
• Results typically last ~10 years; aging resumes over time

Surgical Evolution & Key Anatomy

Understanding complex facial anatomy—SMAS, ligaments, fat compartments—is critical. Surgeons today use techniques that mobilize and resuspend deep structures, not just skin.

Common Complications & Risk Management

• Duration: ~2–6 hours, inpatient ~1 day
• Early swelling peaks ≤ week 1; compression band 7–10 days
• Sutures removed day 7; physiotherapy (e.g., microcurrent) starts post-op
• Edema may take 6–12 months to fully resolve
• Complication rates: hematoma 3–8%, necrosis 1–3.6%, nerve damage <1%, infection, and scarring

Risk factors: high blood pressure, blood thinners, smoking, salt, herbal supplements—all should be stopped ≥ 3 weeks pre-op or 4 weeks post-op.

Lifting methods and development history:

• 1900 Miller, Passot: Excision of elliptical skin segments in various facial regions.
• 1927 Barnes: Wide skin detachment for tightening with removal of excess.
• Aufricht: Subcutaneous tissue replication.
• Pangman: SMAS plication was initially overlooked by the surgical community.
• Wallace: SMAS suspension was also initially underrecognized by peers.
• 1974 Skoog: Introduced SMAS dissection of the superficial fascia, marking the start of the modern facelift era. This technique elevated skin, SMAS, and platysma as a single flap for durable results. However, it carried a risk of facial nerve injury and was not widely adopted at the time.
• 1976 Mitz & Peyronie: Coined the term “SMAS” and popularized its use.
• 1982 Webster: Advocated extending dissection beyond the parotid capsule to enhance mid-face lift.
• 1990 Owsley, Lemmon, Hamra: Described more extensive SMAS dissection combined with flap suspension techniques.
• 1992 Hamra: Introduced the deep-plane facelift—lifting platysma, SMAS, malar fat pad, and orbicularis oculi as a composite unit.
• 1995 Connell & Marten: Performed separate tightening of skin and SMAS with multi-vector flap placement (temporal, zygomatic, mastoid).
• 1995 Stuzin: Developed the two-layer facelift, advancing SMAS dissection beyond Barton’s work without limiting bifurcation to the parotid region.
• 1995 Robbins: Presented a subcutaneous approach targeting the anterior masseter edge to soften the nasolabial fold.
• 1997 Baker: Described lateral smasectomy following the nasolabial fold.
• 1999 Saylan: Introduced the “S‑Facelift” technique.
• 2000 Tonnard: Developed the MACS lift (Minimal Access Cranial Suspension), using limited temporal incisions and vertical suspension of the SMAS for shorter scars.
• 2007 Stuzin: Proposed the “P‑SMAS” algorithm—a facelift tailored for elongated faces, with vertical vectors for wider faces.
• 2008–2009 Barton: Introduced High‑SMAS technique with extension above the zygomatic arch, mobilizing the zygomatic ligament for true upper-cheek lifting; a bivector approach.
• 2009 Rorich: Advocated individualized flap design and side-vector SMAS suspension for long/narrow faces, and vertical vector SMASectomy plus flap suspension for short/wide faces. Simultaneous lipofilling supported the “lift and fill” concept.