MODIFIED S LIFT OF THE LOWER FACE
Aging of the lower face results in sagging and heaviness of the skin and soft tissues next to the mouth, in an area known as the jowl. It also results in laxity and loss of definition of the jawline. A lower facelift is designed to correct these problems. Dr Huang uses a technique known as the Modified S Lift to rejuvenate the lower face.
A curved incision is made in the temple, just like in a midface lift. This incision is continued downwards in front of the ear, along the margins of the ear cartilage, then around the earlobe for a short distance. The placement of the incision in this manner ensures that the surgical scar will be well hidden from direct view. The skin is lifted from the underlying facial muscles in the region of the lower face. The muscles are tightened with special sutures sewn in a purse string pattern, to lift the jowl and jawline areas. Bleeding is meticulously controlled and excess skin is trimmed off before the wounds are carefully closed with fine sutures along the wound in front of the ear and with skin staples along the scalp wound in the temple.
This procedure takes about three to four hours to complete under local anesthesia or intravenous sedation as a day surgery procedure.
Postoperative pain is mild and well controlled with oral pain medication. There is a moderate degree of facial swelling and bruising. The face feels tight. The stitches are removed after one week. A compressive recovery garment is worn continuously for the first two weeks. Thereafter, it is worn at night for the next two weeks. It takes two to three weeks for enough swelling to subside and for some relaxation of the lifted tissues to occur, so that the face looks presentable. The downtime is therefore two to three weeks.
By about one month, the face is usually looking fairly natural. Exercise can be resumed at this time.
The results typically last for five to ten years.
Overall this is a safe technique as the plane of surgical dissection and the method of tightening the facial muscles avoids the branches of the facial nerve. The risk of injuring this nerve is therefore very low. Optimal healing of the wounds requires adequate blood supply to the skin. Risk factors that compromise the skin’s blood supply include diabetes and smoking. Diabetes must therefore be well controlled and smoking must be discontinued at least one month before and after the surgery. General surgical risks such as blood loss and infection are also very low.