We correct the laxity that occurs in the facial skin and subcutaneous tissues during the aging process with facelift surgeries. Facelift surgery - as the name suggests - is designed to tighten the loose and sagging facial skin. Our prospective patients often express their expectations from the surgery by placing the palms of both hands on their cheeks before the surgery and pulling them strongly to the side and upwards and saying "this is how I want my face to be".

If we have a facelift, shouldn't the skin on our face be taut?

It shouldn't.

What is Functional Flexibility of the Face?

Our face is not only good to look at, it has many functions. 

For example, when we eat, we need to open our mouth. Each time the mouth opens, the jawbone stretches the skin of the lower cheek like a canopy. In order for our mouth to open, the tissues around the mouth must have a certain amount of flexibility. Similarly, for our eyes to open and close easily and for our facial muscles to move, there must be a certain elasticity around the eyes. There must be a certain elasticity in the skin of the neck so that we can move our head easily. Examples can be multiplied, but you get the idea. We call the minimum flexibility required for the face to maintain its functions "functional flexibility of the face". 

There is a direct relationship between the functions of the face and the way it ages. For example, the more active your smile muscle is, the deeper your nasolabial fold will be. During laughter, the mid-face soft tissues are compressed like an accordion. This chronic squeezing phenomenon is called the concertina effect. Repetitive chronic compression is considered to be one of the main causes of midface volume loss. When volume is reduced in an area, the skin over that area becomes relatively loose and sagging. 

Similarly, in people with strong chewing muscles, volume loss in the temple due to the compression of the chewing muscle is observed earlier and more advanced. When the temple volume decreases, the skin in this area and on the outer part of the eyebrow becomes relatively loose and skin sagging occurs.  

Eyebrows fall faster in people with very active facial expressions around the eyes. 

People with a prominent chin and a large mouth opening are more prone to mid-face and cheek sagging at an early age. 

Examples can be multiplied.

The most important point you should know is that the functions of the face affect the aging process as well as the process after facial rejuvenation surgery.

No matter how much you stretch the face in facelift surgery, after a certain period of time, the face;  

With the stretching of the skin under tension, 
Thanks to repetitive movements, it will regain the functional flexibility it needs. 
In the early period, we say that the face will be more tense than the final state and this tension will regress to a functional level within 6-12 weeks. There will definitely be some relaxation in the first 3 months after facelift surgery. The functions of your face will determine how much the relaxation will be. 

During the early recovery period (6-12 weeks) after surgery, for this reason, we advise our patients to restrict mouth opening, not to make intense facial expressions as much as possible and not to sleep in positions that will deform their faces.  

At the end of the third month, your face may not be as tense or tense as you want/imagine. Because no facelift surgery is permanent enough to overcome the functional flexibility of the face in the long term. In summary, you should not expect a "taut" face in the medium-long term after facelift surgery. Your face will still be flexible after the surgery and some signs of aging related to this flexibility will naturally continue.

However, some factors may cause relaxation after facelift surgery to occur faster and more than desired. Let's take a look at the causes of "non-functional" premature relaxation. 

 

 

The role of mouth opening in facial relaxation

The most important factor that causes the skin to stretch earlier than desired after facelift surgery is exaggerated mouth opening. For the first 3 months after the surgery, no biting apples, eating wraps, or yawning like a lion. You need to limit the mouth opening. You can eat anything you want, but in small and soft bites. For example, you should prefer soft meatballs instead of hard meats. For this reason, we do not want dental treatments in the early period following the operation. It is preferred that you have completed the treatments related to your teeth before the facelift surgery. 

The role of sleep position in facial relaxation

Another factor contributing to the re-stretching of the skin after facelift surgery is the sleeping position. Repetitive forces applied to the face during sleep can loosen the sutures holding the deep tissues in place in the early postoperative period. We do not want the sutures to loosen before healing is complete. For this reason, we do not recommend patients to lie on the face a lot for the first 6-12 weeks after surgery. 

The role of facial expressions in facial relaxation

Another factor that can stretch the skin and subcutaneous tissues before the healing is completed after facelift surgery is the exaggerated use of facial expressions. Recurrences after forehead lift/brow lift surgery are common in patients with very intense facial expressions around the eyes. No matter how strong you determine, hyperactive eye contour muscles will pull down the eyebrows we lift with surgery in the long term. For this reason, in some forehead lift techniques, the muscles that pull the eyebrows down are deliberately weakened.  Similarly, strong and continuous contraction of the laughing muscles and the platysma muscle in the neck can pull the face down after facelift surgery. We do not want you to walk around with a sullen face after the surgery, but we recommend that you minimize the use of facial expressions and miss your friends who make you laugh with laughter.    

The role of loss of elasticity in facial relaxation

Anything that causes a decrease in skin quality after facelift surgery may result in the face loosening faster than expected. Intense sun damage, smoking, steroid use, age stress, genetic collagen tissue diseases are among the main causes. In some special diseases, facial sagging starts in the twenties. Surgeries cannot stop the biological processes, they only reduce the symptoms.

The role of volume loss in facial relaxation

Fat loss in the postoperative period creates a relative slack in the skin of the face and may result in premature loosening and sagging. Sudden weight loss makes the face sag. For this reason, it is absolutely necessary for patients to be at their ideal body weight before surgery and to maintain the ideal weight in the postoperative period for a permanent result.

What is the Difference Between Functional Flexibility, Laxity and Sagging?

Some patients complain that the laxity continues after the surgery by pulling their face with their hands and that this situation does not meet their expectations. All children's cheeks are flexible. Even in children, if you try to pull the cheeks and neck with your hand, you can see the presence of soft tissue elasticity. Functional elasticity of the face should not be confused with laxity and sagging.

Functional elasticity means that the tissue is as flexible and mobile as it should be in the face of a normal person. "Normal" here varies from individual to individual. For example, a woman with a very big smile will have more functional flexibility around the mouth. Laxity means that the tissue has movement beyond functional elasticity. Sagging means that the tissues are in a lower position than their normal anatomical position during rest. Functional flexibility is completely normal after facelift surgery. If not, there is a problem. Relaxation is expected over time and can sometimes develop faster than expected. Sagging indicates that the surgery has lost its effect.

If you are wondering whether the laxity in your face is at a level that requires surgery yet and if you want more detailed information about facial rejuvenation surgeries, you can contact us. 

Stay with Love

Nice Thick