Early history of facelifting – how the facelift procedure began
Facelift surgery techniques have continued to evolve and improve throughout the years. Facelift surgery (also referred to as rhytidectomy) was first practiced in the early 1900s. The first documented effort to perform what we consider today as being a facelift occurred in 1907 by the American physician Miller. Up until the 1960s, facelift procedures were generally limited to lifting, tightening and repositioning the skin in order to reduce wrinkles and elevate a drooping, aged appearance. However, focusing solely on repositioning the skin can lead to a number of different problems such as: widened scars around the ears, a tense or unnatural appearance due to tightness of the skin, incorrect position of the earlobe, and results that are short-lived. The skin’s primary roles include sensation, protection, and regulation—not to structurally support fat or provide a pleasing contour to the face. Fortunately, less than 20% of facelifts in the United States today are “skin only” facelifts.
In the United States and around the world, more sophisticated facelift techniques have been developed that involve manipulation of the deeper structural layers of the face. With the anatomic description of the deeper layers of the face by Mitz and Peyronie and the seminal work of the Swedish surgeon Tord Skoog, surgeons began to appreciate that more natural-appearing and long-lasting results could be achieved. These advancements in facelift surgery and the discovery of the important role of the SMAS have revolutionized the results of facelift procedures.
The critical issue for prospective facelift patients to understand is that there are several different philosophies on what must be done to the SMAS to obtain the most natural-appearing and longest-lasting facelift results. Choosing the most appropriate technique is one of the keys to choosing the right facelift. This and other issues vital to outstanding facelift results will be discussed in detail in the sections ahead.