Face Lift

What is face lift?

  • Face lift is a procedure to lift sagging skin

Why does skin sag?

Skin sags due to several reasons which may intrinsic or extrinsic. Intrinsic factors include:

  • Ageing skin loses collagen fibres. These fibres are present in skin to give firmness and tensile strength.
  • With ageing, skin becomes thin
  • With ageing, muscles lose tone
  • With ageing , there is loss of fat in the skin

Extrinsic factors for sagging

  • Gravity, stress, sunlight also add to the changes of ageing
  • All these factors together cause wrinkles, sagging, depressions etc
  • Each of these factors need to be corrected while treating ageing skin
  • Hence different treatments may be needed for different people

Different ageing changes

  • Wrinkles form around eyes on fore head, deep creases form between the nose and mouth (nasolabial fold).
  • The jaw line grows slack and skin droops at the jaw line (jowls).
  • Folds and fat deposits appear around the neck.

The aging brow changes include

  • lowering of the eyebrows
  • horizontal furrows and folds
  • vertical lines between the eyebrows
  • elevated hairline due to loss of hair.

The aging eyelid changes include

  • folding of the upper eyelid that can make it difficult to keep the eyelid open
  • weakening of support for the lower eyelid that can let the lid sag away -baggy eyes
  • darkening of skin around eyes
  • wrinkling of skin at the outer corners of the eyes – “crow’s feet”

The aging face changes

  • pigmentation of skin over cheeks
  • descent of tissue from the cheekbones towards the cheeks resulting in less prominent cheeks
  • deepening of the nasolabial folds (the lines between the nose and the corners of the mouth)
  • extra tissue below the jaw line creating bulges called jowls
  • sagging neck muscles that can tighten into bands with expression
  • wrinkles at the angle of the mouth and folds at the angle of the mouth( called marionette lines)

Can these be prevented?

  • There are no fool proof remedies to prevent these changes.
  • Avoidance of sub exposure, use of sun screens, proper diet, avoidance of stress can help in delaying these changes
  • Some drugs such as vitamin C, Vitamin E, retinol, antioxidants may be of benefit, but the effect of these drugs is difficult to quantify

What is face lift surgery?

  • Till 1990s facelift was a major surgery under general anesthesia
  • It needed extensive surgery of sagging, skin, fat, fascia and muscle
  • needed hospital stay of several weeks
  • Recovery time was also at least 4-6 weeks
  • Side effects were significant
  • Was expensive
  • So it was not popular

What is new?

Since early 1990 a number of developments have helped to render this previously difficult procedure in to an easy procedure and accessible to all.


  • Since ageing of skin is due to several different components, one treatment will not suitable for all changes
  • A cocktail of treatments to be tailored for each patient

Ageing skin treatment- new options

  • The first major development was chemical peels
  • Lasers were introduced in early 90s
  • Microdermabrasion was also introduced .
  • Then came Botox and injections called fillers
  • In 1998, came aptos thread to revolutionize the face lift procedure
  • The latest is thermal lift.