It is one of the most popular surgeries in plastic surgery field. The purpose of this operation is to rejuvenate the face and restore the falling tissue to the position it was during the youth.

The human face is divided into a central oval, extending from the tip of the eyebrow and reaches the corner of the lower jaw and a distal oval extending lateral to the center line of the oval.

The aging of the human face is due to genetic, anatomical and environmental factors.

Physiology of facial aging

The facial aging starts mainly to the central oval of the face while after the sixth decade of ones life, it begins to extend to the distal oval of the human face. In the second and third decade of life, collagen and elastin as well as face fat are in high levels but gradually the first signs of face aging begin to appear: fine wrinkles in the lateral eye, wrinkles to the sides of the nose.

In the 3rd to 4th decade of life, wrinkles become more intense and the face begins slowly to lose its triangular shape. The area around and under the eyes starts now clearly to be affected by the process of aging while dark circles and bags under the eyes (see blepharoplasty) start to appear.

In the upper eyelid and the side of the eye intense excess skin raises accentuating even more a tired appearance.

The wrinkles in the sides of the nose (also known as bunny wrinkles) are now visible and the fat percentage in the area is gradually reducing. This results in the face to lose its former youth lines and to appear empty and tired. The rate of cell renewal has significantly slowed down.

In the fifth and sixth decade of life (menopause period) we have further reduction of collagen and elastin fat levels. Furthermore, we have the appearance of osteoporosis in the facial bones resulting in the face bone structure to be slender while soft tissue structures which rest upon them begin to sag.

Up to this point the face is sagging, with bags at the lower eyelid, extensive excess skin of the upper eyelid, a sharp drooping of the corner of the eyebrow.

Bunny wrinkles are now not only noticeable but also drooping to the mandibular angle with formation of excess soft tissue in the corner of the jewels. Similar are the changes in the neck area with the formation of vertical wrinkles in the middle of the neck with a strong excess of skin. The neck has now lost its youthful angle of 90 ° below the jaw and the shape is an extension of the face drooping without being able to outline the deeper structures of the face (lower jaw – neck).

Collagen, elastin and fat levels are now in the lower levels.

Throughout the facial aging, skin has more of an overlapping role rather than a supportive one. The main cause of the faces droopy appearance is not the skin but the tissues below the skin.

(SMAS) superficial muscular aponeurotic system is the terminology of the tissues below the skin that cause the problem of a drooping face which makes us uncomfortable to look our image in the mirror.

The Smas is a fibromuscular tissue located between facial muscles and skin, stretching from the hair line to the base of the neck, providing support to the face during the age of youth. The operation mobilizes and lifts SMAS to a higher position resulting to the lift of the tissues to the position they were 10-15 years ago.

Briefing

During your briefing, Dr Kretsis will assess the quality of your skin, the degree of the facial and neck drooping or any other part of the face that shows signs of aging.

In addition, Dr Kretsis will be fully informed about your medical history and any medications that you might be receiving or any surgeries that you might had undergone in the past. You will be informed about the size of the incisions to be made as well as whether this surgical operation will be combined with another plastic surgery such as Blepharoplasty, Brow lift, Neck lift, Fat Injection.

The operation

The operation is performed under general anesthesia after a full preoperative and laboratorial test. The incisions begin from the top of the ear, continue through the ear and they might reach the end of the lobule or even extend to the back surface and into the occipital of the hair line area depending on the problem.

After skin detachment the Smas is recognized and is prepared and posted in the position it was in the youthful age. This procedure lifts the drooping tissues and gives the face- mainly in the middle- a triangular youthful appearance with sharp corners in the lower jaw and cheekbones.

The operation depending on the problem can last 3-5 hours and quite often is combined with other cosmetic procedures, blepharoplasty, Neck Lift, Brow Lift. Mostly is combined with simultaneous infusion of fat and stem cells in the face.

After surgery the patient remains hospitalized for 24 hours.

Complications

As with any surgery there might be some complications, which in Dr Kretsis hands reach a percentage less than 1%.

Usually these complications can be a hematoma for which a small drainage is placed that gets removed the following day.

Small neuropraxia from an early injury to the facial nerve (very rare).

If the patient is a smoker there is a small probability of low healing procedure in some point of the incision. Therefore it is recommended to stop smoking for 4-6 weeks prior the operation.

Recovery

Swelling and bruising, if any, gradually subside within 7-15 days, the sutures are removed from the fifth day to the 10th day. The patient, in most cases, can return to his professional obligations in 10-15 days.

The complete restoration of the face is complete after 4-6 months. The patient, after 10 days can deal with everyday activities wearing a light foundation.

The High Smas Face Lift is a procedure that really gives restful renewed face without a trace of intervention.

In conclusion

It is an operation performed only by a few plastic surgeons in the world but it is the only one that can restore features of the face similar to those back in juvenile age.

• Corrects the oval face shape.
• Softens bunny wrinkles.
• Restores sagging of the eyelids.
• Removes bags.
• Lifts up eyebrows and temples.
• Restores the relaxation of the neck and drooping cheeks.

Besides the triangular shape that the High Smas Face Lift provides, it also gives a great number of stem cells and adds the lost face fat. All of the above give to the face a youthful appearance, with clean facial lines and a glamourous shinny image.

 Before and After | High Smas Face lift

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