Plastic Surgery of the Face - FACE - RHYTIDOPLASTY

Years ago, when rejuvenescence facial surgery was first described, it consisted of undermining and traction of the skin and simply correcting flaccidity and minimizing the wrinkles.

Although this procedure had its beneficial results, it could lead to artificial results since the outcome was a stretched skin and of younger aspect on a face with aged delineation and contours. For example, the double chin, the bags at the side of the chin (bulldog ears), etc, still remained.

From this initial stage, facial surgery has greatly developed in the last twenty years. Skin traction has been combined to the same surgical procedure, the contents modeled by delicate liposculpture of the face, plus the resource of sometimes working on the facial muscles.

We had the opportunity of publishing a scientific paper on redefinition of the facial contour through liposculpture in a North American specialized magazine, as we were pioneers in this procedure.

At that time, there was a change of concept since a simple stretched skin with fewer wrinkles was not enough. It was necessary that the face contour be compatible with youth. Liposculpture of the face became the new tool that allowed us to achieve this objective.

As in all procedures, facial surgery also requires incisions. It starts at the hairline (sideburns or somewhat higher) at the temporal area and inside the hairline, travels down in front of the ear following its contour, works around the earlobe, rising behind the ear at the angle formed by the ear and the skull, and enters horizontally around 3 to 4cm into the scalp.

It is interesting to notice that due to the abundant blood circulation of the face, scars are usually of very good quality and little or not perceptible, even in front of the ears.

The fat injection, suctioned from the face or other parts of the body, was idealized to fill in the emptiness and depressions that appear with the aging process (i.e., the nasogenian folds, the cheeks that become empty and lose their healthy look and the nasojugal fold next to the nose, that we call “the valley of tears”).

However, fat implantation in the face is usually much absorbed, and that's why plastic surgery is always seeking for new filling in materials.

It seems to us that polymethilmethacrilate (PMMA), recently approved by ANVISA (Brazilian Health Department) for some kinds of deformities, has quite satisfied this need of filling in a definitive way (non absorbable), creating the field of BIOPLASTY, an object of posterior discussion.

Facial surgery of the face demands 24 to 48 hours hospitalization after which, already free of dressings, the patient is released.

The most frequent complication of this procedure is hematomas, which with a well oriented treatment will cause no problems except for delayed recovery.