In this blog post Dr. Zubowicz, a board certified plastic surgeon discusses his experience and a new approach to the composite facelift procedure.
There is renewed interest these days in the “composite” or “deep plane” facelift.
As a matter of fact, it has been around for almost 40 years now. I adopted this approach about 30 years ago. The primary reason for transitioning from the conventional subcutaneous facelift to the deeper approach was maintenance of generous blood supply to the skin.
I Wanted Better Facelift Results
A surgeon improves only if personally critical of their own results. One area that bothered me was the partial recurrence of some of aging addressed by the facelift. This was a bigger problem in the older patients with an exaggerated features of aging. Because of this I incorporated a sequential tension sutures into the composite facelift technique.
Example of Aging Recurrence 1 Year the After Facelift Procedure
Facelifts are designed to eliminate the common signs of aging and restore a rejuvenated appearance. And the results can be long lasting, however, aging recurrence can happen. The example before and after pictures show a female patient who did not receive the sequential tension sutures technique and aging recurrence.
Patient: Older female patient with significant obliquity of neck.
Middle photo: Taken about a week after a composite facelift without the benefit of sequential tension sutures. Note the excellent jawline and neck.
Far Right Photo: Taken a year or so after the operation. You see some recurrence of aging in the neck and jowl.
Sequential tension suture technique can reduce the amount of aging recurrence particularly in older patients with substantial aging features.
What Happens During a Facelift Procedure Using Sequential Tension Sutures?
Prior to adopting the sequential variation, like most facelift plastic surgeons I would reposition the flaps of the face and neck, created by the facelift dissection, over a drain and then close the incisions.
With the introduction of the sequential suturing technique these flaps are anchored to the deeper connective tissue with dissolvable sutures. The tension is directed from the middle of the face towards the incisions (which are around the ear and back of the neck). It would be the biological equivalent of spot welding.
The number of sequential sutures placed on each side of the face varies because of anatomic differences between patients but there are about 10 per side on the average facelift. In the short term, these sutures may produce shallow “dimples” but these fade away as the swelling subsides. The sutures themselves fully anchor for about a month and then dissolve totally around 2 months.
What are Benefits?
There are several benefits I have witnessed.
- Significant reduction of the partial regression of aging features in older patients with exaggerated features of aging
- No drains are necessary. The elimination of dead space by attaching the flaps to the deeper structures removes the need for drains.
- Less post-op complications. As the dead space is substantially reduced by these sutures, this minimizes any fluid or blood collections post-op complication of hematoma (a collection of blood).
Why I Adopted this New Technique
As I continue to perform facelifts, I remain my own worst critic. I will introduce my own variations to the composite technique if it will enhance the results. I adopted this technique as my commitment to my patients and helping them achieve long lasting cosmetic results.
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Dr. Zubowicz, a board-certified plastic surgeon walks each patient through the decision-making process to ensure you have the best information to make an informed decision about your facelift surgery options. He make sure you are educated about your cosmetic surgery options and we help you make the best decision for your individual goals.
Schedule a free consultation to discuss your goals and options at our Midtown Atlanta or Alpharetta locations.
