The History of the Facelift procedure

It may surprise you to know that the Facelift procedure has been around for over 100 years and with pioneering techniques evolving over the years, the facelift has seen many medical advancements in the search for eternal youth.

We discuss the history of the Facelift and the surgeons who first pioneered it including Bella Vou’s Concept™ Facelift procedure pioneered by Head Surgeon Amir Nakhdjevani.

The historical pioneers of the Facelift Procedure

The desire to recapture a youthful appearance led to the first reported attempt of a Facelift procedure that took place in 1901 which was performed by Eugen Hollander in Berlin. A female Polish aristocrat requested that she would like for him to tighten the skin around her cheeks and corners of her mouth. After much deliberation he attempted the procedure to excise an elliptical piece of skin around the ears, but Hollander only excised skin at the front of the ear and closed the hole; he didn’t lift the area.

Erich Lexer

Erich Lexer

It wasn’t until 1916 that German surgeon Erich Lexer was considered the first surgeon to perform a Facelift procedure, that involved lifting the sagging skin on the face from the underlying fat and drawing it back, re-draping it and then removing the excess skin remaining. Lexer, an accomplished sculptor achieved a result that was more aesthetically pleasing and longer lasting than his predecessor. Lexer’s pioneering technique remained the technique used for nearly 60 years. It did however mostly result in a tight, wind tunnel look, but clients still felt this a preferable choice to having visible signs of ageing.

Lexer’s pioneering technique led to others following in his footsteps and among them was the first female plastic surgeon, Suzanne Blanche Gros Noël also known as Madame Noël, who operated on the crème de la crème of Parisian society performing her facelift technique, which was known as the “Petit Operation”. She was viewed as being extremely radical, both for being a female surgeon and an active feminist. Most hospitals did not admit plastic surgeons and in particular female ones during this time, so Suzanne set up a clinic at her home in 1916 only being allowed to perform limited minor procedures such as facelifts and eyelid corrections. Suzanne’s skill became well-known and she became a renowned individual in both the fashion world and amongst the European aristocracy.

The SMAS Facelift

As time progressed so did Facelift techniques. The 1970’s saw the conception of the SMAS (superficial muscular aponeurotic system) facelift. This new technique was viewed as the first innovative advancement for the facelift surgery in over 50 years. The SMAS layer is the layer below the skin and underlying fat and above the facial muscle and parotid gland. This is the area that is responsible for jowls forming and needs to be addressed to create longevity in the facelift. Doing a skin only facelift will only result in temporary skin tightening which will then return back to normal. The SMAS layer can either be lifted and sutured (stitched); lifted and cut (SMASectomy); or lifted and a SMAS flap created (SMAS flap).

The Deep Plane Facelift

In the early 90’s Dr Sam Hamra started to popularise the ‘deep plane lift’. The difference between the deep plane and SMAS lift is that the level of dissection is deep to the SMAS layer. This is a more useful technique in smokers, as the skin thickness and hence blood supply is better and therefore there is less of a risk of skin necrosis occurring where the skin does not heal adequately. Because it is the deeper plane, there is a greater risk of damage to the underlying facial nerve and the risk of this needs to be weighed in with the benefits of a deep plane lift. Whether surgeons carry out a SMAS lift; deep plane lift; subperiosteal lift – the terminology doesn t really make much difference to the patient. What is more important is understanding what the patient desires and using the correct procedure for that patient.

The Concept™ Facelift

Taking his place in history for advancing Facelift techniques, Bella Vou’s Head Surgeon Amir Nakhdjevani developed the revolutionary Concept™ Facelift. The revolutionary new procedure can be performed under a local anaesthetic, dramatically reducing risks involved in undergoing a general anaesthetic and subsequently reducing bruising and downtime recovery.

Non-surgical advancements in Facial anti-ageing techniques

Although the Facelift is still the most desirable surgical procedure for a longer lasting and more dramatic result, time has seen non-surgical alternative options developed for short term relief from lines, wrinkles and tightening.

Dermal Fillers

In the 1930s, scientists developed silicone, a synthetic polymer consisting of silicon, oxygen and carbon side chains. In an attempt to plump out areas of the face and body doctors attempted injecting the substance directly into the patient After failed attempts and subsequent issues resulting from injecting silicone directly into patients, such as migration and granulomas, this paved the way for safer alternatives to be sourced.

The 1970s saw a new era arise of animal collagens (bovine) being researched enough to be considered safe to use on a human being. At the beginning of this century non-animal collagen fillers were developed paving the way for hyaluronic acid fillers to be approved as the next generation of filler treatment and in 2006 the first one was approved by the FDA and these synthetic fillers are what you see used in the cosmetic industry today. Although these are a great alternative for treating the appearance of deeper facial lines, they do not provide much relief, if any from sagging skin and are semi permanent.

View more on our Dermal Fillers.

Thread Lifting

Thread lifts were designed to address sagging underlying tissues of the cheek and jaw line by threading barbed sutures into skin and deeper soft tissues. The non-absorbable threads stay within the deep tissues and provide support. Due to high rates of complications, some surgeons no longer perform the traditional thread lift, but more modern options are available. While a thread lift can be referred to as a minimally invasive surgical procedure, potential complications of thread lifts include puckering where the barb is pulling, visibility of the blue thread through the skin, and threads poking through the skin.

Skin Tightening Laser Treatments

The industry has seen an influx of machines and lasers claiming to achieve younger, firmer and tighter skin without going under the knife. Although, there is evidence of improvement in skin tightening, most treatments require multiple sessions and although they will overall cost less than a conventional surgical facelift the results will be subtler and will not have the long term results shown from having a surgical facelift.