Composite Facelift

As we age, our face tends to lose its shape, often making us look tired and haggard. Today, modern facelifts can help turn back the clock by subtly restoring the youthful contours of the face for a fresher, more revitalised look.

A traditional facelift is done by cutting away excess skin for a tighter looking face, often resulting in an unnaturally ‘stretched’ look or as if a person has been in a wind tunnel. This is an immediate giveaway of a facelift.

This unnatural look is the result of placing tension on the skin, leading to a tight appearance in front of the ears. The tension is ineffectively transmitted to the anterior face (the area where tightening is needed most), hence the laxity here remains, resulting in what is called the lateral sweep deformity, a classic telltale sign of a skin facelift. As the skin is not designed to bear any tension, it relaxes rapidly over time, so the patient ends up with short-lived results.

We can perform a composite facelift, an advanced surgical technique that focuses on restoring and tightening the deeper support layer of the face, which is referred to as superficial musculoaponeurotic layer (SMAS).

The procedure is called a Composite Facelift as the SMAS, subcutaneous fat and skin is lifted as a single unit (hence the term COMPOSITE FACELIFT), to achieve a natural and long lasting result. The SMAS layer is the natural support layer of the face, and this is where anatomically laxity develops. Tightening the SMAS layer therefore directly addresses and reverses the aging changes of the face, while producing a more natural and long lasting facial rejuvenation. This is done by restoring the shape and contours of youth to the cheek, jawline and neck.

The results of a composite facelift are very different from the traditional skin facelift, as it is natural with no telltale signs of surgery. As tightening is done at a deeper level, the face looks fresh without appearing excessively pulled. The youthful shape of the face is also more effectively restored with this approach.

This restores the shape and contour of youth to the cheek, jawline and neck. The composite facelift gives a result that is very different from the traditional skin facelift, one that is natural with no tell-tale signs of surgery. Because of tightening is done at a deeper level, the face looks fresh while not appearing excessively pulled. The youthful shape of the face is also more effectively restored with this approach.

Recent TECHNICAL ADVANCES in the COMPOSITE FACELIFT TECHNIQUES: Through the Facial Soft Tissue Spaces approach to the COMPOSITE FACELIFT
One of the most obvious results of the COMPOSITE FACELIFT is the deep lifting and reshaping of the face. One of the perceived drawbacks of a composite facelift is that it is considered more risky due to the deeper dissection (the technique is also known as the DEEP PLANE FACELIFT) that has to be performed, which potentially has a higher risk of injuring nerves that control facial expression. Thus this is not a technique that is popular with many plastic surgeons.

Fig 1. Facial soft tissue spaces and retaining ligaments of the face.

A composite facelift treats the lower face, including the marionette lines and the jawline. A neck lift is also done as part of the composite lift. In patients that also have midcheek descent, a composite facelift can also be used to lift the cheek as well as the nasolabial fold. This extended dissection is called the extended composite facelift or High SMAS composite facelift. Should there be upper face (brow and forehead) aging, a forehead lift or a brow lift can be included with the composite facelift, which will then be known as a complete facelift.

The Composite Facelift
Today, with new advancements in surgical approaches and techniques, we are seeing a renaissance of surgical facelifts in our practice. You can expect better, more natural results that can now be achieved safely and reliably. A composite facelift will give you a different look that cannot be achieved with traditional facelifts. The result of a composite facelift is a fresher, more vibrant looking you.

As your face is the essence of your identity,it is natural to have plenty of questions before embarking on this procedure. We look forward to sharing these new and exciting developments in our procedures with you. To learn more about a composite facelift, please contact our clinic to arrange a consultation with Dr Wong.

A strong understanding of the anatomy is key to performing this surgery safely. Recently, the FACIAL SOFT TISSUE SPACES of the face have been described and clarified.

Based on detailed knowledge of these spaces, the COMPOSITE FACELIFT can now be performed safely. When the procedure is properly performed, the risks of nerve injuries are minimised. As the spaces are natural planes that separate the SMAS, subcutaneous fat and skin composite above and the deep fascia below, dissection through these spaces are bloodless and non-traumatic. This approach minimises swelling and bruising (much less than traditional facelifts), and recovery time from the surgery is rapid.