Facelift surgery (rhytidectomy) is a type of cosmetic surgery that is used to reduce the signs of aging on the face and neck. It is a popular procedure among both men and women and has been performed for centuries. Examining the history of facelift procedures indicates that they have significantly changed and evolved over time, however, the main goal of the procedures is still the same: to give you a younger-looking and more rejuvenated face.
The Beginning of Facial Plastic Surgery
Ancient Egyptians
The earliest known documentation of plastic surgery involving the face dates back to the ancient Egyptians. The Edwin Smith Papyrus is the oldest known medical document that details how ancient Egyptians treated facial trauma with surgical procedures. This papyrus is believed to have been created as far back as 3000 to 2500 BCE. It includes information about broken noses and their repair.
The ancient Egyptians used “rhinoplasty” procedures to reshape the nose. This involved cutting away excess skin from the side of the nose, then suturing the skin back together to create a more desirable shape. This was also used to correct facial asymmetry and reduce wrinkles and other signs of aging.
Ancient India
The earliest forms of facial plastic surgery can be traced back to the ninth century BCE in India. They were performed by a surgeon called Sushruta, considered to be the “father of plastic surgery.” He is famous for his nasal reconstruction. At the time, skin from the forehead was also used to tighten the skin around the jaw and neck – a form of primitive skin graft.
The Development of Surgical Facelift Procedures
The development of surgical facelift procedures has been a long and varied journey. In the early days of plastic surgery, facelifts focused on removing excess skin and fat to restore a more youthful appearance. Over time, more advanced techniques were developed, such as the SMAS facelift, which lifts the deeper tissues of the face for a more natural look. With the introduction of endoscopic facelifts, surgeons were able to work through smaller incisions, resulting in less scarring and faster recovery times. Today, facelift procedures have continued to evolve, with injectable fillers and other non-invasive treatments being used in combination with traditional surgery to provide longer-lasting results.
European Developments
In the 1700s, surgeons in Italy and France began using a method known as “subcutaneous undermining” to pull the skin up and back on the face. In the 1800s, surgeons in Germany began using a more modern form of facelift surgery, which involved cutting skin and repositioning the underlying muscles and tissues (Cosmetic Surgery: Art and Techniques, Editors M.A. Shiffman, and Alberto Di Giuseppe Editors, 2013).
The Modern Facelift
The first known cosmetic facelift was performed in 1901 in Berlin by Dr. Eugene Hollander. A female Polish aristocrat insisted that he should lift the corners of her mouth and cheeks to tighten her skin and create a more youthful look. Although he didn’t initially want to perform this procedure, he was finally persuaded by his patient and removed a small area of skin at the front of the ear and closed the hole. Technically this cannot really be considered a facelift because the excess skin was just removed and he didn’t lift it.
The First “Face-LIFT” Procedure
In 1916, the German surgeon Erich Lexer actually performed a face “lifting” procedure by applying Hollander’s technique but according to Rajiv Grover, president of the British Association of Aesthetic Plastic Surgeons, he went beyond removing excess skin, he also performed a lifting. He lifted the sagging skin from the underlying fat, by drawing it back, re-draping it, and then removing the excess skin.
This procedure created what was known as the “wind tunnel look.” These early procedures pulled back the skin to create a tight appearance that flattened the face and tended to distort the mouth. For decades facelift procedures basically involved excess skin removal without subcutaneous undermining or deep tissue manipulation that could offer the patient longer-lasting results.
Next Great Development In Facelift Procedures
In the 1970s, Tord Skoog, a Swedish plastic surgeon, introduced new revolutionary concepts to facelift procedures which produced more natural and longer-lasting results.
His technique involved removing excess skin and fat from the face and neck, along with tightening the underlying muscles and tissue to provide a more youthful appearance. This technique differs from the traditional skin-only facelifts of the time in that it was designed to provide lasting results. Skoog’s technique was revolutionary for its time, and it is still used today as the basis for modern facelift surgery since it involves manipulating the deeper layers of the face, allowing them to create a smoother, more natural-looking facelift. This procedure is now referred to as the superficial musculoaponeurotic system (SMAS) technique.
The SMAS Facelift Technique
Superficial muscular aponeurotic sheath facelifts (SMAS facelifts) are a type of facial cosmetic surgery procedure that seeks to lift and tighten the underlying muscles of the face. This type of facelift is performed by making incisions in the hairline around the ears and behind the ears, which allows access to the underlying facial muscles. The surgeon then lifts and tightens the muscles, which can improve the appearance of sagging skin and wrinkles. The results of a SMAS facelift typically last between five and ten years.
In addition to lifting and tightening the underlying facial muscles, a SMAS facelift can also reduce excess fat, restore volume to the face, and help create a more youthful facial contour. The results of this technique can help to make the face look smoother and more youthful, while also reducing the appearance of wrinkles. What’s more, the results can last for years but may require periodic follow-up treatments to maintain the desired results. Since the procedure is relatively minimally invasive, recovery time is usually short, with most patients returning to their normal activities within 10 to 14 days.
Facelift Developments in the Late 20th Century
The subperiosteal facelift procedure, developed by the French surgeon Tessier, is a relatively new development in the field of facial plastic surgery. First developed in the late 1980s, this procedure involves the removal of small amounts of bone around the eye orbits to elevate the tissue. The subperiosteal facelift is ideal for younger individuals with minimal soft tissue sagging, loose skin, and excess skin.
The Subperiosteal Facelift
A subperiosteal facelift is a procedure that focuses on the upper and middle thirds of the face by providing a vertical lift to the soft tissues. This technique involves the detachment of soft tissue at bone level from the cheeks, jowls, lateral canthus, and inferior orbital rim so they can be lifted to create a more youthful position.
Endoscopic Technique for Facelift Procedures
In the 1990s, surgeons began using a technique known as “endoscopic facelift.” This involves making small incisions along the hairline and then using a thin tube to lift the skin away from the underlying tissue. This procedure was less invasive than traditional facelift procedures, resulting in fewer visible scars.
The endoscopic facelift technique may result in a shorter recovery time and minimize the possibility of noticeable scarring, but it is not really used to remove excess skin and loose skin. It is mainly used to address issues with underlying muscle and excess fat tissue. As a result, it is not recommended for individuals with pronounced signs of aging.
Today’s Facelift Procedures
Today, there are a variety of facelift procedures available to patients. These range from the traditional facelift to more advanced procedures such as laser skin resurfacing and fat grafting. Most facelift procedures involve making small incisions along the hairline and then separating the skin from the underlying tissue. The excess skin is then removed, creating a more youthful appearance.
Facelift surgery is a popular procedure among both men and women. The advances in technology and techniques have made it less invasive and more effective. While facelift surgery can reduce the appearance of wrinkles and other signs of aging, it is important to remember that it is not a substitute for healthy lifestyle habits such as good nutrition and exercise.
If you are considering rejuvenating your appearance with a surgical facelift procedure you should consider who will be performing the surgery. You need to choose a board-certified facial plastic surgeon, who has extensive experience and expertise in facelift procedures. By selecting the proper surgeon you will increase the chance of achieving the result you want.
Dr. Andrew Denton is a board-certified facial plastic surgeon, who has extensive experience and expertise in surgical facelift procedures. He understands that each patient has a unique set of expectations, which is why he is always willing to discuss every step of the procedure. At Dr. Denton’s state-of-the-art private operating facility in Vancouver, you will also be able to see the expected results of your facelift through the use of computer imaging. Dr. Denton truly believes that all his patients must be fully informed about the procedures they may be considering so that they can be equal members of the decision-making team.
Schedule your facelift consultation here or call us at 604-879-3223 today and not only breathe easier but also look and feel more confident. Our private and comfortable offices are located in the heart of Vancouver’s medical corridor, just one block from Vancouver General Hospital. Our state-of-the-art on-site surgical suite allows all patient visits – from consultation through surgery and post-operative follow-up – to be scheduled at this location, adding simplicity, familiarity, and convenience to the patient experience.