With ageing and sun damage, the face takes on different appearances. Often there is a change in skin texture with a development of blotchy pigmentation and fine lines. This may be more prominent around the eyes and mouth. At this stage laser resurfacing can produce a smooth and rejuvenated apearence with some skin contraction and elevation.
In the next stage, the skin starts to droop from the facial structures and a type of facial lift is required. Until this point there have been two types of facial lifts. One is a deep plain face lift, where the skin is cut and removed from around the ear, inconjunction with a deep underming of the facial skin and tightening of the underlying muscular and facial tissues. This is the classic face lift.
Over the last few years a more modified, simpler technique has been developed called a Face Skin Lift. The procedure is less invasive and has less risk but it still involves cutting and pulling which can produce scarring.
A plastic surgeon in South Africa has developed a new technique whereby the skin is elevated and lifted with sutures alone. With this procedure there is no cutting. The stitches are made of a nylon material which are placed under the skin and left there permanently. After a few weeks, the skin is held in it’s new position by tissue that forms around the stitches. This is the Face Suture Lift.
The procedure can be performed under a local anaesthetic or a light general anaesthetic. It takes approx 1-2 hours. A small incision is made in the skin either behind the ear for a lower facelift, or in the hairline on the upper forhead for a brow lift type effect. A long needle with the suture is then threaded until it reaches the sagging area. The suture is then fixed in this position and elevated to the ear. It is then tied and hidden under the skin. Several serial stitches are used to hold the skin in the desired position.
The disadvantage of suture alone is there will be initially a plate, wrinkle or a fold of excess skin near where the lift has occurred. Mostly this will be in front of the ear. The fold can easily be covered with ones hair and apparently this fold does relax and settle in the next few months. If it does not settle, laser therapy to tighten the skin may be used or possibly an excision of the excess skin.
Recovery is rapid with the suture lift. Patients can return to ordinary duties the next day although there may be some brusing and swelling. There may be some pain behind the ears but painkillers will help this. This usually settles over 24 hours.
The sutures may last for years, however they can loosen over time. The face may also continue to sag with the ageing process. There are no guarantees at this stage as to the length of time the sutures will last.
If you are unhappy with the result, the sutures can be removed or be redone with new sutures. It is best to do this within 4 weeks after the procedure, before the sutures become fixed by tissue.
This procedure is a relatively non-invasive one so there are few risks associated with it. However, as with any medical procedure there are some potential risks. These include:
• Sutures that are too tight
• Sutures that are too loose
• Breakage of sutures
• Infection
• Bleeding
• Assymetry
• Rippling of the skin
• Fullness in the cheeks
• Able to feel the sutures
• Unhappy with result
• Depression, dents or irregularity in the skin
• Nerve Damage
This is an ideal procedure for patients who are not yet ready for face lift surgery or for those patients who have previously had a face lift and are wanting to improve the residual loose or drooping areas that remain. It is also ideal for those patients who do not wish to have any cutting which may produce scarring after the formal face lift procedure.
The SUTURE LIFT compared to the FACE LIFT
Advantages:
• Less invasive
• Quick procedure
• Skin procedure only
• No/very low risk nerve damage
• Reversible & adjustable
Disadvantages:
• May not be permanant or as effective as a face lift.
• Fold of skin in front of ear may be permanent though could be removed surgically.
As of writing of this April 03. Dr Lanzer wishes to advise his patients that he has been working on a suture skin only facelift for some 12 months, but this technique only since April 2003. He believes this new option offers a new approach that will be very effective and may be used alone of in conjunction with lipo of neck and jowels laser resurf or photorejuvenation. Dr Lanzer wishes to stress that in Australia, this is a new procedure and he will not be giving guarantees as to its effectiveness and longevity. Dr Lanzer will be offering this procedure as a less invasive form of facial rejuvenation and as an alternative to face lift. Dr Lanzer has a fully qualified ENT surgeon who consults in conjunction with Dr Lanzer for advice on the S-Lift technique which may also be appropriate depending on the severity of ones facial drooping.