With age come changes on face and neck that represent normal process of ageing. Many authors consider that due to many factors (genetic, effect of sunlight) skin starts to loosen and gravity acts on it.
Dr. Milan Jovanovic is a strong opponent of this theory, which he has proved in his doctorate. He thinks that: "FACE REJUVENATION HAS TO BE A STRATEGIC BALANCE BETWEEN SUSPENSION AND AUGMENTATION" that is “THAT WITHOUT AUGMENTATION OF THE FACE A GOOD RESULT, I.E., REJUVENATION CAN NEVER BE ACHIEVED” During face lifting surgery, Dr. Milan Jovanovic uses lifting in several layers and in several direction using the technique of augmentation of deeper layers of the face, which, as a result, gains youthful fullness.
Ageing process is connected with influence of inner genetic factors as well as cumulative factors of environment. These age-related changes primarily start in the area of eyelids and brows and slowly expand toward whole face and neck.
There are several methods for rejuvenation of face and neck skin that are used in plastic surgery, but one of the most common and safest is face lift (rhytidectomy) whose goal is tightening and lifting of loose face and neck tissues, wrinkle removal as well as volumetric face rejuvenation. Facelift can once again establish pleasant face and neck contours, that can help the patient to look and feel many years younger than he really is.
Signs of ageing on the face are: 1) in the forehead area – parallel wrinkles; 2) in the area between the brows, so called brow furrow – two vertical and one horizontal in the nose root area; 3) cheek area with nose wrinkles and dents, eye wrinkles and dents, pre-cheek wrinkles and dents, skin flabbiness with ptosis of sides of the face, i.e., flabby cheeks; 4) in the area of the mouth – nasolabial folds and small vertical wrinkles; 5) area around the chin –flabbiness of the chin and lower jaw skin with extension of mouth and nose wrinkles; 6) neck area with transvesal wrinkles and platysma muscle flabbiness in form of stripes, as well as appearance of double chin, so called goose neck, etc. Facelift surgery in combination with other assisting procedures (eyelid correction, dermabrasion or liposuction) can solve all of these face ageing problems.
FACELIFT SURGERY CANDIDATES
Most ideal patient for facelift is a person between 45 and 55 years of age, with normal weight, firm skin, good bone structure, thin neck and deep cervicomental angle.
PRE-OP PATIENT ASSESSMENT
If you decide to have a facelift surgery, first you have to come to Dr. Jovanovic for an examination who will require you to show in front of the mirror what change you want on your face and ask you to openly discuss everything about your appearance. This will help him to understand your wishes, to postoperatively analyze your face and to point you out realistic expectations. Interview with Dr. Jovanovic during the first examination will cover the complete medical history of earlier surgeries and illnesses (if applicable), medicines you are currently taking, possible allergies. Based on medical examination and health history further indication is determined as to prevent complications.
After this you will be examined in detail, your forehead, skin of mid and lower third of the face, area around the mouth and vertical wrinkles, nasolabial folds and so called "malar pockets" will be examined, neck and lower jaw line will be examined and thickness of the hair will be examined, so that the incisions can be planned. In case you decide for surgery, you will have to do laboratory analysis. Use of the aspirin, vitamin E and estrogen hormones is forbidden before the surgery. Many surgeons recommend quitting smoking two weeks before and a week after the surgery.
FACELIFT SURGERY PROCEDURE
Surgery can be done in general, and most often in local anesthesia with strong intravenous sedation. Based on indications you have, Dr. Jovanovic will choose the method best suited for solving your facial problems. Generally (although there are other variations), incision of the skin is hidden in hairy part of the head, it goes then in front of the earlobe, hidden in the natural contour of the ear, extends around and behind earlobe, and ends in hairy part of the side of the neck. After that follows a very careful preparation of subdermal tissues of the face and skin, up to the corners of the eyes, half of the cheeks, nasolabial fold, corners of the mouth, while the skin of the neck is lifted almost to the midline. Preparation must be very careful in order not to damage any of the branches of the facial nerve. When these structures are prepared with repositioning of the deep facial tissue, and skin excess is reduced, youthful contour of your face will be returned. Skin is then stitched with fine atraumatic suture that are removed after seven days.
COMPLICATIONS
Although complications of this cosmetic surgery are very rare, hematoma, bruising, feeling of numbness, sometimes hypertrophic scarring or alopecia around the incision in the hairy part of the head may appear. Patient can help reduce the risks if he adheres to advice and instructions of the surgeon before and after the operation.
POSTOPERATIVE TREATMENT
After completed surgery, patient can go home after a few hours or they can stay for one day in hospital, depending on evaluation. During the first postoperative day, the patient has to minimize movement of the head. Head has to be held slightly raised 30 degrees lying slightly raised. Hair care begins on second or third day after the surgery. Hair may be dried on moderate temperature with a hair dryer. Sunlight exposure is to be avoided for a month after the surgery.
If done right, face lift results are fantastic, which after postoperative recovery, with make up and new youthful appearance of the face, gives the patient a very pleasant and permanent inner and outer sureness and freshness.