Before we delve into the finer aspects of Face-lift, let’s take a look at how skin ages & develops issues. Face-lift comes into the picture as & when your skin starts to sag and you want to do something about it. Skin sags due to several reasons which may be intrinsic or extrinsic. Intrinsic factors include:
  • Ageing skin loses collagen fibres. These fibres are present in skin to give firmness and tensile strength.
  • With ageing, skin becomes thin.
  • With ageing, muscles lose tone.
  • With ageing , there is loss of fat in the skin.

Extrinsic factors for sagging

  • Gravity, stress, sunlight also  add to the changes of ageing.
  • All these factors together cause wrinkles, sagging, depressions etc.
  • Each of these factors need to be  corrected while treating ageing skin.
  • Hence different treatments may be needed for different people.

Different ageing changes

  • Wrinkles form around eyes on fore head, deep creases form between the nose and mouth (nasolabial fold).
  • The jaw line grows slack and skin droops at the jaw line (jowls).
  • Folds and fat deposits appear around the neck.

The aging brow changes include

  • Lowering of the eyebrows.
  • Horizontal furrows and folds.
  • Vertical lines between the eyebrows.
  • Elevated hairline due to loss of hair.

The aging eyelid changes include

  • Folding of the upper eyelid that can make it difficult to keep the eyelid open.
  • Weakening of support for the lower eyelid that can let the lid sag away -baggy eyes.
  • Darkening of skin around eyes.
  • Wrinkling of skin at the outer corners of the eyes – “crow’s feet”.

The aging face changes

  • Pigmentation of skin over cheeks.
  • Descent of tissue from the cheekbones towards the cheeks resulting in less prominent cheeks.
  • Deepening of the nasolabial folds (the lines between the nose and the corners of the mouth).
  • Extra tissue below the jaw line creating bulges called jowls.
  • Sagging neck muscles that can tighten into bands with expression.
  • wrinkles at the angle of the mouth and folds at the angle of the mouth( called marionette lines).

Can these be prevented?

  • There are no fool proof remedies to prevent these changes.
  • Avoidance of sub exposure, use of sun screens, proper diet, avoidance of stress can help in delaying these changes.
  • Some drugs such as   vitamin C, Vitamin E, retinol, antioxidants may be of benefit, but the effect of these drugs is difficult to quantify.

What is face lift surgery?

  • Till 1990s facelift was a major surgery under general anaesthesia.
  • It needed extensive surgery of sagging, skin, fat, fascia and muscle.
  • Needed hospital stay of several weeks.
  • Recovery time was also at least 4-6 weeks.
  • Side effects were significant.
  • Was expensive.
  • So it was not popular.

What is new

  • Since early 1990 a number of developments have helped to render this previously  difficult procedure in to  an easy procedure and accessible to all.


  • Since ageing of skin is due to several different components, one treatment will not suitable for all changes.
  • A cocktail of treatments to be tailored for each patient.

Ageing skin treatment- new options

  • The first major development was chemical peels.
  • Lasers were introduced in early 90s.
  • Microdermabrasion  was also introduced.
  • Then came Botox and injections called fillers.
  • In 1998, came aptos thread to revolutionize the face lift procedure.
  • The latest is thermal lift.