The face and skin have a substantial impact on a person’s physical and aesthetic appearance. It no doubt determines whether or not a person is young, if they are getting old, and it allows us to roughly calculate the age of a person at first sight. Therefore, the ageing of the face and, by extension, the neck have a substantial impact on a person’s appearance, both on an aesthetic and a psychological level as, with the passing of time and due to changes brought about by the tissue deterioration, a person begins to see themselves getting older in the mirror and sometimes not even recognising themselves, which can have a certain impact on their self-esteem.
Surgery to rejuvenate the face and neck, also known as “lifting”, allows for the “repositioning” of the patient’s face and neck tissue. This can take years off their appearance and make them look younger, which means that they regain their self-esteem. It is essential to stress that the basis of this surgery is the rejuvenation of the face, maintaining the essence of the person. It is not a surgery that seeks to change the patient’s features, because if it were so, we would be transforming rather than rejuvenating, which is what we want for our patients.
There is no minimum or maximum age for having this surgery, if the patient is healthy from a medical point of view and has realistic expectations of the outcomes of the surgery, they can be candidates for the surgery.
In order to maximise our patient’s comfort, the surgery is normally performed under general anaesthetic. Although the patient is asleep, the first step is to inject all the areas of intervention with a local anaesthetic to prevent any kind of post-operative discomfort. To perform the procedure it is necessary to make a downwards cut that goes from the area around the temple (within the hairline), close to the front of the ear along its natural folds to the lobe. From there it goes around the back of the ear to the hair once again, this way, the resulting scar is perfectly camouflaged by folds and by the hair. These two incisions are made at each side of the face and are complemented with another incision of 4-5 cm under the chin in order to be able to approach the neck area with precision. After this, the tissue is detached within a safety margin, to avoid any damage to any internal structures (blood vessels, nerves, gland ducts and muscles), and the repositioning of the tissue is then carried out. The most important thing is to reposition the SMAS (superficial muscular aponeurotic system) correctly, as this is the layer that provides support to the skin itself, so if only the skin is repositioned the tissues would very soon pull away again. The vectors on which the SMAS is repositioned will determine the difference between the results, whether they have a marvellous rejuvenating effect or an undesirable transformative effect. After this, the excess skin is removed and the skin is repositioned once again. The incisions are carefully closed so that the scarring is imperceptible. Sometimes, including when the patient has a substantial loss of facial volume, once the tissue has been repositioned, it is normal to add injected fatty tissue to areas such as the cheekbones, ears, chin or the mandibular angle in order to create a younger appearance.
This type of intervention should be carried out by a plastic surgeon with experience in facial surgery. Dr Ospina has trained in this surgery with various internationally-renowned professors such as Dr Artur Carbonell, Dr Juan Carlos León and Dr Gabriel Alvarado, all of whom are experts in facial surgery.
Not only is it important that the surgeon is skilled, but also that they also know how to give the patient’s skin a youthful appearance without the slightest change to their features. It is a case of turning back the clock, not of transforming the patient’s skin to that of another person who the patient does not recognise.
This type of intervention should be performed in a hospital that conforms to all health requirements and which has an intensive care unit. Aesthetic surgery is very well regulated and there are few complications but, should these occur, it is essential to have the support of a good hospital. Low-cost surgeries economise on this aspect and are carried out on small clinics where safety conditions are not met.
Dr Ospina is fully aware of this and, because of this he performs all his surgeries in the operating theatres of the San Roque Hospitals, as this provides the additional safety that he wants for his patients.
After surgery, the patient will need to carry out some basic care at home, such as cleaning the wounds and applying various creams. During the first week, they should sleep on their back with the head of the bed raised. Applying ice to the area will help to reduce the inflammation more quickly. In addition, during the first few weeks, it is important to use compression garments to minimise the inflammation.
It should only take some 10 days to return to normal daily life. That is the time it should take for the inflammation and haematomas to disappear. Sports activities should be reintroduced progressively after the third week.
These will be visible once the inflammation and the small haematomas on the skin disappear. Some results are visible within a week and others will take a little longer, for example, the injections of fat can take at least 3 weeks to stabilise.
Although these are rare, they tend to be related to long-term inflammatory processes or to changes in sensitivity in small areas of the skin. These tend to resolve after a few weeks.
“My facial rejuvenation philosophy is simple. It is about rejuvenating our patient’s skin, removing the years while maintaining their essence, not changing them into a different person”