Essay On Composite Facelift

Composite Facelift

The philosophy of those advocating the composite facelift is that gravity has an effect on all the soft tissues of the face, so lifting the skin alone is not adequate. The composite facelift uses the same incisions described for the traditional facelift procedure, but the dissection is carried out at a deeper level. The skin is left attached to the underlying orbicularis, SMAS, and platysma muscles.
Proponents of the operation have demonstrated some improvements over the traditional facelift operation. Composite procedure restores the fat overlying the prominent area of the cheekbone in the mid portion of the face to a more youthful position. As the soft tissue of the midface is elevated, there is less overhang of skin at the crease at the nasolabial fold. Thus, the cheek can achieve a much nicer correction than is seen in the standard facelift operation. The skin has more blood vessels because it is left attached to the deeper tissues below it. This may offer some advantage to the patients with a smoking history who are at high risk for skin death.
This is a technically exacting operation, so it is imperative that the surgeon is experienced with the composite technique. The surgeon must work

It can be lifted in the subperiosteal facelift. Advocates of the subperiosteal facelift believe that facial aging is caused by the descent of all the soft tissues of the face and, therefore, cannot be corrected even by lifting the skin and the muscular layer together. The advantage of the subperiosteal operation is that it allows repositioning of all the soft tissues of the face, most importantly the fat pad over the cheekbone prominence of the midface. The subperiosteal facelift is generally carried out in conjunction with a brow lift (see Chapter 14). The subperiosteal facelift can be accomplished by lifting two levels of tissue in an “open” technique or by using an endoscopic technique, described