Surgery of facial rejuvenation

The ageing skin process and of the underlying tissues (subcutaneous, muscles, cartilages and bones) is continuous.
As the time goes by, the skin loses its elasticity, causing its excess and flaccidity.
The gravity acts hauling that excess below, making depper the natural furrows of the face (between the nose and the mouth, below the corners of the mouthm, between other marks of the skin)
Beyond the ageing of the skin, the musculature of the face, after years of movement, contributes for the formation of wrinkles in the forehead, around the eyes and in other areas.
Others tissues are also modified of consistency and place, as the greasy bags and the musculature.
All those alterations, together, cause the appearance of ageing.
The surgery of facial rejuvenation has for objective partially revert this procces, due to its acting upon some muscles, greasy bags, re-positioning and removing the excess of existing skin.
The final scars habitually are faint and hidden in the natural furrows of the face and inside the scalp.
It's usually associated to others procedures like the surgery of the eyelids, of the nose and the filling of the furrows/wrinkles.

After anesthesia, initially a small down incision of the chin is done, which way the excess of fatness of the neck is aspired (liposuction) and the suture of the neck muscle is done, what gives the impression of double chin.

Then, the incisions behind and in the front of the ears, and in the region of the scalp are done, according to the following plan.
The dissection of the face's skin and the neck's skin is done, as its underlying tissues.
The flaccid musculature is treated, and fatness bags, if necessary.
A rigorous cauterization of veins is done.
The skin is re-positioned, with the definition of the excess.
Is done the removal of skin excess.
Is done a prudent suture, reconstructing the tissues.
Drains of continuous aspiration are put.
The head and the face are bandaged up.

	Localization of the incisions
	Area that is unstuck (skin and underlying tissues)
	Traction of the skin, with definition of the excess portion.
	Removal and final suture.

 

It´s usually tranquil. There is little or no pain. In the day of the surgery the face and head area will be covered with a bandage in a helmet format, removed with the drains, in the following morning. It is common occur swelling and wound. Those symptoms regress gradually during 15 to 30 days. A residual swelling persists here by until 6 months, being noticed by the patient as a hardening in the local of the scars.
To minimize the formation of the swelling and wounds, physiological compresses chilled of serum or boric acid can be used in the two first post-operative days. A certain insensitivity can occur in some regions of the face, that finishes completely from 6 to 12 months.
Another important care is to avoid the heat (very hot baths, cook, etc.), since this favors the formation of the swelling and wounds. The sun should be avoided by 3 months, with the use of dark eyeglasses and sunblocks.
The stitches are secluded between 7 and 14 days.
The returns are weekly in the first month, and subsequently monthly. These frequencies can vary, according to the case.

The complications include post-operative bleeding, wound, infection, opening of the scar, insensitivity in some locals of the face, more rarely suffering with a possible loss of unstuck skin and loss of movimentation of some areas. The rates are very reduced, when observed all the prescribed post-operative cares.
As all the surgeries, the anaesthetic and sistemic risks still exist. They have to be well should researched in pre-operative phase. Those complications has been less and less frequent with the evolution of the techniques and of the medicine.

Around a month occurs the reabsorption from most of the swelling, giving good notion of how the face will stay.
From the 30th day to the 6th month, the face earns bigger harmony due to the accomodation of the tissues and absorption of the swelling.
The scars are only considered as definitive after the 12th month.

1. Food:
The food after surgery should be gentle to avoid nauseas. The next day, the diet is normal.

2. Positions:
The rest is relative, being bigger in the first day; subsequently, are necessary small walks inside home.
Upon sleeping: always of belly for top (for three weeks), with a high pillow or cushion under the head. It put a wedge kind 02 bricks or 02 phone books under the feet of the head to elevate it in the 4 first days and, then, diminish the swelling.
Do exercises with the calf (roll the feet -10 times of each side) three times a day.
Do not it carry weight in the first fifteen days.
Do not low the head for catch objects.
The gel term mask (or gauzes humids in serum chilled) should be used by 36 to 48 hours after finished the surgery.
Do not lower the head.
Avoid sun, hot localities, wind or cold in the 30 first days.
Avoid straight solar exposition for 60 days. It will be able to, however, expose itself to the occasional sun of street, from the 7th day, with use of solar protector in the face and hats or visors.
Do not smoke for at least 10 days in post-operative
Resolve with us any doubts. Avoid to sensitize yourself by friend's opinions on this initial phase.

3. Baths:
The bandage surgical can not wet in the first 7 days, so that the bath in this period should be taken avoiding wet the face.

4. Medication:
They will be prescribed anti-inflammatory and common painkillers, by a medium period of 5 days.

5. Returns:
The returns are weekly scheduled on the first month. Subsequently, are montly until the 4th month.
Those frequencies can be altered, according to the clinical need.