Face lifts
Face lifts have in recent decades become a common aesthetic operation. In
the latter half of the 1800s there were advertisements for face creams and
lotions that promised to reduce the visible effects of age, but it was not
until the first decade of the 1900s that the desire to look younger led to
surgery.
An American surgeon from
Chicago, Charles Miller, published the first book on cosmetic surgery, “The
Correction of Featural Imperfections”, in 1907. In the book he describes various
ways to remove facial wrinkles. Miller’s work was met with criticism, however,
and he was widely regarded as a quack. Aesthetic surgery to combat the effects
of aging
became more established and respectable during the 1920s and 1930s. The first
woman to concentrate her medical
practice exclusively on aesthetic surgery was the French
doctor Suzanne Noël (1878 – 1954). She published the book, “La chirurgie esthétique:
son rôle social” in 1926. Attempts to surgically restore a youthful appearance
had previously consisted of cutting away excess skin at the temples and around
the ears, but Dr. Noël worked on the premise that this was insufficient: the
skin had to be loosened from the underlying tissues before it was stretched.
During the 1920s, surgical techniques for face lifts were developed into the
standard procedure used, with only minor modifications, for the next 40 years.
Prominent plastic surgeons in the middle 1900s – Gilles (called “the father
of plastic surgery”), McIndoe and others – performed quite a bit of cosmetic
surgery in the 1940s and 1950s, but they kept a low profile about it since
it was not entirely approved of – by either the public or other doctors.
Further development did not occur until a couple of decades ago, when doctors
began to stretch and lift deeper structures. A pioneer in this area was the
legendary Swedish plastic surgeon Tord Skoog, who in 1973 described a method
for stretching the deeper-lying membranes around the parotid glands (the salivary
glands in front of the ears). His technique has since been developed further,
and has become standard around the world. Subsequent improvements include
the addition of liposuction to sculpt the cheeks and throat-line. The most
recent improvement is the introduction of endoscopic techniques and fiber-optic
instruments to loosen the facial tissue, which eliminates the need
to make long incisions.
The aging face
Our skin goes
through characteristic changes as it ages. The dermis, the layer just above
the fatty layer, consists of a dense bed of vascular connective tissue and
four different components: base substance, elastic fibers, collagenous fibers
and connective tissue cells. All these components wither with age. Their atrophy
is a natural change and is controlled partly by heredity. There are individual
differences, and also some racial differences, in how fast the aging of the
skin progresses. It is not determined entirely by heredity, however: there
are other factors involved. The sun is one of the most dangerous. Too much
exposure to sun causes a characteristic type of skin degeneration called actinic
elastosis – the elastic fibers are broken down and become thicker, and the
normal structure of the skin is changed. The sun also has a direct
The effects of aging: The skin develops deeper creases and fine wrinkles, there are bags under the eyes, the chin, nose tip, earlobes and outer ends of the eyebrows begin to droop, and surplus skin becomes increasingly apparent on the neck and along the jawline. It is important to realize that only some of these signs of aging are remediable with a face lift. Other procedures may also be needed for a full correction.
