Definition: Forming or loosing the fats in the face to create a younger outlook,

Lifting and reconstructing the face muscles and tissues,

Recover the sagging skin on the face, under-cheek, chin contour and neck for decreasing the exorbitance

Age limit: If there is no extraordinary event, the lower limit is 16-17 for women, and 18-19 for men. 2. The upper limit is depending to the person’s general health conditions.

Preparations before the surgery: It is requested from the patient to stop smoking 3 weeks prior to the surgery.

Operation time: 3-6 hours.

Inpatient/Outpatient: According to the case.

Anesthesia: General or local anesthesia + sedation. Healing period: Back to the work between 10 days and 2 weeks. Treatment frequency: Generally for once.

Risks: Nerve injuries, hematoma (blood accumulation under the skin), asymmetry, poor wound healing, changed hairline, complications caused by the anesthesia.

The permanency of the results: Log term permanency. (If this operation applied to you, and not applied to your twin sister, you will look 8-10 years younger then her). However as the aging and gravitation affects will last, another or additional surgeries can be requested after several years.

The main questions that you have to ask to your doctor about the face lifting operation:

• Which technique will you offer for me?
• Where will be the cuts and scars?
• How is your experience with this technique?
• Will the face lifting operation brought me to my targets?
• Which type of anesthesia are you suggesting, and who will apply this?
• Post-Operation;
• The inpatient period is between 1-2 days.
• During the first 2-3 days after the operation a bandage will be placed around your face with a light pressure.

The swellings will quickly dissipated in the first couple of weeks, the rest and slightly swellings will be fully dissipate and your face skin will take its final form up to 6 months.

During the first couple of weeks together with the quick healing of the skin, the tonicity feeling and apathy will also lessen and disappear.

The healing period of possible skin bruising is depending on the person’s skin-type. This period can be extended up to 15 days for the people who have a sensitive type of skin.

After the surgery it might be requested not to smoke for the first 3 weeks.

The patient must be protected from the sun, if she can not do this, she should use a sun-protection cream over 30 factors. The patient can turn back to her normal social life in 7-10 days after the endoscopic subperiosteal mid-face lifting surgery, the swellings will be dissipated during the first 3 weeks, and the first 3-6 months time is the remodeling period.

CLASSICAL FACE and NECK LIFTING

As the classical face and neck lifting surgeries will be operated in the same time, they are two different operations which can be discussed together.

However, the common point of the two operations is to realize them either at the same time with the endoscopic upper and mid face lifting operation, or right after this surgery.

The classical face and neck lifting operations are the complementary parts of the combined face rejuvenation surgeries including the solutions for the upper and mid face aging problems.

For the middle aged persons, after the face has been lifted by using the endoscpoic methods, the classical face lifting surgery will be enough for correcting the significant chin contours, taking the sagged skin in front of the cheek and improving the sagging around the mouth. For the elderly people, it might be necessary to make some intervention for the neck skin’s looseness, neck’s sagging and neck muscle (platysma muscle).

It is necessary to look to the face rejuvenation not only as a stretched skin, but also from the depth. Because the face is not only constituted by the skin , but also from a muscle layer, and in deeper level from the bone plan. By the general application either the first layer or two layers on the surface will be lifted and most commonly the appearance will take its previous status before the surgery.
Skin Layer: As the skin constituted from the elastic connective tissue, it is easy to loosen for the skin against the lifting. The lifting operation which will be applied only to this layer will be sagged quickly and earlier.

SMAS Layer: SMAS layer is a layer which includes the casings of the face muscles called fascia and it is a stronger layer then the skin. The lifting operation applied to this layer is more permanent then the skin, but it is not good to bend (plication) this layer.

Sub SMAS Layer: It is the most perdurable layer against the stretching. On this plan the dissections through the SMAS will be more affective and permanent.

For a more permanent result, we are preferring to work on these three layers.

The neck lifting: After the lifting operation all of these three layers of the face (subperiosteal, SubSMAS and skin), will be passed to the neck area in accordance with the patient’s needs.

If there are some fat accumulations under the chin, liposuction or open surgery lipectomy (cutting with the shears) will be applied, afterwards the neck skin and muscles will be eased separately, platysma (neck muscle) will be closed to create the tightness and contour, and the residual skin will be removed from the backside of the ear. Thereby a tight neck, a chin with clear contours and a rejuvenated face will be obtained.

On the contrary to the endoscopic upper and mid-face rejuvenating surgeries, unfortunately these operations made for rejuvenating the upper area of the face are not without scars. The necessary cuts are starting from the front side of the ear, enters into the ear, passing under the earlobe, and from the backside of the ear it reaches to the hairy skin.

However the scars will be perfectly masked and they are not visible. As the three layers of the face have been tightened, the stitch scars will not be stretched and it is not possible for the stitches to become significant.

The scars are red at the beginning but they will be paled during the following months and became invisible.
Preparations for the surgery

The most important and efficacious preparation for the classic face and neck lifting surgery is not to smoke. As all the tissues on the face have been operated, it is very important to have enough blood circulation through the tissues in healing period. Smoking lessens the blood amount which flows between the tissues and negatively affects the nutrition of the newly replacing tissues and delayed the wound healing. That’s why you have to stop smoking before and after the surgery. This will directly affect the operation’s success.

The second important point is the Aspirin usage. Aspirin and similar medicaments are extending the bleeding period, because of this they should be stopped not just before the classical face and neck lifting operation, but also 10 days before all kinds of operations, and they shouldn’t be used for a while after the operation.

As the classical neck and face lifting operation will be realized under general anesthesia, the food consumption should be stooped 6 hours before the operation. When you arrive to the hospital, your blood tests will be done and you will be examined and evaluated by the anesthesiologist. After the necessary drawings for the face and neck lifting operation have been made, you will be ready for the surgery.

The Healing Period after the Face and Neck Lifting Surgery 

The surgery will be done in the hospital under the general anesthesia and it takes 3-4 hours. According to your needs, the endoscopic upper and mid-face lifting, jowl liposuction, classical face lifting and neck lifting operations can be done together at the same time.
You can eat 4 hours after the surgery and then you can stand up.

Generally you have to stay one or two nights in the hospital. You will have some drains for any excess fluid that may collect under the skin. Your drains will be removed depending on the fluid amount in 1-3 days. If you sleep in half-sitting position after the operation, your swelling and pains will be healed more quickly. When the procedure is completed, you will have some hue colored bandages on your face, and some bandages around your chin with a light pressure. These bandages will be used to minimize your possible bruising. The pain that you may feel after the surgery, can easily be ceased with the painkillers.

When you have been discharged, you can wash your hair with lukewarm water. You can wash your face after the bandages will be removed.
You can go back to your normal daily life at the end of the tenth day, but you have to avoid the heavy exercises which need excessive effort for six weeks. Your face will be fully formed in two or three month. Your face will be much better and rejuvenated with the time.

The Risks of the Classic Face and Neck Lifting Surgery 

Bleeding: The bleeding is a complication which can generally be occur because of the Aspirin usage and can be prevented by the drains and pressure bandages.

Infection: It is a rare situation after the surgery. It can be prevented with antibiotics.

Bad scars: Even that a good healing will be expected after the surgery, there is possibility to have some bad scars for the people whose are smoking.

Asymmetries: Normally a human face has an asymmetrical form. After the surgery you may notice this asymmetry because of the stretched tissues that you did not noticed before.

Deep Tissue Damages and Nerve Injuries: The possible deep tissue damages will be rarely permanent and generally they will be healed in long term period.

Hair loss and dissociation on the incisions: These are generally the complications caused by the extreme stretching.

Tissue Losses: Can rarely be seen on the heavy smoking patients.