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The face is the most visible determinant of an individual’s perceived age. A youthful midface is characterised by smooth midfacial skin without wrinkles or pigmentary changes, a smooth transition from the lower eyelid to the lower face, and when viewed from the side, well-projected cheekbones. The lower face is characterized by a sharp, well-defined lower jaw contour, with no loose or overhanging skin. An aesthetic neck is characterized by taut, well-contoured skin, good muscle tone, and a well-defined angle between the chin and neck when viewed from the side. A youthful and aesthetic face and neck projects the image of confidence, vitality, and happiness.
The hallmarks of the ageing face and neck include:
Individuals with aged lower faces are often described as looking angry or tired. They may have diminished self-confidence and social functioning.
Midfacial aging is a complex multi-factorial process involving the skin, subcutaneous fat, the facial muscle (SMAS) layer and the facial skeleton. The two predominant mechanisms of aging in men include significant shrinkage of the superficial and deep fat compartments and facial muscle (SMAS) layer laxity. Both start to occur visibly towards the end of the third decade.
Men generally have thicker and heavier soft tissue, which includes the skin, fat, and SMAS. Consequently, non-surgical techniques including lasers, fillers, and thread lifts tend to have significantly less effect due to the weight of the soft tissue. Some men may have heavy sideburns and face lift surgery needs to be performed with special modifications to ensure a natural result. Men are also more likely to seek long-term improvements including surgery, and are more willing to tolerate postoperative recovery time. Intimate knowledge of the anatomical differences and aging mechanisms between both genders permits administration of gender-specific treatment. This delivers attractive and bespoke outcomes.
We frequently see or hear of people who look unnatural following aesthetic treatments. This is often due to practitioners who attempt to reverse all the signs of aging by using revolumization techniques alone, resulting in an overfilled “pillow face”. Filler injection does not reverse skin and muscle laxity or ligament lengthening. Choice of the incorrect filler type will also result in irregularities that become more prominent when an individual animates the face.
The key to effective and natural-looking rejuvenation in men is tightening of the SMAS (muscle) layer, which is difficult to achieve with non-surgical treatments. Attaining bespoke and natural-looking results that retain an individual’s expressivity is frequently possible and requires accurate assessment, appropriate procedure choice, precise execution by an experienced practitioner.
The face and neck lift (rhytidectomy) is the most comprehensive method of rejuvenation of the midface, lower face and neck. It addresses the multiple causes of facial aging and produces effective, elegant and long-lasting results. The scars are well-concealed at the junction between the face and the ear, and between the posterior hairline and neck.
Rhytidectomy corrects many of the aging changes that cannot be effectively achieved by non-surgical methods because of its ability to tighten the SMAS (muscle) layer and to excise loose and redundant skin. There is often more significant improvement and long-term expenditure reduction with rhytidectomy as compared with recurrent treatment with non-surgical therapies. It is performed as an ambulatory procedure under intravenous sedation and local anesthesia.
The following are good candidates for a face lift:
The face lift tightens and elevates the cheek, lower face and neck, reduces unsightly droopy bulges and effaces the facial grooves, i.e. the tear troughs, midcheek grooves, laugh lines, jowls and marionette lines. The cheeks are elevated and revolumized, recreating the gentle concave contours seen in youthful face. There is improvement to the contour of the lower face and neck. Excess loose skin is excised to create a crisp and smooth skin contour and the scars are inconspicuous when healed. The result is elegant, comprehensive and harmonious improvement of the individual’s facial and neck appearance and reduction of the perceived age. Successful outcomes help to improve body image, self-esteem and social functioning.
Individuals are advised to stop herbal supplements and traditional medicine, and start special medications 7 days prior to surgery to minimize bruising and swelling. Hypertension, if present, should be well-controlled, and smoking needs to be stopped for at least 2 to 4 weeks prior to surgery to minimize the occurrence of complications.
The facelift is performed through well-sited incisions in the hairline, between the ear and the face, and between the neck and posterior hairline. This gives maximal visibility of the SMAS (muscle) layer and permits application of proprietary SMAS tightening techniques that deliver enhanced results whilst minimizing recovery time. SMAS tightening eliminates the facial bulges and grooves and restores a smooth contour in the midface and lower face.
In the lower face, SMAS tightening effaces the marionette lines and improves the lower jaw definition. SMAS tightening is the critical step in facelift surgery and delivers effective, long-lasting and natural-looking results. Facelift surgery is a fine art and strikes a balance between effective facial elevation and tightening whilst avoidance of an overly tightened and unnatural appearance.
Structural fat grafting is often performed to reverse the age-related fat loss in the superficial and deep fat compartments. Finally, the excess skin is excised and wounds are meticulously closed for optimal postoperative outcome. In men with sideburns, special modifications are performed to prevent advancement of the sideburn hair onto the ear tragus.
In some cases, an incision may be placed at the back of the chin for further tightening of the neck muscles, excision of the double chin (fat) and recreation of an aesthetic neck angle.
Stitches are removed on the 5th postoperative day. Mild swelling and bruising is expected, and will mostly resolve by the 10th postoperative day. Most individuals are able to return to work after 1 week.
Neck swelling is improved by lying supine on a neck pillow only (without a head pillow) when sleeping at night for the first 2 to 3 days. Gentle face washing is possible from the second postoperative day onwards. Postoperative swelling is reduced by remaining upright during the daytime, and elevating the head of the bed when asleep at night. Strenuous activity should be avoided for the first two weeks to minimize bruising.
Facial rejuvenation with non-surgical and surgical methods is one of Dr Yeo’s key clinical interests, and he delivers lectures in the Asia Pacific region on these topics. He applies proprietary SMAS modification techniques that are the key to delivering enhanced results while keeping postoperative recovery time to a short duration.
Picasso Plastic Surgery has an en suite operating facility that assures you maximal privacy and convenience and keeps facility and equipment costs contained.