Laser face lift (laser assisted neck lift, laser facialsculpting, laser Smart lifting)
Less invasive procedures for facial rejuvenation are becoming more and more popular. We describe a minimally invasive “laser face and neck lift“ that utilizes minimal access incisions, no general anesthesia, and internal aesthetic laser to disesct in the plane between skin and subcutaneous fat and platysma.
Smart Lifting evolved from application of new technologies in facial plastic surgery. Laser- assisted liposuction has been successfully applied to remove fat and contract skin. Anatomic areas treated included the submentum, jowls, neck, skin, jaw line, cervicomental angle, oral commissures, and nasolabial grooves. Patient returned to their normal lifestyle within 6 to 7 days after treatment. Patient satisfaction is generally higher than that seen in patients receiving a conventional face-lift. The LFL is less invasive treatment with acceptable efficacy, reduced downtime, shorter recovery, and lower cost compared with the traditional face-lift. Laser assisted lypolysis is the use of laser fiber (inside or outside a cannula) to treat fat before removal by suctioning. Laser lypolysis induce skin shrinkage as well as destroy fat cells. Laser could improve skin retraction in small areas such as in the face, and the neck with minimal swelling and bruising a clear advantage over liposuction alone. Laser lipolysis may be a viable option to traditional face and neck lift. It is not an advisable for the patients with no facial fat, poor skin contractibility or elasticity. The access port for the laser access is as a small incision in the temple, anterior to the lobule, in the posterior hairline and under the chin. External and internal temperatures monitoring are introduced to bring the skin to the highest possible temperatures without inducing skin damage. Maximum temperature used is 42 degree Celsius. Patients tolerated their procedures well and they returned to social events within 6 days and to their jobs within 7 days. Some returned to work in 3 to 4 days and few returned the next day. There were no injuries to the facial nerve. Sensation returned more quickly to the face a neck than normally observed. Edema was sometimes greater on the first day after surgery than in a „standard“ face-lift, but it cleared more quickly. Canula laser energy delivery at depths of 5 mm produced less bruising than seen with normal face-lift.
Original goal of laser face lift is to remove fat deposits and tighten the skin. For aging patients in whom loss of facial fat is common, skin contraction is more important than fat removal. Less dramatic results may be expected in elderly patients with minimal skin elasticity, severe photo damage, or both.
For example, a traditional face-lift improves the neck skin, the cervicomental angle, the lower third of the jowl, and the jaw line, but does not improve the nasolabial groove or oral commisure. The current economy and the willingness of patients to accept lesser improvement in exchange for reduced invasiveness, recovery time and cost are curtail factors in the decision to apply option of the laser lypolysis and laser smart firming. The procedure is also less expensive and requires no general anesthesia. Patient who undergo a laser face-lift procedure are generally more satisfied than patients who receive a traditional face-lift. Although generally effective for improvement of jowl ptosis, the ptotic melolabial fold is inadequately corrected by many well established face-lift techniques, certain rhytidectomy techniques may even paradoxically deepen the melolabial fold. Independently, filler injections are limited both by their temporary nature, decreasing effectiveness with increasing nasolabial fold depth or jowl prominence and by the fact that they do not address the primary problem (descent fat).
Autologus fat grafting is another popular method. The procedure does not remove descended fat but attempts to camouflage the anatomic correlates thereof. Some patients may ultimately appear overcorrected with excessive central facial fullness.
Laser - assisted facial contouring of the mid-and lower face with direct reduction of ptotic melolabial folds and jowls is novel minimally invasive option for facial rejuvenation that meets each aforementioned criteria.
