There are many factors that contribute to the aging process of our Face:
Face Lift in Mexico- Sun exposure, smoking, and variations in weight, menopause, and the aging process. Also the genetic information of our skin, somebody with thinner and paler skin will age sooner than a patient with a thicker and darker skin most of the time. The aging process in the face is divided in several degrees, and affects different part of our face.
In order to evaluate the aging process in a potential patient it is always useful to ask for photographs from when the patient was young. This will help us understand: evaluation of the brows, asymmetries on the face, volume in the cheek bones, type of smile, definition of the jaw line and neck, volume and distance of the lips from the nose. Based on these changes, we will plan the operation according to the steps necessary to bring the face to look like it was years ago.
With the aging process on the cheeks, the patient normally has a loss of volume in the cheek bones, emptiness in the tear trot, prominent nasal labial fold lines, and the deposit of jowls (which is the sliding of the SMAS or muscular system of the face).
The first evaluation I make on the patient is how much skin is in front of the ear (a pinch test will determine the amount of skin to be removed). The appearance of a wrinkle in front of the ear is a sign of redundancy of skin. This patient will benefit more from a cheek lift: basically an incision in front of the ear following the natural curve of the ear, behind the triages, and around the earlobe. We undermine the skin and do a placation of the SMAS at the level of the cheek bone. This will correct the jowls, bring back volume to the face, and will make your results last longer. One of the most important details is to avoid the excess of tension in the scar line. This will make sure you have a good scar without tension. Also, the suture of the wound in several layers helps.
If the patient is complaining of premature aging (early 40’s) and doesn’t have an excess of skin, but is noticing reduced volume in the cheek bones, the presence of nasal labial folds, and small jowls, the alternative procedures are:
The intra oral face lift in Mexico , or the Centro facial face lift is basically an incision inside the mouth, (above the canine) and an incision made in the temporal area (above the scalp hair). I undermine and realign the malar fat pad, and place 2 sutures to elevate the malar fat pad. I bring the center of the face up and fix the sutures in the temporal area. This procedure is done in 30 min, and patients can expect to have swelling for 5 to 7 days. The only inconvenience with this technique is the patient will be unable to move the upper lip for the next 4 to 6 weeks. This is 100% reversible.
Neck lift: the aging process in the neck usually involves fat deposits, the appearance of muscle bands, and the sagginess of skin. The neck lift begins with an incision under the chin. I undermine the skin, remove the fat, and tighten the muscles to the middle line. Then, I continue the incision behind the ear and into the hair line. I undermine the skin up to the middle line, continue with muscle tightening and removal of the excess skin behind of the ear. It is important to avoid excessive tension to minimize the scar.
There are a number of additional procedures that can be done at the time of the face lift such as:
Lower eyelids: normally an incision under the lashes, elevation of the skin, small removal of muscle, and possible removal of fat depending upon the patient’s needs. The scar is usually invisible in just a couple of weeks.
Dermabrasion: is a mechanical scraping of the skin, where we remove the top 2 superficial layers of skin. Usually the patient develops a scab, and new skin will be present in 5 to 6 days typically around the mouth, crow’s feet, and frown line.
Filers: with the aging process around the mouth has lost of volume and fine lines the use of a filer will have 2 intentions: definition long the edge, and volume of the red lip.
How it is done:
This procedure is done under general anesthesia in most cases, or twilight sedation and local. A full face lift is done in 2 to 3 hours. Our patients spend the first night at the clinic. The next day, I check everything before they go home or to the hotel.
HOW DO I KNOW IF I NEED BROW LIFT OR UPPER EYELIDS SURGERY?
It is very common for patients to requests upper eyelid surgery and almost 80% of the patients I evaluate need a brow lift, why?
The answer is simple. Go back and evaluate a picture of you 20 years ago, and compare what happened to your eyes, your brows… bingo. Most patients find that their brows used to be in a higher position and they pretty much had the same amount of skin. Less than 20% of the patients genetically had a lot of excess of skin during their younger age.
This is a procedure that is easy to present to the patient. You simply elevate the brow of the patient in front of the mirror and you simply ask if they like it or not. This will simulate the result of the brow lift.
WHEN IS THE BEST TIME TO HAVE A FACE LIFT?
Personally I never read this answer in any book but I found it by communicating with my patients!
For so many years, I have patients asking this question. Either they are looking for the right answer, even if in their heart they know its time, or they need somebody to reassure their needs.
The best answer for this question is: when you wake up in the morning and look at your face in the mirror, and you use your fingers to pull your face back. This is the right time to have a face lift, you just woke up fresh and your face does not look fresh.
Ice all day long, sleep with your head elevated at 45 degrees, shower daily, and clean the scabs of the wounds with a q-tip and hydrogen peroxide once a day. Eat meals that are soft and not hot. Avoid any strenuous exercise, bending over or picking up heavy stuff (no more than 5 lbs). Never apply any heat, and use gauze to help drain any collection of blood behind your ear. Take your antibiotic and pain relief as prescribed. You can also take some sleeping pills the first couple of days. If there is an incision inside your mouth, don’t use mouthwash and only use a baby tooth brush. Sutures must be removed 7 to 10 days postoperative. After 4 to 5 days you can apply petroleum Vaseline to wet the tape on forehead and neck, and gently peel off. If eyelid surgery was done, don’t wear contact lenses until the Doctor suggests. You may resume workouts after 4 to 6 weeks.
Suggestions for a rapid recovery: sleep at 45 degrees with head elevated, ice all day long in the face, arnica (a homeopathic herb available in tablets or tea) every 3 hours, pineapple fruit or juice, and minimal physical activity.
All of this will reduce the chances of a lot of swelling, but some patients will swell no matter what and this is normal. The worst amount of swelling is at day 3 to 5. Patients must have a daily shower.
Important things not to do: no sleeping flat or with the head down, no application of heat, no hard things to chew, no exercise, and no mopping or cleaning. The next follow up visit is at one week normally for removal of stitches. The patient expects to see their face normal after 1 to 2 weeks. He or she will feel tightness and be swollen. Numbness will continue for the next 3 months, and the best result of the scar and numbness will fully recover in one year.