Wrinkle treatments

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Facelift, face lift

Facelift

The natural aging process leads to more or less pronounced wrinkles on the face and neck, which can greatly change your appearance. The skin elasticity is lost and the muscles of the subcutaneous tissue relaxes. It creates the impression that there is too much skin, which sags downwards following gravity. With a facelift, you can largely iron out these signs of the times. You will look younger and brighter and you will probably feel younger too. Whether and at what age you make a facelift depends solely on your personal desire to correct existing signs of aging.

What happens during a facelift?

The typical facelift does not exist. It always depends on what changes you personally want. With a firming of the forehead, the eyebrows are raised and the frown lines are smoothed. Temporal lifting additionally leads to a tightening of the eye area.

The cheek lift not only removes the wrinkles in this region, it also restores the fatty tissue that has slipped down the zygomatic arch. When tightening the neck, excess fat can be removed through another small incision under the chin. The so-called mini-lifting takes place mainly in the area of ​​the temples and is only useful if no major changes are to be eliminated.

Normally, the facelift tenses your temples, cheeks, and neck all at once, with an additional shift in the superficial muscles. Through this intervention in the superficial musculo-necrosis system (SMAS), a significantly better tension is achieved overall.

The lifting of one or more facial regions can be supplemented by further interventions (like eyelid surgery). Due to the facelift, no tightening of the fine wrinkles around the mouth and eyelids is to be expected. If you find these troublesome, other methods (abrasion or chemical peeling) must be used.

Before you have a facelift, you should consult with your surgeon. This will allow you to find out in detail about the different methods and work with the surgeon to determine how best to achieve the desired results.

Which results can be achieved with the facelift?

With a facelift, the skin is toned and your appearance rejuvenates for up to ten years. However, the natural aging process of the skin can not be completely stopped by a lift. How long the result of a lift will last depends on your individual equipment and the condition of your tissue. Usually, it is not a problem to repeat the operation after eight to ten years.

In order to maintain your natural facial expression, you will still have some wrinkles after the procedure. If all wrinkles were rigorously rigorously finished, they would have a mask-like appearance. Here, the skill and experience of your surgeon is crucial to the success of the surgery.

Anesthesia form and hospital stay

The procedure of facelifting is usually performed inpatient and can be performed either under general anesthesia or under local anesthesia with sedation. The operation takes about three to four hours. The necessary preliminary examinations are carried out the day before your appointment in the clinic. You also have the opportunity to discuss the anesthetic with the specialist. Depending on the procedure, a hospital stay of 1 to 2 days is to be expected.

How do I prepare for the operation?

As a smoker you should stop smoking at least four weeks before your appointment in order to avoid the risk of wound edge necrosis. For a period of 14 days before surgery, you should be aware of painkillers such as aspirin like blood thinner, as they delay the blood clotting. Alcohol and sleeping pills should be largely avoided. If you are wearing your hair very briefly, you may want to let it grow a little to better conceal the surgical scars.

How is the operation going?

The surgeon sets the cuts in the same way as he discussed them with you before. By the way, it is not necessary to shave the hair before the procedure.

The normal incision extends from the temples hair about five-six cm behind the hairline, passes in front of the ear and then ends behind the ears in the neck. In a forehead lift, the cut is at peak height and extends from one ear to the other.

The skin is removed from the underlying tissue along the incision line, and the connective tissue beneath the skin, the relaxed facial expressions and deep-set flaps can be corrected. Thin threads fix the deep-set connective tissue as well as the musculature in their original place.

Especially on the forehead, in the cheek area and in the eye area, many of these corrections can be made endoscopically today. This method has the advantage that the cuts are much smaller. After closing the wound edges with submerged dissolvable sutures and intracutaneous sutures, you will usually receive two drains and a light bandage around the head.

Overall, the operation takes about three to four hours depending on the extent. During this time, the surgeon has fine sculptural work to do. His skills, his experience and his aesthetic feeling determine the result of your facelift.

What happens after the operation?

After surgery, your skin will be tense and swollen. Also, bruising around the cheeks and under the chin, as well as a slight numbness of the entire facial area are completely normal. The strongest puffiness occurs one to two days after the procedure and can temporarily change the appearance of your face. The swelling will return within the next two to three weeks.

Also, do not worry if you feel pain behind the ear. They are caused by the tension with which the skin was fixed. A final result can only be assessed after a few months, depending on the extent of the procedure.

Which risks should you consider?

If you are allergic to certain medicines or care products or if you have other known illnesses, you must notify the doctor in any case. If you have noticeable bruises or if you have persistent bleeding after minor injuries, a coagulation disturbance before the operation should be excluded by appropriate examination. You should also tell your surgeon if you are planning to lose much weight because it may change the outcome.

What complications can arise during a facelift?

After a major facelift or forehead lift, the skin feeling in front of the ears or on the forehead may be impaired in the long term. Any bruising that may occur postoperatively can significantly delay the healing process and is therefore removed by a small surgical procedure. Under the strong tension of the facial skin it can occasionally come to hair loss in the temple area. However, the hair will grow back over the next few months.

Circulatory disorders of the skin as a result of excessive nicotine consumption can lead to wound edge necrosis and eye-catching scars. These may need to be aftertreated. If bacterial infections occur, delaying secondary healing of the wound can lead to broader scars. These can be corrected by another small intervention. Damage to the facial nerves, which are almost excluded in expert hands, generally regenerates within three to six months.

Occasionally lesions of skin and muscle nerves can occur, but these regenerate independently within weeks to months. A permanent disorder of the facial muscles caused by nerve injuries is an extremely rare complication.

Which after treatment is required?

The dressing and, if necessary, the drains are removed as early as two days after the facelift, and the sutures can usually be removed after ten days.

What should be considered after the facelift?

The period of time until complete regeneration can be very different depending on the individual disposition and extent of the intervention. After the facelift you should definitely allow yourself rest for at least five to seven days. During this time you should not burden your skin with creams or ointments. Your skin helps itself best. After just eight days, you can shower as usual and put on make-up.

Do not use nicotine and painkillers during the first four weeks. Direct sunlight should be avoided for a period of four weeks. If you expose yourself to the sun during the following weeks, sun protection with a high sun protection factor is recommended. Most of the time you can resume your sporting activities after four weeks. A medical consultation is still advisable.

Brow lift

Brow lift

The forehead is constantly in motion. Frowning, tensions, the natural aging process, sunlight and heavy weight loss lead to the loss of skin elasticity. Deep forehead wrinkles, sloping eyebrows and wrinkled eyelids are the result.

What happens during the brow lift?

Most surgeons now use the endoscopic surgical procedure with very small incisions beyond the hairline. The procedure is almost invisible and the healing process is usually fast. The procedure of open brow lift requires an extensive cut around the upper half of the face. Which method is used, decides the individual patient situation.

Which results can be achieved?

A brow lift makes the face appear friendly and fresh again by correcting the forehead skin, the tissue and the corresponding muscle parts. Raising the eyebrows is a positive side effect, while reducing wrinkles on the upper eyelids.

Anesthesia form and hospital stay

Before the operation, an anesthetist examines the individual anesthetic capacity. Open brow lifts are mainly performed under general anesthesia. Alternatively, local anesthesia using regionally injected narcotics is available for endoscopic brow lift. In this case, an additional sedative is often administered.

How is the operation going?

Procedure with an open brow lift

By weaving the hair, the scalp is exposed. Subsequently, the skin incision is placed behind the brow-hair border. The Plastic Surgeon lifts the frontal skin and muscles to remove excess skin. Also essential is the weakening of the mimic muscles to counteract excessive wrinkling. After wound closure, a dressing is applied.

Procedure for an endoscopic brow lift

After the hair is braided about two to four centimeters long cuts are placed behind the forehead-hair border. These endings are used to detach the frontal muscle to the lateral ends of the eyebrows under endoscopic camera control and move it upwards. In order to hold the eyebrows in the desired position, they are fixed at the incision sites with small fixings in the skullcap. The height of the attachment depends on the extent of wrinkling. Then the incisions are closed and a bandage applied.

Procedure for a temporary brow lift

If a lateral smoothing and tightening of the forehead and temporal skin is desired, an additional cut is made in the temporal region for endoscopy.

What complications can arise?

A brow lift, regardless of the method of operation, is a low-complexity operation with a high degree of efficiency and safety for qualified physicians. In rare cases, weakness of the frontal muscle is caused by an injured nerve. This can lead to limited mobility of the eye. Rarely, hair loss can occur in those parts of the scalp where cut or endoscopic devices have been inserted.

As with any surgery, bruising and deafness in the surgical area may occur after bruising, which in most cases will heal on its own.

Which after treatment is required?

The bandage is usually removed after a few days. After the procedure, it is advisable to cool the eye area to reduce swelling and bruising. In retrospect, dry eyes should be treated with a special eye ointment. At the end of the second week, the threads can be removed. Sport is allowed after doctor’s agreement after about three weeks.

Eyelid surgery, eyelid surgery

Blepharoplasty

Eye wrinkles, bags under the eyes and sagging eyelids are – due to their family – more or less pronounced and, in extreme cases, cause pathological limitations of the field of vision. This natural aging process leads to a nasty change in the eye area and affects a youthful appearance. Eyelid surgery is almost always done for aesthetic reasons and only you can decide if and at what age you want to undergo this procedure.

What happens with the plastic surgery?

Eyelid surgery removes the excess skin on the upper and lower eyelids with the scalpel. The extent of correction depends heavily on the individual condition of your eyelids. By accurately measuring the skin on the eyelids, a uniform, symmetrical result can be achieved. The tightening of the skin and muscles is self-evident when the excess skin is removed – that’s about as much as two fingers can hold.

The so-called eye bags consisting of fatty tissue are gently removed during the eyelid surgery. With strong smile lines in the lower eyelids, a part of the overstretching eyelid muscles is additionally taken away.

Which results can be achieved?

After the operation, the lower eyelids are wrinkle-free when resting, but not when smiling. Also, the sometimes dark and extremely thin skin of the lower eyelids can not be brightened or strengthened by a plastic eyelid.

What remains is a fine, thin line, which is based on the natural eyelid folds. The upper eyelids are much smoother after the procedure, the eyes look more open and the eyes look brighter.

Anesthesia and hospital stay

A tranquilizer will relieve you of nervousness and excitement and will ensure that you experience the procedure in half asleep. For local anesthesia you will get a puncture on the four eyelids with a tiny cannula, which you will hardly feel.

However, if you do not want to hear about the operation, you can also undergo surgery under general anesthesia. For this the necessary examinations have to be carried out on the day before your appointment and the anesthesia must be discussed with the anesthesiologist. However, keep in mind that general anesthesia always involves additional risks. As a rule, this procedure is carried out as part of a short inpatient stay (one night).

How do I prepare for the operation?

Before the operation, you will need an ophthalmological examination to detect any impairment of your field of vision or tear secretion. Furthermore, your eyes should also be examined before a blepharoplasty. Please present the findings at the surgery date.

For a period of 14 days prior to surgery, you should not use any analgesics, such as Aspirin and blood thinners, herbal products and supplements, as they delay the blood clotting. Alcohol and sleeping pills should be avoided.

Get a small supply of compresses and two to three soft cooling elements. A migraine mask also serves well. Further preparations are not required. However, you should not make-up and rested and bring dark sunglasses.

How is the operation going?

Before the actual procedure, the surgeon decides on the incisions which leads to an optimal result. With a pen, he draws an exact sketch on the skin. The excess skin is removed in much detail with the scalpel. Stitching is done with continuous, extremely thin threads, which are buried in the skin and externally not visible (intracutaneously). The procedure lasts about one to one and a half hours.

What happens after the operation?

Immediately after the operation, your eyes will be more or less swollen, which will fade after one to two days. You will also have bruising around the eyes after eyelid surgery. The bruise settles in the lower eyelids and disappears within a week.

Since the suture comes to lie exactly in the eyelids forming when the eyes are open, it is usually barely visible after just eight days. However, if the incision had to be made over the outer border of the eye socket, these additional scars, which are one to two centimeters long, may be reddened for several weeks.

Your eyelid may appear a little smaller, mainly due to the swelling. However, after a few weeks, this is completely back.

What risks are otherwise to be considered?

Do you suffer from allergies, such as  against drugs or care products, or other diseases, so you must tell us in any case. If you have noticeable bruises or if you have persistent bleeding after minor injuries, a coagulation disturbance before the operation should be excluded by appropriate examination.

What complications can arise in a blepharoplasty?

Bleeding is extremely rare but may occur one to two days after surgery. In this case, a quick intervention by the surgeon or his representative is required to avoid damage that could even lead to the loss of vision.

Depending on the extent of the bruise and the individual scarring, the lower eyelid can be subject to a temporary slight protrusion of the lower eyelid and an increased amount of tears. This risk mainly affects older patients and second-aid procedures. If these symptoms do not return independently within six weeks, another minor intervention may be required.

In patients with a predisposition to excessive scar formation, the cut lines may be somewhat rough and red for several weeks. In this case, we advise you on the appropriate aftercare. A slight dryness of the eyes after surgery is normal. However, if your eyes are more irritated or red, it is best to consult your ophthalmologist.

There are a few cases of persistent visual impairment in the literature. The cause of this must be assumed arteriosclerosis of the eye vessels. However, the ophthalmological examination excludes this risk.

What kind of after-treatment is necessary for the blepharoplasty?

Be prepared to cover your eyes with wet compresses and ice packs for a day or two. This is how the swelling sounds faster. Any blood residue along the seam can be carefully removed with moist pads. The intracutaneous threads are pulled in the clinic on the fifth day after the operation.

What should be considered after the procedure?

You should not put eye creams or ointments in the first week after surgery. Even make-up should not be brought directly to the fresh scar. Remember, the skin helps itself best. To conceal any bruising, it is best to wear dark sunglasses.

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