Surgical Rejuvenation of the Ageing Face
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Careful incision design and placement are vital to achieving natural-appearing results in rhytidectomy. The ideal incision camouflages scar formation, minimizes changes in the temporal and postauricular hairline and avoids distortion of the earlobe. An oblique incision begins in the temporal hair tuft region and varies for the individual patient. If a low temporal hairline is present, the incision is placed within the hair tuft to raise the hairline to a normal position post-operatively. If a normal or elevated temporal hairline is present, the incision is designed to run directly on the hairline to avoid elevating it further. The incision extends posteriorly 2–3 cm, gently curving into the temporal hair. It is then redirected inferiorly toward the root of the helix and into the preauricular crease.
The Conception Vessel (CV)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Features associated with aging include laxity of the soft tissues on the ventral neck and loss of the cervicomental angle.6 This can occur due to loss of skin elasticity and deterioration of skin quality, loss of tone in the platysma muscle, and accumulation of submental (subplatysmal) fat. Ordinarily, the procedure of choice is cervicofacial rhytidectomy. However, cervicofacial rhytidectomy poses unacceptable risks for some patients, leading to a range of alternate approaches. Thus, one must weigh the risk of complications from more invasive procedures against the possibility of providing only marginal results from less invasive methods.7 A novel technique that creates a “corset” of the anterior digastric muscles draws the two together and anchors them onto the mylohyoid (i.e., the muscle that creates the “floor” of the mouth), producing striking changes in appearance.8
Cosmetic dermatology
Ronald Marks, Richard Motley in Common Skin Diseases, 2019
The first treatments for ageing skin were, in the most part, rather crude in their effects. A ‘face-lift’ or rhytidectomy consists of removing a segment of cheek skin immediately anterior to the ears, undermining the skin of the cheek, and suturing the remaining skin more tightly across the face. In extreme cases the skin, which had lost all elasticity, was so tightened across the face that natural movement and facial expressions were impossible. The ‘improved’ appearance might look impressive at rest, but artificial and awkward when the person was animated.
Clinical efficacy and safety of a focused-radiofrequency device on middle and lower face rejuvenation: a retrospective clinical study
Published in Journal of Cosmetic and Laser Therapy, 2021
Yiqiu Zhang, Min Yan, Jing Mi, Ying Zeng, Huyan Lin, Min Yao, Jiying Dong, Shen Wang
Skin aging is a natural process characterized by facial sagging, obvious wrinkles, and decreased skin quality from hereditary diseases, increased age, and external environmental factors, such as chronic ultraviolet radiation exposure (1). Age-related facial skin changes create a less-appealing appearance and lead to quests for a more youthful appearance using clinical intervention (2,3). Although surgical rhytidectomy as the traditional invasive procedure remains an extremely effective treatment approach for severe facial laxity and static rhytide reduction, it can have side effects, such as pain, postsurgery hematoma, scarring, and undesirable skin texture changes (4); therefore, plastic surgeons and dermatologists are seeking a safe and new micro-invasive or noninvasive treatment for skin rejuvenation, including energy and nonenergy treatments. Most popular nonenergy methods include botulinum neurotoxin injections, which dramatically eliminate dynamic lines but not static lines (5), and local syringe-based fillers to restore facial volume loss instead of restoring texture and tightening (6). These nonenergy devices have the common disadvantages of being short term and resulting in only minor facial rejuvenation. Thus, various energy devices have become popular with patients and have excellent clinical efficacy with minimal risks, rare postsurgery complications, and a quick recovery (7).
Surgical applications of intracorporal tissue adhesive agents: current evidence and future development
Published in Expert Review of Medical Devices, 2020
Nicholas Gillman, David Lloyd, Randy Bindra, Rui Ruan, Minghao Zheng
ARTISS® sealant has a separate indication for adhesion of autologous skin grafts or tissue flaps to surgically prepared wound beds in facial rhytidectomy surgery [77]. ARTISS® sealant has also been successfully trialed as a replacement for staples in patients undergoing split-thickness skin grafts (STSG) on the dorsum of hands and fingers [78] and has been found to reduce post-reconstructive morbidity when used to close large debridement wound flaps after Fourneir’s gangrene [79]. Study of intraoperative feasibility showed that ARTISS® sealant was technically easy to administer [80], and the preparation time of ARTISS® to be significantly less than that of Tisseel® [81]. ARTISS® sealant has also been found to reduce fluid production at the surgical site of application [82–84], however, does not cause a major decrease in seroma formation [78,83,84]. The adhesive has a low thrombin concentration and should not be used as an adjunct to hemostasis. Moreover, ARTISS® is not recommended for laparoscopic/endoscopic use [72], which may prevent integration with modern surgical techniques.
Effectiveness and safety of nonablative fractional laser and infrared bipolar radiofrequency for treating periorbital wrinkles
Published in Journal of Cosmetic and Laser Therapy, 2022
Xianglei Wu, Qingqing Cen, Jiafang Zhu, Ying Shang, Xiaoxi Lin
Since 2002, when RF was approved by the FDA to improve wrinkles and laxity of periorbital skin, many studies have been conducted using different RF, including monopolar, bipolar, or unipolar devices. Bipolar RF travels from the positive pole to the negative pole, which is typically built into the handpiece. It is not as penetrating (1–4 mm) as a monopolar RF, whereas it is less painful (15). Fitzpatrick et al. conducted monopolar RF treatment in patients with periorbital wrinkles. After 6 months of follow-up, the Fitzpatrick score in 83.2% (99/119) of the patients with periorbital rhytidectomy improved by at least 1 point (19). Akita et al. used bipolar RF (eMatrixTM, Syneron & Candela, USA) to treat 10 older Japanese women (mean age: 58.6 years) with wrinkles of the lateral canthus and lower eyelid. Eight subjects indicated ‘very good’ outcomes (improvement by > 50%) in the wrinkle improvement (20).
Related Knowledge Centers
- Blepharoplasty
- Craniofacial Surgery
- Platysma Muscle
- Rhinoplasty
- Skin
- Neck
- Skin Grafting
- Plastic Surgery
- Face
- Twilight Anesthesia