The results that can be achieved using the PAVE-Lift are significantly superior to those achievable with standard techniques. In developing the PAVE-Lift, I ran a clinical trial with more than 200 patients, which was published in plastic surgery journals. Consequently, the medical community has shown much interest in the technique and I have lectured on the subject at medical meetings around the world.
Course of the operation
Why is the PAVE-Lift such an innovation? There are three elements to the PAVE-Lift that distinguish it from an ordinary minimal invasive (MACS) facelift. The first is the addition of a fourth ‘suture’ to provide support for the neck.
A suture is a portion of surgical material that is woven into the face in order to provide strong anchor points for the repositioning of facial muscle. In the MACS lift usually only three sutures are used, but this means there is no support for the neck. Consequently, the appearance of sagging neck skin and platysmal bands – a concern for many patients – is not addressed.
|Figure 4: Traction vector of the "fourth suture" (yellow) with its anchorage point on the sternocleidomastoid fascia (K. O. Kay)|
The PAVE-Lift includes a suture placed under the chin, which enables sagging skin and hard platysma bands to be effectively treated. In addition to this, the treatment incorporates liposuction, removing fatty deposits under the chin and sculpting the jawline. We believe this is vital for achieving a truly youthful look.
The second innovation is using fat grafting (transplanting fat from elsewhere on the patient’s body) to re-volumise the face and fill out wrinkles. Young people carry fat in their cheeks and lips but this decreases with age and can lead to hollow cheeks and eye sockets and thin lips. This is very ageing but can be rectified with fat grafting – a safe and permanent solution.
Finally, we treat the appearance of the skin. We do this by carrying out a chemical peel to remove the top layers of damaged, discoloured and winkled skin.
All carried out together, the PAVE-Lift not only offers patients the best results possible, it also reduces the cost, discomfort and downtime associated with having multiple procedures.
The PAVE-Lift is carried out like a usual MACS facelift (Minimal Access Cranial Suspension lift), or a so-called Omega Lift, utilising short scar techniques.
The tissue and skin is drawn gently upwards and secured into place, with excess skin removed. The incision is meticulously closed, resulting in a near invisible scar and a very natural looking result.
To carry out the chemical peel, a TCA or phenol solution (or a combination of both) is applied to the skin and allowed to soak in, breaking down the top layers of epidermis. Peel type and depth (the number of skin layers removed) is determined by the ingredients and concentration of the solution.
If we have been unable to obtain fat for re-volumising the face from under the chin or the jowls, it will be removed from a donor site on the patient’s body (usually the stomach, waist, thighs or flanks). It is extracted with a very fine, needle-like cannula that should not leave any noticeable scars.
The fat is prepared for reintroduction to the body and transferred to a small syringe. A special cannula for injecting fat is attached to the syringe, which allows for meticulous injection and does not create any scarring.
Tiny droplets of fat are injected into the recipient site with great precision, ensuring more cells will gain a blood supply and become permanent tissue.
Areas of the face that might be treated include the lips, cheeks, temples and tear troughs. It can also be used to soften deep wrinkles such as those which appear around the mouth (nasolabial folds).
Between 20-30 % of fat will be reabsorbed by the body in the first three weeks, so we ‘over correct’ to make allowances for this.
|Illustration of the amount of cervical skin that can be redisributed during the modified MACS lift with its "fourth suture!|
Duration of the operation
In total, the PAVE-Lift procedure takes around four hours. It can sometimes be performed on an outpatient basis meaning the patient can go home immediately afterwards. In other cases, where a patient has received full anesthesia, they must stay in overnight.
After surgery and recovery time
Because the short scar facelift procedure is less invasive than other types of facelifts it tends to produce less bleeding and swelling. Patients therefore usually enjoy a faster recovery time and the procedure is considered safer, with less risk of nerve damage.
There will be some swelling and bruising that will last around 14 days and we recommend you take this period off work.
Pain can be well managed with over the counter painkillers and stitches can be removed after 7-10 days. The face will be virtually scar-free, thanks to the zig-zag pattern incision that makes the scar blend with the hairline.
Although it can take up to a year for healing to fully complete and the true results to be visible, patients will immediately notice an uplifted face, with greater definition but also a youthful plumpness.
The results are both effective and long lasting. Of course a facelift cannot stop the aging process but typically you will always appear around 10-years younger than you really are. Results can be maintained as long as possible through avoiding sun exposure and other skin aging activities such as smoking and drinking.
Who is this procedure intended for?
The PAVE-Lift is suitable for older patients (providing they are in good general health) as well as those in their 40s and 50s who require more subtle correction. The results of a PAVE-Lift are very natural and it does not leave patients with that tell-tale ‘wind tunnel’ look.
We have now carried out this ‘enhanced facelift’ on hundreds of patients and continue to be highly satisfied with the improved aesthetic outcome it provides. For further information, read the research published in the Journal for Plastic, Reconstructive and Aesthetic Surgery (JPRAS).