Circular facelift

A facelift is indicated for age-related changes in the subcutaneous muscles, fascia, and skin, which manifest as:

• deep forehead wrinkles;

• drooping brows and upper eyelids;

• drooping outer corners of the eyes;

• sagging skin above the upper eyelid;

• bags under the eyes;

• wrinkles on the bridge of the nose and in the periorbital area;

• loss of a clear facial contour;

• sagging cheeks, “jowls”;

• double chin;

• deep nasolabial folds;

• skin folding in the preauricular area;

• problematic neck (loose, wrinkled skin).

The surgeon selects the facelift technique based on the patient’s age, skin type, individual anatomical features, and personal preferences. The decision is made together with the patient. There are several facelift methods.

Surgical SMAS lifting is a modern, classic, and at the same time the most complex type of facelift, during which the superficial musculoaponeurotic system (the structural framework of the face) is lifted. The incision is made in a zigzag pattern along the hairline in front of the ear, then behind the tragus, along the earlobe, and behind the ear. The surgeon carefully separates the SMAS layer (one of the most challenging stages of the procedure) and lifts it. Fixation is done to the bone rather than to the skin, which significantly reduces the load on the scar, making it invisible. Excess skin is removed. SMAS lifting is considered the most popular technique because it provides the most harmonious and long-lasting rejuvenating effect, proven by clinical studies. This type of surgery is most suitable for patients with a full or round face.

SPACE lifting (endoscopic facelift) is a less traumatic method compared to SMAS, based on facial physiology. The face consists of dense and looser layers that do not contain large blood vessels or nerves. These layers are called spaces. Over time, tissue displacement occurs in these spaces, causing deep wrinkles and sagging skin. The surgeon gently separates small sections of skin, repositions the sagging tissues back into their original spaces, and fixes them to the deep, immobile structures of the face (in the preauricular region). The procedure is performed endoscopically. This technique is well suited for patients with elongated, slim faces.

MACS lifting is a simplified, minimally invasive facelift for slender patients with early signs of aging. The incision is almost the same as in SMAS lifting, but the key difference is that only the skin is separated, and three special purse-string loop sutures are applied to the SMAS layer to lift it. The thread is fixed to the preauricular fascia. The effect is good, though not as pronounced or long-lasting as with SMAS and SPACE lifting. However, according to research from the University of Florida, MACS lifting has a shorter recovery period and works well for mild skin laxity and as a preventive measure against future ptosis.

At ANACOSMA clinic, a patented three-level rejuvenation technique has been developed for patients with full faces and necks. This approach involves removing and reducing subcutaneous fat in the neck and lower third of the face using the world’s safest EUROMI (Belgium) vibration liposuction, removing or repositioning the Bichat fat pads, tightening and fixing the SMAS layer edge to edge, and, if necessary, placing a surgical thread to create a defined facial contour and a sharp jawline-to-neck transition angle. This type of facelift in overweight patients provides a stable and long-lasting result for 10–15 years.

Complications after a facelift may occur if the doctor’s recommendations are not followed and if special rehabilitation procedures are neglected. Possible negative consequences include both medical and aesthetic complications such as necrosis, facial nerve paresis, hyperpigmentation, and skin irregularities.

At ANACOSMA, patients are required to spend the first three postoperative days in the hospital under the supervision of the surgeon and assistants. This is important because the medical team can promptly adjust treatment — reduce swelling in the operated area, restore tissue trophism, and prevent hematomas, the appearance of which may lead to secondary interventions and facial unevenness. With an experienced surgeon and a proper recovery period (strictly following all the rehabilitation specialist’s recommendations), the risk of complications is minimized.

In this case, and throughout the entire website www.anacosmo.ua, the term “facelift” refers to the surgical lifting of the lower and/or midface performed using the method recommended by an ANACOSMA clinic surgeon.